A meta-analytic review of psychosocial interventions for substance use disorders.
OBJECTIVE
Despite significant advances in psychosocial treatments for substance use disorders, the relative success of these approaches has not been well documented. In this meta-analysis, the authors provide effect sizes for various types of psychosocial treatments, as well as abstinence and treatment-retention rates for cannabis, cocaine, opiate, and polysubstance abuse and dependence treatment trials.


METHODS
With a comprehensive series of literature searches, the authors identified a total of 34 well-controlled treatment conditions-five for cannabis, nine for cocaine, seven for opiate, and 13 for polysubstance users-representing the treatment of 2,340 patients. Psychosocial treatments evaluated included contingency management, relapse prevention, general cognitive behavior therapy, and treatments combining cognitive behavior therapy and contingency management.


RESULTS
Overall, controlled trial data suggest that psychosocial treatments provide benefits reflecting a moderate effect size according to Cohen's standards. These interventions were most efficacious for cannabis use and least efficacious for polysubstance use. The strongest effect was found for contingency management interventions. Approximately one-third of participants across all psychosocial treatments dropped out before treatment completion compared to 44.6% for the control conditions.


CONCLUSIONS
Effect sizes for psychosocial treatments for illicit drugs ranged from the low-moderate to high-moderate range, depending on the substance disorder and treatment under study. Given the long-term social, emotional, and cognitive impairments associated with substance use disorders, these effect sizes are noteworthy and comparable to those for other efficacious treatments in psychiatry.
Dutra
Lissa
L
Center for Anxiety and Related Disorders, 648 Beacon St., Fl. 6, Boston, MA 02215, USA.
Stathopoulou
Georgia
G
Basden
Shawnee L
SL
Leyro
Teresa M
TM
Powers
Mark B
MB
Otto
Michael W
MW
D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000628:therapy; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000523:psychology / Q000628:therapy; D009293:Opioid-Related Disorders / Q000523:psychology / Q000628:therapy; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011613:Psychotherapy / Q000379:methods* / Q000706:statistics & numerical data; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D055502:Secondary Prevention; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome