Polydrug use and recreational motives are associated with lower posttraumatic symptoms in survivors of a mass trauma event
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Objective
Drug use after trauma is common, but polydrug use patterns, motives, and associations with subsequent symptoms are poorly understood. We examined these associations among mass-casualty terror attack survivors, 72% of whom used drugs immediately before trauma exposure.
Methods
Survivors of the October 7, 2023 Nova Festival attack reported use of six drug types (alcohol, cannabis, ketamine, stimulants, MDMA, psychedelics) and motives (avoidance, emotional regulation, self-medication, sleep, recreation) longitudinally at three timepoints (TP): 1-6 months (N=772), 8-12 months (N=453), and 17-24 months (N=302) post-attack. Separate latent class analyses of TP2 data characterized drug use, motives, and their combination. Linear regression and mixed-effects models examined associations between class membership and PTSD Checklist for DSM-5 (PCL-5) scores, adjusting for age, sex, time since trauma, and TP1 PCL-5 scores.
Results
At TP2, 70% reported polydrug use, 17% used one drug, and 13% reported no use. The high drug-load class (mean 4.6 drug types) had lower PCL-5 scores than the low drug-load class (mean 1.5 drug types); this difference was evident among participants using ≥4 drug types and persisted through TP3. The self-medication-motive class had higher PCL-5 scores than the recreational-motive class. In joint analyses, recreational-motive users at both low and high drug loads had lower PCL-5 scores than participants reporting self-medication motives and primarily cannabis use.
Conclusions
Polydrug use was common among the mass-trauma survivors in our study. Self-medication motives were associated with higher PTSD symptom severity than recreational motives. Unexpectedly, higher polydrug use was associated with lower PTSD symptom scores.
