Pubdate: Fri, 05 Jan 2007 Source: Montreal Gazette (CN QU) Copyright: 2007 The Gazette, a division of Southam Inc. Contact: http://www.canada.com/montreal/montrealgazette/ Details: http://www.mapinc.org/media/274 Author: Debbie Parkes, The Gazette TRAUMA, DRUGS FORM VICIOUS CIRCLE A growing body of research that indicates many alcoholics and drug addicts also suffer from the after-effects of trauma is leading some Quebec treatment centres to alter their approach. One goal of the change is to prevent clients from dropping out. If trauma syndromes go undetected, "an awful lot of these people will not last more than a few weeks in treatment," said David Ross, co-ordinator of professional services at the Foster Pavilion, an English-language addiction-treatment agency that treats about 1,200 Quebecers annually. Researchers in the United States have found that between 21 and 44 per cent of clients in substance-abuse treatment programs are suffering from concurrent post-traumatic stress disorder (PTSD), Ross said. (The figures vary according to type of treatment program.) For some, PTSD is caused by an adulthood trauma; in other cases, it is the result of childhood abuse. Standard interventions for alcoholics and drug addicts can severely increase anxiety symptoms for people suffering from post-traumatic stress, because most use an emotion-focused group approach in which clients are encouraged to talk about their life experiences, Ross said. For PTSD sufferers, talking about the trauma can bring on their symptoms, creating a vicious circle, he explained. "When you elicit PTSD symptoms, it evokes a craving for anxiety-reducing drugs," Ross said. One step to increasing the chances of treatment success is to ensure counsellors know which clients are suffering from PTSD so they can tread carefully on sensitive themes, Ross said. Another step is to urge clients to ask their physician to prescribe anti-anxiety drugs. Another issue that often comes up with trauma survivors is trust, said Louise Nadeau, a psychologist and addiction specialist at the Universite de Montreal. "If you've been betrayed by a significant adult, it's really hard to trust humanity," Nadeau said. Distrust can impede development of a positive working relationship with a therapist, said Nadeau, a member of a research team at the Centre Dollard Cormier, a Montreal treatment centre. Nadeau's team has applied for a federal research grant to assess Dollard Cormier's clients for concurrent PTSD. Ross said his centre began three years ago to train staff to better address PTSD. Now, Foster Pavilion clients are assessed for PTSD and other concurrent mental disorders with the help of a special questionnaire. Ross and a colleague are looking for funding to have the questionnaire translated into French so other treatment centres in Quebec can use it. The questionnaire also has been useful for identifying clients with depression, Ross said. Foster Pavilion workers have been adapting their methods of working with those clients, too. - --- MAP posted-by: Derek