title: Efficacy of Cognitive Behavioral Therapy on Opiate Use and Retention in Methadone Maintenance Treatment in China: A Randomised Trial.
abstract: OBJECTIVE
  Methadone maintenance treatment (MMT) is widely available in China; but, high rates of illicit opiate use and dropout are problematic. The aim of this study was to test whether cognitive behavioral therapy (CBT) in conjunction with MMT can improve treatment retention and reduce opiate use.
  
  
  METHODS
  A total of 240 opiate-dependent patients in community-based MMT clinics were randomly assigned to either weekly CBT plus standard MMT (CBT group, n=120) or standard MMT (control group, n=120) for 26 weeks. The primary outcomes were treatment retention and opiate-negative urine test results at 12 weeks and 26 weeks. The secondary outcomes were composite scores on the Addiction Severity Index (ASI) and total scores on the Perceived Stress Scale (PSS) at 12 weeks and 26 weeks.
  
  
  RESULTS
  Compared to the control group in standard MMT, the CBT group had higher proportion of opiate-negative urine tests at both 12 weeks (59% vs. 69%, p<0.05) and 26 weeks (63% vs. 73%, p<0.05); however, the retention rates at 12 weeks (73.3% vs. 74.2%, p=0.88) and 26 weeks were not different (55.8% vs. 64.2%, p=0.19) between the two groups. At both 12 and 26 weeks, all of the ASI component scores and PSS total scores in the CBT group and control group decreased from baseline; but the CBT group exhibited more decreases in ASI employment scores at week 26 and more decrease in the PSS total score at week 12 and week 26.
  
  
  CONCLUSIONS
  CBT counselling is effective in reducing opiate use and improving employment function and in decreasing stress level for opiate-dependent patients in MMT in China.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01144390.
authors.affiliation: Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai, China, 200030.
authors.forename: Shujun
authors.initials: S
authors.lastname: Pan
authors.affiliation: Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai, China, 200030.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai, China, 200030.
authors.forename: Jiang
authors.initials: J
authors.lastname: Du
authors.affiliation: Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai, China, 200030.
authors.forename: Hanhui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai, China, 200030.
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Li
authors.affiliation: Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Walter
authors.initials: W
authors.lastname: Ling
authors.affiliation: Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai, China, 200030.
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
mesh_terms: D000328:Adult; D002681:China; D015928:Cognitive Behavioral Therapy; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000503:physiopathology; D010352:Patient Dropouts; D016896:Treatment Outcome
chemical_list: D008691:Methadone