The author will review the published data on complex posttraumatic stress disorder (Complex PTSD) in patients with substance abuse. Especially after interpersonal traumatization in childhood PTSD symptoms may be complicated by personality changes suchs as disturbed affect regulation, memory, self-image and relational problems. This syndrome has been labelled "PTSD with associated features" in DSM-IV-TR and is known by clinicians as "complex PTSD" or "Disorders of Extreme Stress NOS". The recognition of the range of interrelated problems associated with a history of early severe interpersonal trauma is an important development with much relevance for the field of substance abuse. Despite the evidence that a majority of women who are seeking treatment for addictions have been exposed to early and multiple traumatic experiences, standard treatment programs do not typically assess or target these associated impairments, which greatly complicates the prognosis. In practice, integrating interventions that specifically target the associated features are often recommended for these patients. Suggestions will be given for furture research.