Integrated treatment programs for individuals with concurrent substance use disorders and trauma experiences: a systematic review and meta-analysis.

The purpose of this study was to examine the evidence of psychotherapeutic integrated treatment (IT) programs for individuals with concurrent substance use disorders and trauma histories. Electronic searches of Cochrane Central Register of Controlled Trials, MEDLINE, Web of knowledge, PubMed, PsycINFO, CINAHL, PILOTS, and EMBASE identified 17 IT trials (9 controlled trials). Both narrative review and meta-analysis indicate that IT effectively reduces trauma symptoms and substance abuse from pretreatment to longest follow-up. However, IT and nonintegrated programs appear to produce similar declines in symptoms. Methodological issues limiting the current body of work and recommendations for future research are discussed. Well-designed randomized controlled trials are clearly needed, particularly large sample studies evaluating understudied IT programs and exposure-based approaches.