Individual Counseling and 12-Step Participation May Be Helpful for Those Undergoing Treatment with Medication for OUD
Despite the existence of safe and effective FDA-approved medications for opioid use disorder (OUD), only a small percentage of individuals with OUD receive treatment and the rate of returning to opioid use after treatment is relatively high.
Both the American Society of Addiction Medicine (ASAM) and the World Health Organization (WHO) recommend that medications for OUD be combined with psychosocial interventions to achieve optimal treatment outcomes. However, studies have yet to conclusively examine the distinct effects of the most widely used psychosocial treatment modalities.
This study, a secondary analysis of data from CTN-0059 (Extended-Release Naltrexone vs. Buprenorphine for Opioid Treatment), investigated the relationship between individual counseling, group therapy, and 12-step participation and illicit opioid abstinence for 570 participants at the end of treatment, and at 1 and 3 months post-treatment.
Results found that hours of individual counseling and 12-step participation significantly predicted abstinence at follow-up. There was also a significant interaction between individual counseling and 12-step participation. Participant age and employment status also significantly predicted abstinence from illicit opioids.
However, hours of group therapy, the most common form of psychosocial intervention provided in SUD treatment facilities, was not found to significantly predict illicit opioid abstinence.
Conclusions: Despite limitations of this study, including a short follow-up period and a reliance on self-report, this is the only known study to look at the effects of the 3 most widely used psychosocial intervention approaches in a multisite and diverse sample of individuals receiving medication for OUD. Findings suggest that individual therapy and 12-step group participation may be helpful for those undergoing medication treatment for OUD. These findings can be used to guide the selection and use of adjunctive psychosocial interventions during MOUD.
Citation: Harvey L, et al. Psychosocial intervention utilization and substance abuse treatment outcomes in a multisite sample of individuals who use opioids. Journal of Substance Abuse Treatment 2020 (in press).