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Who Benefits Most From Drug Counseling?

Treatment programs for opioid addiction sometimes include group or individual counseling sessions in addition to medication and other forms of care. According to the results of a large-scale, federally sponsored project called the Prescription Opioid Addiction Treatment Study (POATS), this counseling does not seem to do much good. In a study published in April 2014 in the journal Drug and Alcohol Dependence, a team of U.S. researchers reexamined POATS in order to clarify these findings. The researchers concluded that drug counseling does work for some opioid-addicted patients/clients when these individuals actively stick to their overall program regimen.
Who Benefits Most From Drug Counseling?

Drug Counseling

Drug counseling, also known as addiction counseling, is geared to help people recovering from substance problems reduce or cease their drug or alcohol intake and regain their health and well-being. Steps toward this objective include evaluating client/patient substance issues, helping clients/patients chart out appropriate goals for treatment, helping clients/patients uncover and understand the factors that contribute to dysfunctional substance use, helping clients/patients develop the ability to change their dysfunctional behaviors in the future and directing clients/patients toward additional resources that improve the odds of maintaining the gains of treatment over extended periods of time. While some people receive drug or addiction counseling in group settings, others receive it in individualized, one-on-one sessions with a counselor or therapist. As a rule, individualized sessions provide greater opportunities for fine-tuning and customization of the counseling process.

Prescription Opioid Addiction Treatment Study

The Prescription Opioid Addiction Treatment Study was conducted in the first decade of the 2000s by the National Institute on Drug Abuse Clinical Trials Network. It was designed to assess the relative effectiveness of several courses of treatment for prescription opioid (PDF) addiction. The courses under consideration included short-term treatment with the opioid medication buprenorphine, long-term treatment with buprenorphine, the combination of short-term buprenorphine treatment and drug counseling, and the combination of long-term buprenorphine treatment and drug counseling. All of the treatment courses also involved standard medical care designed to meet the needs of people detoxifying from the use of opioid medications. One of the main findings of POATS was the identification of long-term buprenorphine use as a superior method of treatment in comparison to short-term buprenorphine use. The authors of the study also concluded that the addition of drug counseling does not significantly improve the odds that a person will recover from opioid addiction.

Importance of Treatment Adherence

In the study published in Drug and Alcohol Dependence, researchers from Harvard Medical School, Harvard-affiliated McLean Hospital, the Yale University School of Medicine and the University of Texas Health Sciences Center at San Antonio reanalyzed the original findings of the Prescription Opioid Addiction Treatment Study. The main motivation for this reanalysis was a belief that some groups of clients/patients may benefit from the combined use of drug counseling and buprenorphine, even if these benefits don’t apply to most individuals. Secondarily, the researchers wanted to know which factors make it more or less likely that a recovering opioid addict will improve with the combined use of counseling and buprenorphine. Factors under consideration included a history of heroin intake, the presence of long-term pain and having a relatively high score on a screening procedure called the Addiction Severity Index.

After completing their reanalysis, the researchers concluded that the addition of drug counseling to a basic treatment regimen is potentially quite useful for recovering opioid addicts who have a history of involvement in some form of heroin use. In fact, recovering addicts with such a history have substantially improved odds of largely or entirely eliminating their opioid intake when their treatment includes counseling. However, the researchers also concluded that the benefits of drug counseling only appear when the person going through recovery consistently adheres to his or her treatment program and regularly attends scheduled counseling sessions. The researchers found that having long-term pain problems or a relatively high Addiction Severity Index score does not alter the effectiveness of drug counseling for people also receiving buprenorphine treatment.

The study’s authors believe their results show that people recovering from opioid addiction are a diverse population. In addition, they believe their results show that recovering opioid addicts have diverse treatment needs and do not necessarily respond to the same types of treatment approaches. Finally, the authors specifically note that apparently crucial importance of sticking to established treatment plans during addiction recovery.

Posted on July 22nd, 2014
Posted in Drug Treatment

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