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Behavioural treatment combined with buprenorphine does not reduce opioid use compared with buprenorphine alone

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Question: In the treatment of opioid dependence, does the addition of behavioural treatment to buprenorphine reduce opioid use compared with buprenorphine alone?

Patients: In total, 202 people meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revised (DSM-IV-TR) criteria for opioid dependence. Participants had to have good general medical and psychiatric health, no sensitivity to buprenorphine or naloxone, and no dependence on alcohol, benzodiazepines or any other drug.

Setting: Outpatient clinical research centre in Los Angeles, California, USA.

Intervention: In total, 16 weeks of buprenorphine with medical management plus either cognitive behavioural therapy (CBT, n=53), contingency management (CM, n=49), both CBT and CM (CBT+CM, n=49) or no behavioural treatment (n=51). CBT involved weekly 45 min sessions with a counsellor addressing topics relevant to drug use and recovery. CM involved receiving an increasing monetary reward for each consecutive opioid-negative urine result. Following …

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  • Sources of funding National Institute on Drug Abuse.


  • Competing interests RDW receives support from grants U10 DA15831 and K24 DA022288 from the National Institute on Drug Abuse, USA.