Psychosocial intervention utilization and substance abuse treatment outcomes in a multisite sample of individuals who use opioids.
There are several relatively safe and effective FDA-approved medications for opioid use disorder (OUD). Despite the existence of these medications, the rate of returning to opioid use after treatment is relatively high, underscoring the need for continued enhancement of treatments. Adjunctive psychosocial interventions paired with medication have been shown to improve OUD treatment outcomes. However, studies have yet to conclusively examine the distinct effects of the most widely utilized psychosocial treatment modalities.
The current study investigated the relationship between individual counseling, group therapy, and 12-step participation and illicit opioid abstinence at the end of treatment, and at 1 and 3 months after treatment.
A secondary analysis was conducted with data from CTN-0051 (“Extended-Release Naltrexone vs. Buprenorphine for Opioid Treatment”), which used a sample of 570 individual diagnosed with OUD recruited from 8 substance use disorder treatment centers in the U.S. Participants were enrolled in a two-group randomized, controlled trial testing buprenorphine-naloxone versus extended-release naltrexone for OUD. A two-level hierarchical linear growth model was used to examine the effects of individual counseling, group therapy, and 12-step participation on illicit opioid abstinence (urinalyses) 1- and 3-months post-treatment.
Hours of individual counseling and 12-step participation significantly predicted abstinence at follow-up. There was a significant interaction between individual counseling and 12-step participation. Additionally, participant age and employment status were significant predictors of illicit opioid abstinence. Hours of group therapy was not found to significantly predict illicit opioid abstinence.
Conclusions: This is the only known study to examine the effects of the 3 most widely used psychosocial intervention modalities in a multisite and diverse sample of individuals receiving mediation for OUD. Findings suggest that greater levels of individual therapy and 12-step participation may be beneficial for individuals receiving medication treatment for opioid use disorder. The relatively low percentage of individuals who achieve long-term abstinence suggests there is room for improvement in OUD treatment outcomes, and findings can be used to guide the selection and use of adjunctive psychosocial interventions during medication treatment for OUD.
Related protocols: CTN-0051