Cognitive Behavioral Therapy for Opioid Use Disorder

Cognitive Behavioral Therapy for Opioid Use Disorder has been studied in combination with naltrexone, buprenorphine, and methadone, and in combination with other behavioral treatments such as Motivational Interviewing and Contingency Management.

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

Cognitive Behavioral Therapy for Opioid Use Disorder (CBT-OUD) has been studied in combination with both medication and behavioral treatments. When combined with medication, the results have been mixed, with some studies suggesting that it does not have significant additive effects and other studies suggesting that it has beneficial long-term effects comparable to the effects of Contingency Management. CBT has also been studied in combination with Motivational Interviewing and Contingency Management. In general, combining CBT with other behavioral treatments appears to be at least as effective as CBT alone.