Journal Article

Efficacy of Cognitive Behavioral Therapy on Opiate Use and Retention in Methadone Maintenance Treatment in China: A Randomised Trial

Chen, Hanhui, Li, Zhibin, Pan, Shujun, Ling, Walter, Jiang, Haifeng, Zhao, Min, Du, Jiang

2015

Overview

Methadone maintenance treatment (MMT) is widely available in China; but, high rates of illicit opiate use and dropout are problematic. The aim of this study was to test whether cognitive behavioral therapy (CBT) in conjunction with MMT can improve treatment retention and reduce opiate use. A total of 240 opiate-dependent patients in community-based MMT clinics were randomly assigned to either weekly CBT plus standard MMT (CBT group, n=120) or standard MMT (control group, n=120) for 26 weeks. The primary outcomes were treatment retention and opiate-negative urine test results at 12 weeks and 26 weeks. The secondary outcomes were composite scores on the Addiction Severity Index (ASI) and total scores on the Perceived Stress Scale (PSS) at 12 weeks and 26 weeks. Compared to the control group in standard MMT, the CBT group had higher proportion of opiate-negative urine tests at both 12 weeks (59% vs. 69%, p<0.05) and 26 weeks (63% vs. 73%, p<0.05); however, the retention rates at 12 weeks (73.3% vs. 74.2%, p=0.88) and 26 weeks were not different (55.8% vs. 64.2%, p=0.19) between the two groups. At both 12 and 26 weeks, all of the ASI component scores and PSS total scores in the CBT group and control group decreased from baseline; but the CBT group exhibited more decreases in ASI employment scores at week 26 and more decrease in the PSS total score at week 12 and week 26. CBT counselling is effective in reducing opiate use and improving employment function and in decreasing stress level for opiate-dependent patients in MMT in China. ClinicalTrials.gov NCT01144390.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Addiction / Addictions / Addictive behaviors / Adult / Alcohol / Behavior modification / China / Clinical outcomes / Cocaine / Cognitive ability / Cognitive Behavioral Therapy / Drug abuse / Drug dosages / Drug use / Employment / Female / Heroin Dependence - drug therapy / Heroin Dependence - physiopathology / Humans / Male / Medicine / Mental disorders / Mental health / Methadone / Methadone - administration & dosage / Middle Aged / MMT / Narcotics / Opioid-Related Disorders - drug therapy / Opioid-Related Disorders - physiopathology / Patient Dropouts / Patients / Psychiatry / Retention / Social psychology / Studies / Substance abuse treatment / Systematic review / Therapy / Treatment Outcome / Urine