Outcomes of adding cognitive behavioral therapy to medication-assisted treatment for opioid use disorder.

Abstract

With increasing rates of opioid overdose deaths throughout the United States, there is an urgent need to implement interventions to mitigate this trend. Psychosocial interventions are reported to improve retention rates in rehabilitation centers with medication-assisted treatment (MAT) programs for opioid use. In 2020, 14% (187 of 1,309) of opioid overdose deaths in Georgia were in Dougherty County where an intensive outpatient MAT program had historically used twice weekly group therapy plus individual cognitive behavioral therapy (CBT) with an inconsistent duration and frequency. Using existing clinical data, a quality-improvement project was designed and implemented to determine whether 60 min of CBT every other week, in addition to weekly group therapy, and prescription medication would result in higher opioid use disorder treatment retention rates. A 6-month data analysis of monthly MAT reports compared program retention rates from the 3 months before to 3 months after the policy change. The retention rate significantly increased from 8% to 56% (χ 2 = 8.93, p = .01) following the policy change, adding consistent (98%) individual CBT every other week. Implementing a policy with a consistent 60 min of individual CBT every other week in addition to the group counseling twice a week and the prescribed medication was associated with an increased retention rate among patients engaged in MAT for opioid use.