Psychosocial treatments for opioid use disorder: state of the qualitative literature

Conflict exists between clinical practice guidelines and empirical evidence regarding the use of psychosocial interventions to treat opioid use disorder (OUD). While most evidence is based on meta-reviews and quantitative data, the current scoping review supplements these data with qualitative studies. This review aims to evaluate the state of the qualitative literature on psychosocial interventions for OUD and to synthesize the main findings from these studies. A systematic search was conducted in 2017 and updated in July 2023, 39 qualitative and mixed methods articles were included in this review. Two reviewers critically appraised the qualitative studies according to the Critical Appraisal Skills Programme Qualitative Checklist and the National Institute for Health and Care Excellence guidelines. Of the 39 qualitative studies, 12 were mixed-method studies. Less than half met high quality standards (high = 17, moderate = 18, low = 4). Most studies were conducted in adult populations (n = 26), with heroin as the opioid most often used (n = 22). High-quality qualitative studies (n = 17) suggested that psychosocial treatments may address social barriers (e.g. homelessness, unemployment), enhance social support, and improve treatment retention. Overall, our review suggests psychosocial treatments may contribute to OUD treatment. These treatment programs should reflect the goals and outcomes desired by people who use drugs, provide opportunities for self-growth, facilitate social connection, and support recovery post-treatment.