The effectiveness and cost-effectiveness of cognitive behaviour therapy for opiate misusers in methadone maintenance treatment: a multi-centre randomised controlled trial

There is evidence to support the effectiveness of

methadone maintenance treatment (MM) from several

countries, and it is increasingly applied as a treatment

approach in Europe. The quality of provision of

adjunctive psychosocial treatments has been shown

to be important in the effectiveness of MM. Cognitive

behaviour therapy (CBT) has become the leading treatment

approach in a variety of psychological disorders.

In contrast, relatively little research has been conducted

to evaluate the effectiveness, and particularly

cost effectiveness, of CBT in substance use disorders.

There are several reasons to expect that CBT could

make a significant impact on drug misuse and associated

problems. CBT has been evaluated as an adjunct

to MM. Several RCTs have been undertaken to assess

the efficacy of psychotherapy in methadone maintenance

treatment. The evidence from these studies,

which were exclusively conducted in the US, overall

support the efficacy of CBT, although the models of

CBT applied varied considerably between studies.

One study showed that CBT was more effective than

minimal methadone treatment. However, the efficacy

and cost effectiveness of CBT in MM in the UK NHS

setting is unknown.