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Convention 2019
OPIOID USE DISORDER
What Is Cognitive Behavior Therapy?

Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.

Changes or goals might involve:

  • A way of acting: like smoking less or being more outgoing;
  • A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
  • A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
  • A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past. They concentrate on a person’s views and beliefs about their life, not on personality traits. Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families. Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.

HOW TO GET HELP: If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet. You may, or may not, find a competent therapist in this manner. It is wise to check on the credentials of a psychotherapist. It is expected that competent therapists hold advanced academic degrees. They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association. Of course, they should be licensed to practice in your state. You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations. You may, of course, visit our website (www.abct.org) and click on "Find a CBT Therapist"

The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition. These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.

Substance use disorders are one of the most common and devastating health problems in the United States. One group of substances that can lead to a substance use disorder is called opioids. Opioids are a type of drug that include prescription pain medications (for example, oxycodone, morphine) as well as heroin. Since the rise of prescription drugs like Oxycontin in the early 2000s, the misuse of these types of drugs has skyrocketed. Approximately 12.5 million people over the age of 12 in the United States misused prescription opioids in 2015. This means that they took them differently than how they were prescribed, usually in higher doses or for longer periods of time, or took them even though they were not prescribed. Along with this increased use and misuse of these addictive prescription drugs has come an increase in drug overdose deaths. This is due in part to the fact that people who misuse prescription opioids are 19 times more likely to use heroin in the future, compared to those with no history of prescription opioid misuse.

Cognitive behavioral therapy (CBT), alone or in combination with medication, can be helpful in reducing opioid use. For those who initially began taking opioids for pain, CBT for chronic pain can also provide alternative pain management strategies to decrease opioid use.

Opioid Use Disorder

Characteristics

Opioid use disorder is characterized by having at least a few of the following symptoms: (1) taking more opioids than one wanted, or intended to; (2) having trouble cutting down on opioid use; (3) spending a lot of time getting, using, or recovering from the effects of opioids; (4) experiencing cravings, or urges to use opioids; (5) having trouble with work, school, home, or family or other relationships because of opioid use; (6) using opioids in dangerous situations (like while driving); (7) needing increasingly more opioids than one to get the same effect (tolerance); (8) continuing to use opioids even though they make a physical or psychological problem worse; (9) experiencing withdrawal symptoms from opioids.

Withdrawal symptoms for opioids usually feel flu-like: diarrhea, vomiting, nausea, weakness, sweating, anxiety, aches and pains, and restlessness are a few of the common symptoms. In fact, these withdrawal symptoms are so unpleasant that many people with opioid use disorder continue to take opioids just to avoid the withdrawal symptoms.

Treatment

CBT is effective on its own and in combination with other therapies for substance use disorders, including opioid use disorder. CBT can be especially effective for opioid use disorder when combined with medicines that block the effects of opioids.

CBT for substance use disorders is often delivered in a group format, but sometimes is delivered by a therapist who will provide one-on-one treatment. There are many cognitive and behavioral strategies that are effective in reducing substance use. Some of these strategies include:
  • providing education about substance use disorders and the effects of drugs on the body and brain;
  • providing incentives, or rewards, for abstaining from drugs;
  • teaching individuals how to identify the “triggers” that create cravings and urges to use drugs so that clients can come up with plans to cope with these situations;
  • providing tools for thinking in more helpful ways when experiencing urges to use drugs; and
  • providing general strategies for coping with difficult situations.

If an individual began using opioids for chronic pain and then developed an opioid use disorder, the therapist may teach CBT skills for pain management to teach the individual how to manage pain more effectively while reducing opioid use. CBT is effective for chronic pain.

Although CBT on its own is effective for substance use disorders, such as opioid use disorder, opioid use disorder is unique in that there are special medications that can significantly reduce the risk of fatal overdose. Medications like methadone or “opiate replacement therapies” are opioids that don’t give people a “high” and can help people quit heroin. Other drugs, like naloxone, prevent and reverse overdose by blocking the effects of opioids. It is important to note that people with opioid use disorders are much more likely to take these medications as directed if they also

Resources

The National Institute on Drug Abuse (NIDA) has material on many different drugs and treatments, including opioids, a class that includes heroin and many pain relievers:

https://www.drugabuse.gov/drugs-abuse/opioids

Substance Abuse and Mental Health Services Administration (SAMHSA) is a clearing house for many related groups offering help:

https://www.samhsa.gov/atod/opioids

And ABCT has lots of additional information on CBT and addiction as well as a list of CBT therapists at

http://www.findcbt.org/xFAT.

 

For more information or to find a therapist:

Please feel free to photocopy or reproduce this fact sheet, noting that this fact sheet was writen and produced by ABCT. You may also link directly to our site and/or to the page from which you took this fact sheet

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