Wild, C.
Psychosocial interventions in the treatment of opioid use disorder: A Scoping Review
Cameron T. Wild, Fadi Hammal, Myles Hancock, Nathan Bartlett, Kerri Kaiser Gladwin, Denise Adams, Alexandra Loverock, David C. Hodgins
Review of evidence problematizes whether opioid agonist treatment (OAT) alone is sufficient to support positive patient outcomes or whether greater efforts should be made to provide high-quality psychosocial interventions alongside pharmacotherapies. The aim of this scoping review was to look at the evidence available to inform the question of the role of psychosocial interventions in opioid use disorder (OUD).
A total of 25,637 unique records were identified. Screening process identified 3,820 full-text articles that were reviewed in a second screening phase, of which 366 articles describing results of 367 studies were included in the review. Five members of our research team extracted data using a predeveloped coding manual. A subset of 106 included articles was double-extracted to assess inter-coder reliability.
Of the 367 articles, 26 used qualitative methods, 40 were reviews, and 301 were quantitative studies. Of the latter 213 compared outcomes of a psychosocial intervention for OUD to alternative treatment condition(s). Of comparative studies 201 were randomized controlled trials while 12 used quasi-experimental designs. A minority (n = 27) of comparative studies did not examine pharmacotherapy at all, while 8 directly compared psychosocial intervention vs. pharmacotherapy, and 9 investigated whether adding pharmacotherapy to psychosocial interventions provided additional benefit to patients. Out of 40 reviews, 1/7 Cochrane reviews, 3/11 meta-analyses, 5/11 systematic reviews, and 4/11 other reviews looked at role of psychosocial interventions independent of pharmacotherapy. The majority of empirical studies were conducted among general population (>80%), within the context of community based care (>75%), and reported on outcomes related mainly to drug use (>85%) and treatment retention (>82%) of the studies.
Our findings indicate that most evidence were within the context of pharmacotherapy. Generation of evidence on the role of independent psychosocial interventions is needed.