The field of addiction treatment sometimes feels like it has split into two worlds – those who believe that therapy is integral to helping patients overcome their addictions and those who believe medication is the answer. I’m not sure how we got to such a stark either/or place, but it does our patients a disservice.
We know that many patients in therapy-based treatment benefit from taking medications (see Vivitrol Improves the Likelihood of Recovering from Alcoholism by 26%). Is the reverse also true that patients on medication-assisted treatment benefit from receiving therapy? Let’s dive into the data.
Buprenorphine Patients Receiving Therapy
Remained in Treatment 70% Longer
Dr. Hillary Samples et. al did an analysis of Medicaid claims data for 61,976 adults who received buprenorphine for at least 7 consecutive days between 2013 and 2018. They found that patients who received two or more individual, group or family psychotherapy or counseling services per month remained in treatment about 70% longer than those who received little or no therapy:
Unfortunately, similar research has not been published for patients on methadone. It would be surprising, however, if such research contradicted the findings of the buprenorphine study that therapy improves treatment retention.
OUD Patients Receiving At Least 16 Minutes of Weekly Therapy Were More Likely to Be in Recovery One Year Later
Vista’s research confirms the importance of therapy. Among 409 patients with Opioid Use Disorder who left treatment on buprenorphine or Suboxone, those who reported receiving 16 minutes to an hour of individual therapy each week during treatment were 55% more likely to be reachable and abstaining from alcohol and non-prescribed drugs one year after discharge than patients who had received little or no individual therapy:
Patients who received more than one hour per week of individual therapy were 31% more likely to be successfully abstaining compared to those who received 15 minutes or less of therapy per week.
Based on my discussions with MAT treatment center leaders, I believe that most would like to offer strong counseling and behavioral services to receptive patients. Unfortunately, once the costs for dispensing, toxicology, and clinic administration are covered, there’s not a lot left over from CMS’s $226.76 weekly bundled payment to cover counseling costs. My hope is that additional MAT clinics start taking advantage of CMS’s $804.60 weekly payment for Intensive Outpatient Services to offer more individual and group counseling to their patients.
Vista’s Patient Monitoring Helps Improve
OTP/OBOT Retention
Vista’s research tracks how your patients are progressing throughout treatment on easy-to-understand patient dashboards. Warning signs that a patient is at high risk of dropping out of treatment include:
increases in the strength and frequency of cravings
use of substances the patient has previously deemed to be unacceptable
unhappiness with the medication they’re taking
dissatisfaction with their treatment.
Fill out your information below to learn more about how Vista’s outcomes research helps MAT centers retain patients in treatment:
[1] Samples H, Williams AR, Crystal S, Olfson M. Psychosocial and behavioral therapy in conjunction with medication for opioid use disorder: Patterns, predictors, and association with buprenorphine treatment outcomes. J Subst Abuse Treat. 2022 Aug;139:108774. doi: 10.1016/j.jsat.2022.108774. Epub 2022 Mar 18. PMID: 35337716; PMCID: PMC9187597.
