Counseling as a complement to buprenorphine treatment for opioid use disorder: A retrospective observational study of patient outcomes

Introduction

This study investigated the clinical benefit of counseling as a complement to buprenorphine treatment for opioid use disorder (OUD). The research addresses a critical gap in understanding whether counseling, when received concurrently with buprenorphine, can enhance patient outcomes.

Methods

We conducted a retrospective cohort study using data from the Massachusetts Department of Public Health's Public Health Data Warehouse (PHD). The study included patients who initiated buprenorphine treatment between January 2015 and December 2019. Investigators measured outcomes including medication adherence, treatment discontinuation, and opioid-related overdose over a 12-month period. We evaluated the effectiveness of counseling based on whether patients attended a minimum of three sessions in the first three months of buprenorphine treatment. We employed multivariate logistic regression and propensity score matching to analyze the data.

Results

The study sample comprised 32,688 patients with 8871 (27 %) receiving counseling concomitantly with buprenorphine. Results from the regression analyses showed that counseling was associated with 17 % lower likelihood of poor medication continuity (OR = 0.83, 95 % CI = 0.78–0.87) and 21 % lower likelihood of treatment discontinuation (OR = 0.79, 95 % CI = 0.75–0.83). Counseling was not associated with the odds of opioid-related overdose. Additional results from sensitivity analyses pointed to a dose-response relationship for counseling within the parameters studied.

Conclusions

Findings suggest that counseling, when combined with buprenorphine treatment for OUD is associated with better patient outcomes in terms of medication continuity and treatment retention. However, the impact of counseling on opioid-related overdose risk was inconclusive, highlighting the need for further research to understand its role in overdose prevention.