Cognitive Behavioral Therapy for Opioid Use Disorder

Based on the existing literature, the main logistical consideration associated with the implementation of Cognitive Behavioral Therapy for Opioid Use Disorder is the time and effort required to train staff and build their capacity to deliver it.

Evidence for the intervention

There is moderate quality and heterogeneous evidence for Cognitive Behavioral Therapy for Substance Use Disorder (CBT-SUD). Effect sizes tend to be higher for individuals receiving CBT-SUD for cannabis than for opioids or stimulants, and there have been mixed results when examining the effects of CBT-SUD as an adjunct to medication for opioid use disorder (OUD). A systematic review and meta-analysis published in 2020 concluded “the evidence cautiously suggests that for OUD, there may be some benefit to adding non-individual CBT to buprenorphine therapy.” We therefore give this a rating of yellow.

Evidence-based Scale

Competency-based training is necessary for staff members to deliver Cognitive Behavioral Therapy for Opioid Use Disorder (CBT-OUD) to patients, which requires substantial time considerations. Additional supervision or coaching from therapists experienced in CBT was found to be beneficial for provider fidelity in a study implementing CBT for substance use (including opioids and other drugs) in the Veterans Health Administration.