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Psychotherapy for opiate addicts.

G E Woody, L Luborsky, A T McLellan

    NIDA Research Monograph
    |April 1, 1983
    PubMed
    Summary
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    Opiate addicts in methadone programs showed significant improvement with added psychotherapy. Patients receiving supportive-expressive or cognitive-behavioral therapy alongside counseling benefited more than those with counseling alone.

    Area of Science:

    • Addiction Medicine
    • Psychotherapy Research
    • Mental Health Treatment

    Background:

    • Opiate addiction is a complex condition requiring multifaceted treatment approaches.
    • Methadone maintenance is a common treatment, but additional therapies may enhance outcomes.
    • Patient engagement in adjunctive psychotherapy can be a challenge.

    Purpose of the Study:

    • To evaluate the effectiveness of adding psychotherapy to standard counseling for opiate-addicted patients in methadone maintenance.
    • To compare supportive-expressive psychotherapy (SE) and cognitive-behavioral psychotherapy (CB) against drug counseling (DC) alone.
    • To identify patient characteristics that predict benefit from adjunctive psychotherapy.

    Main Methods:

    • 110 opiate-addicted patients on methadone maintenance were randomized to DC, DC+SE, or DC+CB for six months.

    Related Experiment Videos

  • Patients were assessed using various outcome measures.
  • Subgroup analyses were conducted based on psychiatric symptoms and personality disorders.

    • Main Results:

    • All treatment groups showed improvement, but patients receiving psychotherapy (SE or CB) improved in more areas and to a greater extent than those receiving DC alone.
    • Patients with depression and those with high psychiatric symptom levels benefited significantly from additional psychotherapy.
    • Patients with antisocial personality disorder did not show significant benefits from psychotherapy.

    Conclusions:

    • A significant portion of opiate-addicted patients are interested in and can benefit from adjunctive psychotherapy within methadone maintenance programs.
    • The type of psychotherapy may influence specific areas of improvement.
    • Tailoring administrative procedures can optimize the effectiveness of psychotherapy for this population.