Therapy Adds No Value to Drug Treatment of Opioid Dependence

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NEW HAVEN — In a surprise finding, Yale researchers report that adding cognitive behavioral therapy to the most commonly used drug treatment for opioid dependence does not further reduce illicit drug use by patients. The study, which could change how such dependence is viewed and treated in the U. . health-care system, appears online in the American Journal of Medicine.

The medication, buprenorphine, has been in use for a decade, and is now the most-prescribed compound to treat opioid dependence. Cognitive behavioral therapy (CBT) is an intervention that has demonstrated effectiveness for many "/files//#valium_generic">valium generic conditions and substance-abuse disorders, even beyond the period of treatment, but the impact of combining it with buprenorphine has not been clear until now.

To assess the impact, researchers conducted a randomized clinical trial involving 141 opioid-dependent patients in a primary-care clinic. The patients were divided into two groups: those who received buprenorphine treatment alone under the care of a physician, and those who received the buprenorphine and cognitive behavioral therapy.

The two treatments showed similar effectiveness — a significant reduction in self-reported frequency of opioid use. But the group receiving cognitive behavioral therapy showed no more reduction in use than those receiving buprenorphine and physician care.

This finding contrasts with earlier studies that demonstrated improved outcomes with counseling services in patients receiving medication treatment. But the Yale team notes that the key to success in the non-CBT group was that they were still under a primary physician’s care while receiving buprenorphine — even if there was only a limited amount of counseling provided.
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