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Study: No Added Benefit From Cognitive Behavioral Therapy for Opioid Dependence

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People who are dependent on opioids and are being treated with buprenorphine do not receive additional benefit from cognitive behavioral therapy, a new study finds. The study could change how opioid dependence is viewed and treated, according to MedicalXpress.

Buprenorphine is the most commonly prescribed drug of its kind to treat opioid dependence, the article notes. Cognitive behavioral therapy is used to treat many psychiatric conditions and substance use disorders. The researchers from Yale University studied 141 people with opioid dependence. They were divided into two groups. One group received buprenorphine treatment alone, and the second group received the drug treatment plus cognitive behavioral therapy.

Both treatments were similarly effective. Patients in both groups had a significant reduction in self-reported frequency of opioid use. Those receiving cognitive behavioral therapy did not have a greater reduction in use than those receiving buprenorphine treatment alone.

The findings appear in the American Journal of Medicine.

“This study demonstrates that some patients can do very well with buprenorphine and minimal physician support,” lead author Dr. David A. Fiellin noted in a news release. “This treatment represents an important tool to help reduce the adverse impact of addiction, HIV, and overdose due to heroin and prescription opioids.”

8 Responses to this article

  1. PWKaplan / January 18, 2013 at 12:15 pm

    Self-reported opiate abuse of 141 people in treatment and they are going to claim their data is significant and relevant? Self-report in any substance abuse study suggests that either the author doesn’t know what he’s doing or he had limitations placed on his choice of indicators that were so restrictive as to render the study unworkable. It would be irresponsible to draw any conclusions from this study other than that the things that these 141 subjects self-reported. It has no face validity and certainly no generalizability. The only thing that would have made it more perfect for Join Together would have been if the participants had said that they all started using heroin because marijuana had been decriminalized in their state.

  2. Ben House / January 8, 2013 at 1:35 am

    Richard points to good idea, read the article. The link gives a bit more but leaves lots of questions. Like others I want to defend CBT and wonder what was the focus? Bad CBT exists. Some populations ready for change do have only minimal benefit from CBT so who knows. Reminds us one size does not fit all.

  3. Avatar of Cindy Shaw-Wilson
    Cindy Shaw-Wilson / January 7, 2013 at 10:04 am

    Self-report alone does not seem to be an adequate measure of drug use, particularly if the patient sees no benefit in being honest.

  4. Avatar of Richard
    Richard / January 5, 2013 at 1:31 pm

    Very good questions. There’s a good deal to be read between the lines here. So, it’s best to review the article as it appears in the Am J of Med.

  5. Avatar of Liora
    Liora / January 4, 2013 at 2:17 pm

    Did they do other outcomes measures, or just self-report of use?

  6. profbam / January 4, 2013 at 1:19 pm

    Did the researchers use any urine tox screens? What was the rate of cocaine abuse? Methadone and buprenorphine treated addicts love to use cocaine.

    Just asking.

  7. Eric Wood / January 4, 2013 at 12:44 pm

    But what happens when the patient weans off buprenorphine? Medication does not make choices, does not create insight, does not change people, places and things.

  8. doogiem / January 4, 2013 at 12:09 pm

    Makes sense. Not every diabetic, COPD, heart disease, chronic pain or depressed/anxious patient needs (CBT) counseling/therapy. It’s good that it’s offered on the patient’s menu, though.

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