Evidence-Based Practices in Addiction Treatment

This page offers a brief listing of some of the evidence-based practices most commonly used in the treatment of drug and alcohol addiction. This list does not represent a complete listing of all evidence-based practices or best practices in the field of addiction treatment. For more information about these and other evidence-based practices, please go to SAMHSA's National Registry of Evidence-Based Programs and Practices (NREPP) at: http://www.nrepp.samhsa.gov/


Evidence-Based Treatment Interventions


Studied Populations


Behavioral Couples Therapy for Alcoholism and Drug Abuse (BCT)

Methadone-maintained opioid-addicted men; drug-abusing women.

BCT is a family-based treatment program for promoting substance-use abstinence and improving relationships among married or cohabiting adults. It utilizes a sobriety/abstinence contract and behavioral principles to reinforce abstinence from drugs and alcohol.

Brief Intervention

It is most often used with adult and adolescent patients who are not alcohol dependent, and its goal may be moderate drinking1 rather than abstinence.  

Brief intervention is designed to be conducted by health professionals who do not specialize in addictions treatment. To identify the key ingredients of brief intervention, Miller and Sanchez (20) proposed six elements summarized by the acronym FRAMES: feedback, responsibility, advice, menu of strategies, empathy, and self-efficacy. Brief intervention is generally restricted to four or fewer sessions, each session lasting from a few minutes to 1 hour.  

Brief Strategic Family Therapy

Hispanic adolescent polydrug-abusers, with and without conduct problems, and their families, in Southern Florida  

Because of concerns with the sustainability of existing contingency management programs, this approach (based on one developed for alcohol abuse) takes advantage of the fact that people will work for the chance to win a tangible prize intermittently.  

Cognitive Behavioral Interventions

Cocaine-dependent adults

Adapted from Marlatt and Gordon's Relapse Prevention treatment for problem drinking, CBT strategies are based on the theory that learning processes play a role in the development of maladaptive behavioral patterns. Individuals learn to identify and correct problematic behaviors.

Community Reinforcement Approach

Mainly Caucasian intranasal and IV cocaine-dependent individuals (many of whom also use alcohol).  

CRA is an individual counseling approach originally developed for alcoholism that includes a Job Club, Marital Counseling, Social Skills/Relapse Prevention training and Disulfiram (Antabuse).

Contingency Management


Contingency Management involves systematically reinforcing a client with a tangible good or service in exchange for a target behavior, usually abstinence from an illicit drug confirmed by a drug-negative urine specimen.  

The Matrix Model

cocaine addicts and methamphetamine users

The Matrix Model of outpatient treatment was developed during the 1980s in response to an overwhelming demand for stimulant abuse treatment services. Treatment materials draw heavily upon published literature pertaining to the areas of relapse prevention (Marlatt and Gordon,1985), family and group therapies, drug education, self help participation and drug abuse monitoring.  

Motivational Interviewing/ Enhancement


Motivational Enhancement Therapy (MET) seeks to evoke from clients their own motivation for change and to consolidate a personal decision and plan for change. The approach is largely client centered, although planned and directed. MET is based on principles of cognitive and social psychology. The counselor seeks to develop a discrepancy in the client's perceptions between current behavior and significant personal goal; emphasis is placed on eliciting from clients self-motivational statements of desire for and commitment to change. The working assumption is that intrinsic motivation is a necessary and often sufficient factor in instigating change.  

Multidimensional Family Therapy

Multidimensional Family Therapy (MDFT) studies have been conducted among diverse samples of adolescents including, African-American, Hispanic/Latino, and White males and females between the ages of 11 and 18 in urban, suburban and rural settings with various socioeconomic backgrounds.

MDFT is used to treat polydrug-abusing adolescents by targeting the individual adolescent, the parent(s), the relationship between children and parents, and other systems (school, peers, juvenile justice, etc.).

Pharmacological Interventions: Naltrexone

Adult heroin users

Using naltrexone for opiate addicts usually is conducted in outpatient settings, although initiation of the medication often begins after medical detoxification in a residential setting. Naltrexone is a long-acting synthetic opiate antagonist with few side effects that is taken orally either daily or three times a week for a sustained period. Individuals must be medically detoxified and opiate-free for several days before naltrexone can be taken to prevent precipitating an opiate abstinence syndrome. When used this way, all the effects of self-administered opiates, including euphoria, are completely blocked.    

Pharmacological Interventions: Buprenorphine

Adult heroin users

Buprenorphine is related to morphine but is a partial agonist (possesses both agonist and antagonist properties). Partial agonists exhibit ceiling effects (i.e., increasing the dose only has effects to a certain level) and thus have greater safety profiles than full agonists, like heroin. Buprenorphine tablets (either buprenorphine alone or the combination with nalaxone) were shown in a large clinical trial to be superior to placebo treatment in reducing opiate use. The treatment of patients by physicians or group practice would allow office-based treatment to augment the current system, while placing an adequate level of control on the dispensing of these medications.  

Pharmacological Interventions: Methadone

Adult heroin users

Methadone is a long-acting synthetic opiate medication administered orally for a sustained period at a dosage sufficient to prevent opiate withdrawal, block the effects of illicit opiate use, and decrease opiate craving. Patients stabilized on methadone can engage more readily in counseling and other behavioral interventions essential to recovery and rehabilitation. The best, most effective methadone maintenance programs include individual and/or group counseling, as well as provision of, or referral to, other needed medical, psychological, and social services.    

Solution-Focused Brief Therapy

The approach was developed for low-income clients with serious alcohol or other drug problems. Many were African-American. The majority of clients were unemployed and may be homeless at the time treatment is initiated. The approach has also been used with clients who use a variety of drugs. Because the model stresses that the problem and solution are not necessarily related, the type of drug is not seen as a critical factor in determining differential treatment.  

The Solution-Focused Model is a brief therapy approach developed over the past 20 years at the Brief Family Therapy Center in Milwaukee, WI. Primarily, the model is designed to help clients engage their own unique resources and strengths in solving the problems that bring them into treatment. Goals are the entire focus of the solution-focused brief therapy approach. The model uses a specialized interviewing procedure to negotiate treatment goals whose qualities facilitate efficient and effective treatment.  

Supportive-Expressive Therapy

Supportive-Expressive therapy (SE) has been manualized for a variety of disorders including depression, generalized anxiety disorder, opiate drug dependence, and cocaine dependence. 

Supportive-Expressive therapy (SE) is a short-term psychodynamic treatment. Its goal is to help patients gain understanding of conflictual relationship patterns. The main techniques include supportive techniques to bolster the therapeutic alliance and interpretations to help patients gain self-understanding.  

Twelve-Step Faciliation

TSF has been utilized in controlled outcome studies with alcohol abusers and alcoholics and with persons who have concurrent alcohol-cocaine abuse and dependency. It has been used with clients of diverse socioeconomic, educational, and cultural backgrounds and a range of maladjustment

Twelve-Step Facilitation (TSF) consists of a brief, structured, and manual-driven approach to facilitating early recovery from alcohol abuse/alcoholism and other drug abuse/addiction. It is intended to be implemented on an individual basis in 12 to 15 sessions and is based in behavioral, spiritual, and cognitive principles that form the core of 12-step fellowships such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). It is suitable for problem drinkers and other drug users and for those who are alcohol or other drug dependent.