By Barbara Goodheart, ELS
Opioid overdose rates have risen to epidemic levels, underscoring the need for comprehensive treatment of opioid misuse. Effective medications are available, but there’s “a dearth of empirical research on the optimal psychosocial interventions to use with the medications.” That’s according to the findings from a literature review recently published in the Journal of Addiction Medicine.
The review, available for free download, is summarized below:
—27 articles and 3 reviews
—Years covered: 2008 through 2014
—The most widely studied methods of treatment were contingency management and cognitive behavioral therapy
—Most studies focused on methadone treatment
—Methadone: studies generally supported use of psychosocial intervention; e.g., 9 of 14 studies: significant effects on treatment attendance and drug use
—Buprenorphine: in general, support for the efficacy of psychosocial intervention was “less robust for buprenorphine,” e.g., 3 of 8 studies showed significant effects on treatment attendance and drug use
√ Key Point
The authors emphasized the extent of the opioid overdose epidemic and reiterated the need for psychosocial intervention: “A clear understanding of the safest and most effective combination of [medications and psychosocial intervention] is imperative to successfully treat opioid addiction”
(See the published study for details.)
Role of the Counselor
Counselors use psychosocial intervention to help patients control urges to use drugs, and to cope with the emotional strife that often accompanies addiction.
Counselors deliver psychosocial intervention in a variety of formats, methods, settings, and treatments. The authors of the study point out that although the various types of therapy may differ in structure and theoretical underpinnings, many use the same therapeutic elements.
In doing so, they direct their efforts at:
- Helping patients change underlying processes that enable them to continue their addictive behavior
- Encouraging patients to use drug therapy
- Treating any coexisting psychiatric conditions that complicate the addictive disorder, or that trigger relapses
The authors emphasize that this is why “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.
The problem is: data to use as a basis for drawing up a three-pronged plan—intervention method, treatment method, and type of medication—are not yet available.
In summarizing their data, the authors commented that the effectiveness of psychosocial intervention “varied for different outcomes, across studies, and within psychosocial intervention types.”
Perhaps their most striking finding was the lack of information about “the use of specific medications in combination with specific types of psychosocial interventions during all phases of treatment, and among different subpopulations”—a situation the authors considered particularly important, given the likely upcoming increase in patient demand for treatment.
The authors called for research directed at identifying the psychosocial interventions that are most effective when combined with specific medications, patient populations, and treatment settings. Noting once again the extent of today’s overdose-death statistics, the authors emphasized that “the urgency for an expanded research agenda on best practices for comprehensive treatment could not be more critical.”
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Dugosh K, Abraham A, Seymour B, McLoyd K, Chalk M, Festinger D. A systematic review on the use of psychosocial interventions in conjunction with medications for the treatment of opioid addiction. J Addict Med. 2016;Mar-Apr;10(2):91-101. doi: 10.1097/ADM.0000000000000193.