Cognitive Behavioral Therapy for Opioid Use Disorder

Cognitive Behavioral Therapy can be delivered by psychologists, social workers, mental health or addiction counselors, advanced practice mental health nurses, or other healthcare providers under the supervision of a licensed clinician.

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

During the national implementation rollout across the Veterans Healthcare System, Cognitive Behavioral Therapy (CBT) targeting opioid use and other drugs was delivered by master's-level and some doctoral-level therapists, psychiatrists, and advanced practice mental health nurses.

In the research literature, CBT for Opioid Use Disorder (CBT-OUD) is often delivered by master or doctoral-level therapists or counselors. There is far less data available on the effects of CBT-OUD when delivered by real-world clinicians.