treatment

Behavioural Activation (BA) interventions were found in a systematic review without meta-analysis (Matrínez-Vispo et al 2018, studies = 8, 6 of which RCTs) to potentially improve:

• substance use (2 out of 6 RCTs reported statistically significant results in favour of BA)
• depressive symptoms (6 out of 8 studies reported statistically significant results in favour of BA)

A systematic review (Klimas et al, 2018, 7 trials, n= 825, low to very-low quality evidence) comparing different types of psychosocial interventions did not find clear superiority results in:

•  reducing alcohol use among people who use illicit drugs (mostly opioids and stimulants).

Compared psychosocial interventions included among others 12-steps programmes, educational interventions only, motivational interviewing, and treatment as usual.

A  systematic review (Harada et al 2018) of two small RCTs (n=210) addressing the efficacy of cognitive-behavioural treatment (CBT) for people with amphetamine-type stimulants (ATS) use disorder found that there were insufficient data for conclusive assessment of CBT in the treatment of ATS use disorders (SMD -0.28, 95% CI -0.69 to 0.14).

The same result was confirmed by a systematic review of reviews (Ronsley et al., 2020, 29 systematic reviews examining eleven intervention modalities) that found no no significant benefit was identified for abstinence at 12 weeks, at the end of treatment, or at longest follow up.

Specifically for methamphetamine use disorder, a systematic review without meta-analysis (AshaRani et al., 2020) found that most of the behavioural interventions i.e., CBT, GCBT, MI and counselling demonstrated treatment some efficacy in reducing METH use in the participants however, a clear superiority of one over the other was not demonstrated. Moreover, while CM (contingency management) and CBT, both demonstrated positive outcomes individually, no clear synergism was observed when CM interventions were combined together with CBT.