For patients with comorbid substance use disorder and anxiety, adding cognitive behavioral therapy for anxiety disorders (CALM ARC) to typical treatment for substance abuse disorders may help prevent the return of symptoms, according to a study published in Behavioral Research and Therapy.

The study included community-based participants from a randomized clinical trial at an outpatient, community, substance use disorder specialty clinic (n=75). Participants who met the criteria for an anxiety disorder or substance use disorder were randomly assigned to receive typical treatment for substance use disorder or typical treatment plus CALM ARC. The researchers assessed anxiety symptoms, drug use, and alcohol use at baseline, posttreatment, and at 6 months.

Participants who were older in age and women were found to be more likely to experience greater improvement in anxiety symptoms with the combination therapy compared with typical treatment alone. Participants who had an alcohol use disorder had greater improvement in alcohol use with the combination therapy compared with typical treatment alone, and participants with several substance abuse disorders had greater improvement in substance use when treatments were combined.

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“Should these preliminary findings replicate with larger and more diverse samples, they can inform treatment prescription recommendations for clinicians in addiction treatment settings and may provide incentive for resource-scarce addiction clinics to invest in training and implementation of [cognitive behavioral therapy] for anxiety disorders as part of their clinical services,” the researchers wrote.

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Wolitzky-Taylor K, Niles AN, Ries R, et al. Who needs more than standard care? Treatment moderators in a randomized clinical trial comparing addiction treatment alone to addiction treatment plus anxiety disorder treatment for comorbid anxiety and substance use disorders. Behav Res Ther. 2018 May 17;107:1-9.