Buprenorphine treatment for opioid use disorder (OUD) plus standard medical medication management counseling was as effective as treatment with buprenorphine plus intensive behavioral therapy, a recent study found. Effectiveness was defined as treatment retention and opioid-free weeks over a 12-week period.

Those who received buprenorphine with medical management counseling had an average of 7.00 opioid-free weeks, and they stayed in treatment for an average of 10.21 weeks out of a maximum of 12 weeks. Comparatively, those who received buprenorphine with medical management counseling plus additional behavioral therapy had 7.16 opioid-free weeks, and they stayed in treatment for 10.29 weeks out of a maximum of 12 weeks.

The findings were based on an analysis of four randomized clinical trials conducted in the United States from 2000 to 2011 that included 869 adult participants diagnosed with OUD who received buprenorphine. Across the four studies, the participants were assigned to various treatment groups, including no additional behavioral treatment, varying levels of behavioral therapy, standard medical management, physician management, physician management plus cognitive behavioral therapy, contingency management, contingency management plus cognitive behavioral therapy, and standard medical management plus opioid dependence counseling.

For the analysis, the researchers created two groups: those who received no additional behavioral treatment and those who received additional behavioral treatment. The outcomes were weeks of treatment with buprenorphine out of a possible 12 weeks, and changes in participant functioning in seven domains: medical, employment and financial support, social and family, alcohol, drug, legal, and psychiatric.

In the analysis of changes in participant functioning, there were no significant differences between the two comparison groups in any of the seven domains. Both groups had minimal changes in functioning over the 12 weeks of buprenorphine treatment. The researchers proposed that the 12-week duration of the comparison might not have been long enough to capture differences.

These findings were reported in Behavioral Therapy as an Adjunct to Buprenorphine Treatment for Opioid Use Disorder by R. Kathryn McHugh, Ph.D.; Allen J. Bailey, Ph.D.; Brooke A. McConaghy, BA; and colleagues. They sought to present the linear effects of buprenorphine treatment plus additional behavioral therapy.

The full text of Behavioral Therapy as an Adjunct to Buprenorphine Treatment for Opioid Use Disorder was published on August 20, 2025, by JAMA Network Open. A free copy is available (accessed October 22, 2025).

For more information, contact: R. Kathryn McHugh, Ph.D., Chief of Psychology & Director, Stress, Anxiety, and Substance Use Laboratory, Division of Alcohol, Drugs and Addiction, McLean Hospital, 115 Mill Street, Proctor House 3, MS 222, Belmont, Massachusetts 02478; Email: kmchugh@mclean.harvard.edu; Website: https://www.mcleanhospital.org/profile/r-kathryn-mchugh