Randomized Pilot Trial of Web-Based Cognitive-Behavioral Therapy Adapted for Use in Office-Based Buprenorphine Maintenance

Background: Despite the clear success of office-based buprenorphine treatment in increasing availability of effective treatment for opioid use disorder, constraints on its effectiveness include high attrition and limited high-quality behavioral care in many areas. Web-based interventions may be a novel strategy for providing evidence-based behavioral care to individuals receiving office-based buprenorphine maintenance. This report describes modification and initial pilot testing of Web-based training in cognitive-behavioral therapy (CBT4CBT) specifically for use with individuals in office-based buprenorphine. Methods: Twelve-week randomized pilot trial evaluating effects of CBT4CBT-Buprenophine in retaining participants and reducing drug use with respect to standard office-based buprenorphine alone was carried out. Twenty individuals meeting DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) criteria for current opioid use disorder were randomized to standard buprenorphine treatment or buprenorphine plus access to CBT4CBT-Buprenorphine. Results: There were promising findings regarding rates of urine toxicology screens negative for opioids (91% versus 64%; P = .05, effect size d = 0.88) and all drugs (82% versus 30%; P = .004, d = 1.2). Individuals randomized to CBT4CBT-Buprenorphine completed a mean of 82.6 (SD = 4.4) days of treatment (of a possible 84) compared with 68.6 (SD = 32.6) for those assigned to standard buprenorphine treatment. Conclusions: Although preliminary and limited by the small sample size, this trial suggests the feasibility and promise of validated, Web-based interventions, tailored for this specific patient population, for improving outcomes in office-based buprenorphine.

• Publication year

  2019

• Venue

  Substance Abuse

• Publication date

  2019-02-04

• Fields of study

  Medicine, Psychology

• Identifiers
  DOI 10.1080/08897077.2019.1569192PMID 30714880PMCID PMC6874094
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Randomized Clinical Trial of Computerized and Clinician-Delivered CBT in Comparison With Standard Outpatient Treatment for Substance Use Disorders: Primary Within-Treatment and Follow-Up Outcomes.

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• Galantamine and Computerized Cognitive Behavioral Therapy for Cocaine Dependence: A Randomized Clinical Trial.

  2017cited by this paper
• Internet interventions for adult illicit substance users: a meta‐analysis

  2017cited by this paper
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  2017cited by this paper
• Medications for opioid use disorder: bridging the gap in care.

  2017cited by this paper
• The Role of Behavioral Interventions in Buprenorphine Maintenance Treatment: A Review.

  2017influential reference
• National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment.

  2015cited by this paper
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  2015cited by this paper
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  2014cited by this paper
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  2009cited by this paper
• Computer-assisted delivery of cognitive-behavioral therapy for addiction: a randomized trial of CBT4CBT.

  2008cited by this paper
• Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.

  2008cited by this paper
• Office-Based Management of Opioid Dependence with Buprenorphine: Clinical Practices and Barriers

  2008cited by this paper
• Counseling plus buprenorphine-naloxone maintenance therapy for opioid dependence.

  2006cited by this paper

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