Psychotherapy and counseling for methadone-maintained opiate addicts: results of research studies

Data have been presented about the potential role of psychotherapy for psychiatrically impaired methadone-maintained opiate addicts. Complete data from one study, and preliminary data from a second, indicate that professional psychotherapy can be helpful as a supplement to ongoing drug-counseling services for patients having clinically significant psychiatric symptoms. If psychotherapy is to be used, care must be taken to integrate it into the ongoing clinical services of the methadone-treatment program. Not all therapists are equally adept at engaging and working with addicts. In hiring therapists, attempts should be made to identify those who are not only technically competent but also interested and comfortable with this population. It should also be emphasized that there is considerable variability among methadone programs in such vital areas as leadership, staffing patterns, organization, dosing procedures, location, physical plant, and availability of ancillary services. These administrative differences may play a significant role in the feasibility and success of attempts to use psychotherapy in drug-treatment programs. Finally, it should be noted that there is no evidence that psychotherapy cures addiction or that it can be used successfully without integrating it into other important services, such as drug counseling, methadone treatment, and the overall program structure. There is reason to believe, however, that it can provide additional and clinically meaningful benefits to that subgroup of methadone patients who are psychiatrically impaired.