Opioid Dependence | Cocaine Dependence | Alcohol Dependence | Marijuana Use Disorders
Counseling or psychotherapy in the absence of opioid agonist
or antagonist treatment has been shown to be ineffective due to
very high dropout and continuing drug use (Mayet et al. 2005).
Methadone maintenance markedly reduces both of these problems, allowing
psychotherapy and drug counseling to be studied. The same probably
holds true for buprenorphine. In a study conducted at a VA medical
center, drug counseling alone was compared with drug counseling
plus supportive-expressive psychotherapy or CBT. Patients who received
the additional psychotherapy improved more than those who received
counseling alone, but these benefits were mainly due to improvements
among psychotherapy patients who had high levels of psychiatric
symptoms; patients with low symptom levels improved as much with
counseling alone as with the extra psychotherapy (Woody et al. 1983, 1985). These findings were later confirmed
in a study conducted in three community-based programs in Philadelphia
(Woody et al. 1995).