A Cochrane review [Abstract] 1 included 35 studies on the effectiveness of combining a psychosocial treatment with an agonist treatment in suppressing heroin use, with a total of 4 319 subjects.
The studies considered 13 different psychosocial interventions. Comparing any psychosocial plus any maintenance pharmacological treatment to standard maintenance treatment, results do not show benefit for retention in treatment, RR 1.03 (95% CI 0.98 to 1.07; 27 studies, n=3124), abstinence by opiate during the treatment, RR 1.12 (95% CI 0.92 to 1.37; 8 studies, n=1002), compliance, MD 0.43 (95% CI -0.05 to 0.92; 3 trials), psychiatric symptoms, MD 0.02 (-0.28 to 0.31; 3 trials), depression, MD -1.70 (95% CI -3.91 to 0.51; 3 trials) and results at the end of follow up as number of participants still in treatment, RR 0.90 (95% CI 0.77 to 1.07; 3 studies, n=250) and participants abstinent by opioid, RR 1.15 (95% CI 0.98 to 1.36; 3 studies, n=181). Comparing the different psychosocial approaches, results are never statistically significant for all the comparisons and outcomes.
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