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Psychotherapy for opiate addicts. Does it help?

G E Woody, L Luborsky, A T McLellan

    Archives of General Psychiatry
    |June 1, 1983
    PubMed
    Summary
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    Adding psychotherapy to methadone maintenance treatment significantly improved outcomes for opiate addicts. Patients receiving counseling plus psychotherapy showed greater benefits than counseling alone.

    Area of Science:

    • Addiction Medicine
    • Clinical Psychology
    • Psychopharmacology

    Background:

    • Methadone maintenance is a standard treatment for opiate addiction.
    • Integrating psychotherapy into addiction treatment may enhance patient outcomes.
    • Patient engagement in psychotherapy can be a challenge.

    Purpose of the Study:

    • To evaluate the effectiveness of adding psychotherapy to methadone maintenance.
    • To compare supportive-expressive psychotherapy and cognitive-behavioral psychotherapy against counseling alone.
    • To assess patient interest and engagement in psychotherapy.

    Main Methods:

    • Random assignment of opiate addicts to three groups: counseling alone, counseling plus supportive-expressive psychotherapy, or counseling plus cognitive-behavioral psychotherapy.

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  • 110 subjects completed intake and maintained appointments.
  • Standardized psychological tests, observer ratings, and drug use records were collected at baseline and seven-month follow-up.

    • Main Results:

    • All treatment groups showed significant improvement.
    • Patients receiving additional psychotherapy demonstrated greater improvement across more areas.
    • Psychotherapy groups used less medication and showed reduced illicit drug use.

    Conclusions:

    • Psychotherapy, including supportive-expressive and cognitive-behavioral approaches, is beneficial when added to methadone maintenance for opiate addicts.
    • A significant portion of opiate addicts are interested in and benefit from psychotherapy.
    • Administrative strategies are crucial for maximizing the effectiveness of psychotherapy in this population.