Substance abuse is increasingly becoming a worldwide trend in both rich and poor countries. The Centre for Disease Control and Prevent (CDC) states that medication-assisted treatment (MAT) remains the best treatment option for Opioid Use Disorders (OUD). Strong evidence supports long-term opioid therapy as superior to abstinence-based treatment or withdrawal management alone, claiming these methods are associated with increased rates of relapse, morbidity, and death, and are therefore not recommended. These maintenance programs are typically paired with counselling and behavioural therapy such as cognitive-behavioural therapy (CBT). The present FDA-approved medications for maintenance treatment of OUD in the USA are methadone, buprenorphine, and naltrexone. In addition, the FDA has recently approved lofexidine, an a2-adrenergic agonist like clonidine, for treatment of opioid withdrawal. In general, psychosocial therapies, when delivered alone, have limited efficacy in addressing the complex symptomatology and physical aspects of OUD. Across substance use disorders, contingency management is the psychosocial treatment that consistently shows the best evidence for producing positive outcomes including reduced substance use. Motivational interviewing is a psychotherapeutic approach designed to explore and resolve ambivalence to behaviour change. Principles of motivational interviewing include expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. Cognitive-behavioural therapy (CBT) is based on the perspective that thoughts, emotions, and physical sensations can affect behaviors such as opioid use, and vice versa Several family therapies have been applied to opioid use disorder patients and their families/partners who express interest in family therapy wherein the focus is a person’s opioid use Although current treatment models have shown efficacy in preventing relapse and maintaining abstinence, approximately 40 to 60% of patients relapse while on MAT. The latest innovations aim to reduce the relapse rate, increase ease of access, and improve safety profiles.

Opioid Use Disorders, Treatment Modalities