Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Recorded presentation

Sandro Galea, MD, DrPH¹, Danielle C. Ompad, PhD², Grant Marshall, PhD³, Terry Schell, PhD³, Christina Chan, MPH², Vijay Nandi, MPH², and David Vlahov, PhD². (1) Department of Epidemiology, University of Michigan School of Public Health, 1214 South University, Room 243, Ann Arbor, MI 48104, 734 647 9741, sgalea@nyam.org, (2) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, (3) RAND, Corp., 1776 Main Street, Santa Monica, CA 90401

Increasingly, evidence suggests that complex trauma exposure may play a role in determining both drug use behavior and PTSD. A community-based sample of non-drug users, former drug users, non-injection drug users and injection drug users aged >=18 years were recruited. Interviewer-administered questionnaires assessed trauma exposure, PTSD symptoms, and drug use. We constructed a complex trauma score representing cumulative lifetime experience of qualifying criterion A traumatic events. Among 405 recruited, 50.6% were Hispanic, 39.0% Black and 10.3% other race. The sample was mostly male (70.6%); median age was 37. Overall, 88.9% had experienced >=1 traumatic event, 3.2% reported lifetime and 1.7% past-6 month PTSD. Violent assault was the most frequently reported trauma (67.7%), followed by a relative's death (52.6%), sexual assault (48.4%), injury/disease (42.7%), child abuse (39.0%), witnessing injury/death (35.1%), motor vehicle accident (21.5%), disaster (17.5%), and war/conflict (4.7%). Average trauma score was 3.4 (SD=2.4). In adjusted models, the trauma score was not associated with illicit drug use overall; however, in separate models, there was a significant 12-13% increased risk for opiate, hallucinogen, and barbiturate use for every unit increase in trauma score after adjustment for key covariates including lifetime PTSD. These preliminary data suggest that while complex trauma exposure is not associated with overall increased risk of illicit drug use, it is associated with increase risk of specific drugs, all of which have depressant properties. Although partly consistent with a self-medication hypothesis, the persistent association between complex trauma and illicit depressants even adjustment for PTSD suggests multiple mechanisms are operating.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe the prevalence of trauma and PTSD symptomlogy among a community-based sample
• Discuss specific types of trauma experienced in New York City neighborhoods
• Describe the impact of cumulative trauma exposure on illicit drug use

Keywords: Mental Health, Substance Abuse

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation