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Review calls for further research on combination treatments for opioid addiction

Findings from a systematic review generally support the efficacy of psychosocial interventions in conjunction with medications to treat opioid addiction, though evidence is significantly lacking.

“There is, however, limited research addressing the efficacy of psychosocial interventions used in conjunction with medications to treat opioid addiction,” Karen Dugosh, PhD, of the Treatment Research Institute, Philadelphia, and colleagues wrote. “Although each type of therapy may differ in its structure and theoretical underpinnings, many utilize common therapeutic elements in an aim to (a) modify the underlying processes that serve to maintain addictive behavior, (b) encourage engagement with pharmacotherapy, or (c) treat psychiatric comorbidity that either complicates the addictive disorder or acts as a trigger for relapse. Therefore, selecting a combination of medication and psychosocial treatment that is appropriately targeted and designed to best suit a patient’s individual needs is vitally important.”

Researchers reviewed three prominent prior reviews and 27 recent publications of empirical studies on the use of psychosocial interventions in conjunction with medications to treat opioid addiction.

Contingency management and cognitive behavioral therapy were the most widely studied psychosocial interventions in conjunction with medications for opioid addiction. Most of these focused on methadone treatment.

Findings generally supported efficacy of providing psychosocial interventions in combination with medications to treat opioid addictions, though the incremental utility varied across studies, outcomes, medications and interventions.

“This literature review highlights significant gaps in the research base regarding use of psychosocial interventions in conjunction with medications for the treatment of opioid addiction. Although many studies have examined psychosocial treatment as an adjunct to methadone maintenance therapy, relatively fewer studies have examined it as an adjunction to buprenorphine or naltrexone treatment, which can be delivered in primary care settings,” the researchers wrote. “There are many important areas for future research that should be explored immediately, given the enormity of the opioid problem and evidence suggesting that psychosocial interventions can be an important part of comprehensive, recovery-oriented treatment.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.