Cognitive Behavior Therapy as Relapse Prevention for Opioid Use Disorders :  Cognitive Behavior Therapy for Opioid Use Disorders

Mafia Shahzadi; Mehwish Jabeen; Aqila Unbrin; Qurat Ul-Ain; Zobia Amin

doi:10.54393/tt.v4i04.184

Authors

Mafia Shahzadi Department of Applied Psychology, Government College University, Faisalabad, Pakistan
Mehwish Jabeen School of Professional Psychology, University of management and Technology, Lahore, Pakistan
Aqila Unbrin Pakistan Institute of Mental Health, Lahore, Pakistan
Qurat Ul-Ain Department of Psychology, Emerson University, Multan, Pakistan
Zobia Amin Rak Hospital, Ras Al-Khaimah, United Arab Emirates

DOI:

https://doi.org/10.54393/tt.v4i04.184

Keywords:

Cognitive Behavior Therapy, Opioids, Occupational Functioning

Abstract

Opioid use disorder (OUD) is a prevailing psychiatric illness that provides foundations of morbidity and mortality. Objective: To investigate the effectiveness of Cognitive Behavior Therapy (CBT) in terms of relapse prevention in the treatment of patients with opioid use disorders. Methods: After the period of detoxification, an individualized treatment plan was made based on CBT. To assess the effectiveness of planned and executed CBT sessions, pre and post assessment method was opted. Results: Results specify that CBT worked successfully as relapse prevention in one-on-one sessions. CBT attested to be working in treating patients' lapses as well as relapses by increasing control on cravings and improving assertive behavior. Conclusions: The conclusion can be drawn that CBT is an effective methodology that successfully deals with patients' cravings, and develops assertive behavior thereby preventing relapse.

References

Morin KA, Eibl JK, Gauthier G, Rush B, Mushquash C, Lightfoot NE, et al. A cohort study evaluating the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment (OAT) across Ontario, Canada, using administrative health data. Harm Reduction Journal. 2020 Dec; 17(1): 1-3. doi: 10.1186/s12954-020-00396-x.

Zedler B, Xie L, Wang L, Joyce A, Vick C, Kariburyo F, et al. Risk factors for serious prescription opioid-related toxicity or overdose among Veterans Health Administration patients. Pain Medicine. 2014 Nov; 15(11): 1911-29. doi: 10.1111/pme.12480.

Lutz PE and Kieffer BL. Opioid receptors: distinct roles in mood disorders. Trends in neurosciences. 2013 Mar; 36(3): 195-206. doi: 10.1016/j.tins.2012.11.002.

Shahzadi M and Mahmood K. Level of Depression, Criminogenic Cognition, Relapse Risk, and Quality of Life among Patients with Substance Use Disorders: Level of Depression, Criminogenic Cognition and QoL. Pakistan Journal of Health Sciences. 2023 Sep:112-8. doi: 10.54393/pjhs.v4i09.1030.

Singhal A, Tien YY, Hsia RY. Racial-ethnic disparities in opioid prescriptions at emergency department visits for conditions commonly associated with prescription drug abuse. PloS One. 2016 Aug; 11(8): e0159224. doi: 10.1371/journal.pone.0159224.

Shahzadi M, Unbrin A, Jabeen M. Internalizing disorder among individuals with substance use disorders: a systematic review. Journal of Development and Social Sciences. 2022 Mar; 3(1): 166-83. doi: 10.47205/jdss.2022(3-1)14.

Strang J, Volkow ND, Degenhardt L, Hickman M, Johnson K, Koob GF, et al. Opioid use disorder. Nature Reviews Disease Primers. 2020 Jan; 6(1): 1-28. doi: 10.1038/s41572-019-0137-5.

Blanco C and Volkow ND. Management of opioid use disorder in the USA: present status and future directions. The Lancet. 2019 Apr; 393(10182): 1760-72. doi: 10.1016/S0140-6736(18)33078-2.

Taylor JL and Samet JH. Opioid use disorder. Annals of Internal Medicine. 2022 Jan; 175(1): ITC1-6. doi: 10.7326/AITC202201180.

Porucznik CA, Sauer BC, Johnson EM, Crook J, Wrathall J, Anderson JW, et al. Adult use of prescription opioid pain medications-Utah, 2008. Morbidity and Mortality Weekly Report. 2010; 59(6): 153-7.

Volkow ND, Jones EB, Einstein EB, Wargo EM. Prevention and treatment of opioid misuse and addiction: a review. JAMA Psychiatry. 2019 Feb; 76(2): 208-16. doi: 10.1001/jamapsychiatry.2018.3126.

Government of Pakistan’s Ministry of and Interior and Narcotics Control, Pakistan Bureau of Statistics, The United Nations Office on Drugs and Crime. Drug use in Pakistan 2013. 2014. [Last cited: 9th Jan 2024]. Available at: https://www.unodc.org/documents/pakistan/Survey_Report_Final_2013.pdf.

Shahzadi M and Abbas Q. Individualised cognitive behaviour therapy in patients of substance use disorders: three case studies. JPMA. The Journal of the Pakistan Medical Association. 2020 Sep; 70(9): 1657-60.

Mazza J, Conrad KJ, Scott CK, Dennis ML. Reliability and validity of a substance craving scale. Drug and Alcohol Dependence. 2014; 140: e138. doi: 10.1016/j.drugalcdep.2014.02.392.

Ruben DH, Perra RG, Bakker RJ. Validity of norms for drug addicts on the Rathus Assertiveness Schedule. Psychological Reports. 1984 Aug; 55(1): 125-6E. doi: 10.2466/pr0.1984.55.1.125.

Guven FM, Camsari UM, Senormanci O, Oguz G. Cognitive behavioral therapy in cannabis use disorder. In: Handbook of Cannabis and Related Pathologies. 2017. Academic Press; 1056-65. doi: 10.1016/B978-0-12-800756-3.00127-7.

Tripp CC, Rak E, Burker E. A review of effective treatments for patients with co-occurring chronic pain and opioid addiction. Vistas Online. 2017; 43: 1-5.

Lingford-Hughes AR, Welch S, Peters L, Nutt DJ. BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP. Journal of Psychopharmacology. 2012 Jul; 26(7): 899-952. doi: 10.1177/0269881112444324.

Albano AM and Kendall PC. Cognitive behavioural therapy for children and adolescents with anxiety disorders: Clinical research advances. International Review of Psychiatry. 2002 Jan; 14(2): 129-34. doi: 10.1080/09540260220132644.

Mueser KT, Rosenberg SD, Xie H, Jankowski MK, Bolton EE, Lu W, et al. A randomized controlled trial of cognitive-behavioral treatment for posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology. 2008 Apr; 76(2): 259. doi: 10.1037/0022-006X.76.2.259.

Shahzadi M, Bhati KM. Relationship Between Coping Strategies and Quality of Life with Mediating Role of Depression and Stigmatization among Patients with Opioid Use Disorder (OUD) With Relapse Condition. Pakistan Journal of Humanities and Social Sciences. 2023 Sep; 11(3): 3499-506. doi: 10.52131/pjhss.2023.1103.0631.

Dutra L, Stathopoulou G, Basden SL, Leyro TM, Powers MB, Otto MW. A meta-analytic review of psychosocial interventions for substance use disorders. American Journal of Psychiatry. 2008 Feb; 165(2): 179-87. doi: 10.1176/appi.ajp.2007.06111851.

Powers MB, Vedel E, Emmelkamp PM. Behavioral couples therapy (BCT) for alcohol and drug use disorders: A meta-analysis. Clinical Psychology Review. 2008 Jul; 28(6): 952-62. doi: 10.1016/j.cpr.2008.02.002.

Carroll KM, Fenton LR, Ball SA, Nich C, Frankforter TL, Shi J, et al. Efficacy of Disulfiram and Cognitive Behavior Therapy in Cocaine-DependentOutpatients: A Randomized Placebo-Controlled Trial. Archives of General Psychiatry. 2004 Mar; 61(3): 264-72. doi: 10.1001/archpsyc.61.3.264.

Walters D, Connor JP, Feeney GF, Young RM. The cost effectiveness of naltrexone added to cognitive-behavioral therapy in the treatment of alcohol dependence. Journal of Addictive Diseases. 2009 Apr; 28(2): 137-44. doi: 10.1080/10550880902772456.

Pan S, Jiang H, Du J, Chen H, Li Z, Ling W, et al. Efficacy of cognitive behavioral therapy on opiate use and retention in methadone maintenance treatment in China: a randomised trial. PloS One. 2015 Jun; 10(6): e0127598. doi: 10.1371/journal.pone.0127598.

Dugosh K, Abraham A, Seymour B, McLoyd K, Chalk M, Festinger D. A systematic review on the use of psychosocial interventions in conjunction with medications for the treatment of opioid addiction. Journal of Addiction Medicine. 2016 Mar; 10(2): 91. doi: 10.1097/ADM.0000000000000193.

Magidson JF, Belus JM, Seitz-Brown CJ, Tralka H, Safren SA, Daughters SB. Act Healthy: a randomized clinical trial evaluating a behavioral activation intervention to address substance use and medication adherence among low-income, Black/African American individuals living with HIV/AIDS. AIDS and Behavior. 2022 Jan; 26(1): 102-15. doi: 10.1007/s10461-021-03354-1.