Celeste Patton, CCNY, %Dr. Ann Boyer, Mount Sinai Medical Center, 1 Gustave Levy Place, Box 1045, New York, NY 10029, 212-923-9352, ann.boyer@mssm.edu

Issues: There is a silent majority of Women in substance treatment programs who use drugs to self-medicate: the 50 to 90% who are untreated victims of childhood sexual abuse (UCSA). They suffer symptoms of Post Traumatic Stress Disorder (PTSD) including intrusive thoughts, somatic effects (panic/anxiety attacks…), avoidance behavior, poor functionality. They have overwhelming trust and safety issues, self-blame, self-hatred and, consequently, extremely high relapse rates.

Description: Women entering 3 treatment programs were screened for a history of CSA. Those who were positive were educated to the fact that they had a true mental health disorder, and were invited to attend groups on site (called ‘Women-to-Women’) and/or 'Bird Song,' held at a central location, for weekly meetings. Both groups build coping mechanisms to deal with life without drugs and are geared to those with PTSD. Those who became ‘ready’ were referred to individual trauma therapy.

Lessons Learned: Of the Women screened, 70% had a history of UCSA. Virtually none had disclosed her abuse or was believed if she did disclose. All were surprised and validated when they learned they had a ‘legitimate,’ treatable mental disorder. Within the past year, over 50 Women have regularly attended 1 or both groups. Of those, none is known to have relapsed.

Recommendations: All personnel working in drug treatment centers should be sensitively trained about CSA. New program entrants should be screened. Support groups tailored to their needs should be created as well as individual counseling with someone experienced in treating this devastating form of PTSD.

Learning Objectives: 1)Skills

Attendees will have a greater understanding of the difference between substance users who are self-medicating at an early age as a result of severe prior trauma, and those who use drugs for other reasons.
• Attendees will realize that it is of extreme importance to ascertain the 'hidden agenda' behind a person's substance use in order to help that person to confront life without substances. 3)Learning objective
  To bring into public recognition the fact that a number of substance users are not just trying to 'get high,' but are, in fact, saving their lives by numbing their unbearable pain by the only means available to them other than self-annihalation. To clearly understand that treatment of this population requires a different approach than simply abstinance from drugs -- pain relief, pharmacologic and psychotherapeutic are also necessary.

  Keywords: Adult and Child Mental Health, Chemical Dependence

  Presenting author's disclosure statement:
  I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

  Co-morbidity and Treatment Effectiveness Poster Session

  The 132nd Annual Meeting (November 6-10, 2004) of APHA