An Exploratory Study of Trauma Histories, Symptoms, and Vicarious Trauma Among Opioid Treatment Program Staff: Implications for Provider Functioning

Opioid treatment programs (OTPs) are an important part of the U.S. strategy to address the opioid epidemic and reduce overdose deaths. OTP providers face a heightened risk for secondary trauma exposure and vicarious trauma (VT) reactions. This study is the first to characterize trauma, VT, and substance use histories among OTP staff and assess how these factors impact provider well-being. Staff across three OTP clinics (N = 40, 37.5% Hispanic/Latina) completed validated assessments of lifetime trauma, VT, posttraumatic stress, depression, anxiety, burnout, compassion satisfaction, and perception of workplace safety. Staff reported high rates of traumatic stress (62.5% with clinical symptoms) and VT (72.5% with moderate to high symptoms). Lifetime trauma exposure was associated with increased compassion satisfaction (β =.31, p =.04) and perceived workplace safety (β =.37, p =.04), while VT symptoms predicted higher burnout (β =.52, p,.01) and lower compassion satisfaction (β = −.39, p =.04). Staff with lived substance use disorder experience showed greater vulnerability to VT, including higher depression (β =.55, p =.02) and lower perception of workplace safety (β = −.51, p =.01). Results highlight the complexity of provider lived trauma and substance use disorder as both resilience and risk factors. To enhance provider well-being and quality of patient care, OTPs should implement strategies to reduce VT exposure and provide opportunities for staff to address trauma symptoms and participate in reflective trauma-informed supervision.