Psychosocial combined with methadone maintenance treatments versus methadone maintenance treatments alone for treatment of opioid use disorder: A meta-analysis

Abstract

Background

Psychosocial combined with methadone maintenance treatment aimed at opioid use disorder is effective, but the efficacy of the psychosocial intervention in such treatment is questionable.

Objectives

This study aims to evaluate the effectiveness of psychosocial plus methadone maintenance treatment versus methadone maintenance treatment alone for opioid use disorder in improving treatment retention and reducing drug use.

Methods

An exhaustive literature search was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, PsycINFO, CINAHL, China National Knowledge Infrastructure database, “the Wan Fang database, the VIP database, and the Chinese Biomedical Literature Database”, and randomized controlled trials were identified from their inception to February 2021.

Results

Twenty-four studies were included. The results of this meta-analysis showed that adding any psychosocial treatment to standard methadone maintenance treatment significantly improved the illicit drug use during the treatment relative risk (RR) 0.62 (95% CI 0.48 to 0.79), and retention in treatment RR 1.18 (95% CI 1.11 to 1.25). No statistically significant additional benefit was detected in terms of retention at follow-up RR 1.08 (95% CI 0.95 to 1.22).

Conclusions

The present evidence suggests that adding psychosocial intervention to methadone maintenance treatment significantly improves the nonuse of opioids and retention in treatment. It should be noted that psychosocial treatment is only beneficial for methadone treatment when methadone is provided in subtherapeutic doses. Additionally, the finding about the improvement effect of retention at follow-up did not achieve statistical significance. Due to the diversity of outcome indicators in relevant original studies, the included studies are limited.

Keywords:

• opioid use disorder
• methadone maintenance therapy
• psychosocial intervention

Authors’ contributions

Chengbin LIU: Methodology, Data Curation, Formal Analysis, Supervision, Writing - Review & Editing. Yangyang LI: Conceptualization, Methodology, Project administration, Data Curation, Formal Analysis, Writing - Original Draft. Each author certifies that their contribution to this work meets the International Committee of Medical Journal Editors standards.

Disclosure statement

All authors have no conflicts of interest. On behalf of all authors, the corresponding author states that there is no conflict of interest.

Funding

The author(s) reported there is no funding associated with the work featured in this article.