Although Veterans with posttraumatic stress disorder (PTSD) are vulnerable to opioid misuse, there is limited research evaluating the psychosocial and medical sequalae experienced by Veterans with comorbid PTSD and opioid use disorder (OUD). Using data from a nationwide, longitudinal registry of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) Veterans oversampled for PTSD with a 1:1 ratio of men to women, we identified Veterans with lifetime diagnoses of comorbid PTSD and OUD (n = 40), PTSD and non-opioid substance use disorder (SUD; n = 386), PTSD only (n = 901), and non-opioid SUD only (n = 52) using medical record data. We then compared these groups on Veterans Affairs emergency, urgent care, and inpatient healthcare utilization, suicide risk, functional impairment, and the presence of comorbid mental conditions in the following 1–2 years. Relative to all other groups, Veterans with comorbid OUD and PTSD had increased likelihood of emergency room and inpatient care, probable somatoform and major depressive disorders, and greater functional impairment. Both the PTSD/OUD group and PTSD/non-opioid SUD group demonstrated increased suicidality, urgent care utilization, and probable generalized anxiety disorder relative to Veterans with PTSD only or non-opioid SUD only. Results suggest that comorbid OUD and PTSD are associated with greater likelihood of negative psychiatric and healthcare related outcomes, even relative to PTSD comorbid with other types of SUDs. Findings support the importance of concentrated and sustained efforts to improve prevention and intervention strategies for Veterans struggling with PTSD symptoms and opioid misuse.

尽管患有创伤后应激障碍（PTSD）的退伍军人容易受到阿片类药物滥用的影响，但是对于评估患有合并性PTSD和阿片类药物使用失调（OUD）的退伍军人所经历的心理社会和医学痛感的研究还很有限。利用全国范围内的持久自由行动/伊拉克自由行动/新黎明行动（OEF / OIF / OND）的纵向注册数据，对PTSD进行了超采样的男女比例为1：1的退伍军人，我们确定了终身诊断为共病的退伍军人PTSD和OUD（n = 40），PTSD和非阿片类物质使用障碍（SUD; n = 386），仅PTSD（n = 901）和仅非阿片类SUD（n = 52）使用病历数据。然后，我们比较了这些人的退伍军人事务紧急情况，紧急护理和住院医疗利用率，自杀风险，功能障碍，并且在接下来的1-2年内出现合并症。相对于所有其他组，患有OUD和PTSD合并症的退伍军人的急诊室和住院治疗，可能的躯体形式和重度抑郁症以及更大的功能障碍的可能性增加。相对于仅使用PTSD或仅使用非阿片类SUD的退伍军人，PTSD / OUD组和PTSD /非阿片类SUD组均显示出增加的自杀性，紧急护理利用和可能的广泛性焦虑症。结果表明，与PTSD合并其他类型的SUD合并症相比，OUD和PTSD合并症与精神病学和医疗保健相关负面结果的可能性更大。