{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T15:48:55Z","timestamp":1782229735542,"version":"3.54.5"},"reference-count":48,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Adjunctive psychosocial treatments are recommended for many using medications for opioid use disorder (MOUD), but it is unclear which approaches can best enhance treatment outcomes.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To evaluate the comparative effectiveness of 2 psychosocial treatments, peer recovery support (PRS) and cognitive-behavioral therapy (CBT), on opioid abstinence when used as adjunctive therapies to office-based buprenorphine treatment in adults with opioid use disorder (OUD).<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This randomized clinical trial included US adults diagnosed with OUD referred for care at 5 federally qualified health centers with office-based addiction treatment programs by their clinicians from 2020 to 2024. Participants were followed up for 1 year postenrollment. Analyses were conducted September through November 2025.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants were randomized to 1 of 4 conditions: MOUD treatment as usual, MOUD plus 12 weeks of CBT, MOUD plus 12 weeks of PRS, or MOUD plus 12 weeks of CBT and PRS. The CBT intervention consisted of 12 individual, manualized sessions over 12 weeks focused on goal setting, functional analysis, cognitive restructuring, skill building, and relapse prevention. The PRS intervention required at least once-weekly contact for 12 weeks and focused on shared lived experience, goal setting, and navigation assistance to meet immediate needs. In the CBT plus PRS condition, participants were assigned to 12 weeks of concurrent CBT and PRS.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measure<\/jats:title>\n The primary outcome was urinalysis-confirmed opioid abstinence at 3, 6, 9, and 12 months.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 340 participants were included (mean [SD] age, 42.3 [10.9] years; 100 female [29.4%]). Neither CBT (odds ratio [OR], 1.16; 95% CI, 0.63-2.13), PRS (OR, 0.87; 95% CI, 0.48-1.59), nor their interaction (OR, 0.99; 95% CI, 0.30-3.27) was associated with urinalysis-confirmed opioid use.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this randomized clinical trial, CBT and PRS had no effect on rates of opioid abstinence in the year following the initiation of MOUD.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT04257214<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.19826","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T15:24:54Z","timestamp":1782228294000},"page":"e2619826","source":"Crossref","is-referenced-by-count":0,"title":["Adjunctive Psychosocial Interventions and Opioid Abstinence Among Patients Receiving Buprenorphine"],"prefix":"10.1001","volume":"9","author":[{"given":"Michelle R.","family":"Lent","sequence":"first","affiliation":[{"name":"Department of Clinical Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily E.","family":"Hurstak","sequence":"additional","affiliation":[{"name":"Boston Medical Center and Grayken Center for Addiction, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin G.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Loscalzo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Inspira Medical Center, Mullica Hill, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Mazur","sequence":"additional","affiliation":[{"name":"Atlanticare Health Services, Atlantic City, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen L.","family":"Lugo","sequence":"additional","affiliation":[{"name":"Berks Community Health Center, Reading, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen L.","family":"Dugosh","sequence":"additional","affiliation":[{"name":"Research & Evaluation Group, Public Health Management Corporation, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"issue":"5","key":"zoi260550r2","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1001\/jamapsychiatry.2019.4170","article-title":"All-cause and cause-specific mortality among people using extramedical opioids: a systematic review and meta-analysis.","volume":"77","author":"Larney","year":"2020","journal-title":"JAMA Psychiatry"},{"issue":"238","key":"zoi260550r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109551","article-title":"Prevalence of mental disorders among people with opioid use disorder: a systematic review and meta-analysis.","author":"Santo","year":"2022","journal-title":"Drug Alcohol Depend"},{"key":"zoi260550r4","doi-asserted-by":"publisher","DOI":"10.1177\/2150132720932017","article-title":"Mental health and psychosocial needs of patients being treated for opioid use disorder in a primary care residency clinic.","volume":"11","author":"Hooker","year":"2020","journal-title":"J Prim Care Community Health"},{"issue":"2","key":"zoi260550r5","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1111\/ajad.12862","article-title":"Effective management of opioid withdrawal symptoms: a gateway to opioid dependence treatment.","volume":"28","author":"Kosten","year":"2019","journal-title":"Am J Addict"},{"issue":"6","key":"zoi260550r7","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1016\/S2215-0366(23)00095-0","article-title":"Buprenorphine versus methadone for the treatment of opioid dependence: a systematic review and meta-analysis of randomised and observational studies.","volume":"10","author":"Degenhardt","year":"2023","journal-title":"Lancet Psychiatry"},{"issue":"124","key":"zoi260550r8","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2021.107113","article-title":"Systematic review and meta-analysis of retention in treatment using medications for opioid use disorder by medication, race\/ethnicity, and gender in the United States.","author":"Hochheimer","year":"2022","journal-title":"Addict Behav"},{"issue":"3","key":"zoi260550r9","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1176\/appi.focus.130309","article-title":"Medication-assisted treatment with buprenorphine: assessing the evidence.","volume":"13","author":"Thomas","year":"2015","journal-title":"Focus (Am Psychiatr Publ)"},{"issue":"1","key":"zoi260550r11","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1080\/08897077.2019.1640831","article-title":"Initiating opioid agonist treatment for opioid use disorder nationally in the Veterans Health Administration: who gets what?","volume":"41","author":"Manhapra","year":"2019","journal-title":"Subst Abus"},{"issue":"10182","key":"zoi260550r13","doi-asserted-by":"publisher","first-page":"1760","DOI":"10.1016\/S0140-6736(18)33078-2","article-title":"Management of opioid use disorder in the USA: present status and future directions.","volume":"393","author":"Blanco","year":"2019","journal-title":"Lancet"},{"issue":"Suppl 3","key":"zoi260550r14","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1007\/s11606-020-06257-4","article-title":"Barriers and facilitators to the use of medications for opioid use disorder: a rapid review.","volume":"35","author":"Mackey","year":"2020","journal-title":"J Gen Intern Med"},{"issue":"6","key":"zoi260550r15","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1080\/00952990.2023.2251653","article-title":"Meta-analysis of primary care delivered buprenorphine treatment retention outcomes.","volume":"49","author":"Cooper","year":"2023","journal-title":"Am J Drug Alcohol Abuse"},{"issue":"1","key":"zoi260550r16","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s13722-024-00527-w","article-title":"Organization of primary care and early MOUD discontinuation.","volume":"19","author":"Harris","year":"2024","journal-title":"Addict Sci Clin Pract"},{"key":"zoi260550r17","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2025.209879","article-title":"Buprenorphine dosing patterns and treatment outcomes for patients with opioid use disorder insured by Medicaid in Philadelphia.","volume":"183","author":"French","year":"2026","journal-title":"J Subst Use Addict Treat"},{"issue":"146","key":"zoi260550r18","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.09.160","article-title":"Cognitive behavioral therapy improves treatment outcome for prescription opioid users in primary care based buprenorphine\/naloxone treatment.","volume":"100","author":"Cutter","year":"2015","journal-title":"Drug Alcohol Depend"},{"issue":"8","key":"zoi260550r19","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.28529","article-title":"Behavioral therapy as an adjunct to buprenorphine treatment for opioid use disorder: a secondary analysis of 4 randomized clinical trials.","volume":"8","author":"McHugh","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"5","key":"zoi260550r20","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1080\/00952990.2020.1780602","article-title":"Cognitive-behavioral therapy and buprenorphine for opioid use disorder: a systematic review and meta-analysis of randomized controlled trials.","volume":"46","author":"Gregory","year":"2020","journal-title":"Am J Drug Alcohol Abuse"},{"issue":"2","key":"zoi260550r21","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1097\/ADM.0000000000000193","article-title":"A systematic review on the use of psychosocial interventions in conjunction with medications for the treatment of opioid addiction.","volume":"10","author":"Dugosh","year":"2016","journal-title":"J Addict Med"},{"issue":"1","key":"zoi260550r22","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2012.07.005","article-title":"A randomized trial of cognitive behavioral therapy in primary care-based buprenorphine.","volume":"126","author":"Fiellin","year":"2013","journal-title":"Am J Med"},{"issue":"7","key":"zoi260550r23","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1176\/appi.ps.201400047","article-title":"Peer recovery support for individuals with substance use disorders: assessing the evidence.","volume":"65","author":"Reif","year":"2014","journal-title":"Psychiatr Serv"},{"issue":"3","key":"zoi260550r24","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1177\/10783903221128062","article-title":"The effect of peer support on treatment engagement for opioid use disorder.","volume":"30","author":"Zuccarini","year":"2024","journal-title":"J Am Psychiatr Nurses Assoc"},{"key":"zoi260550r25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jsat.2016.01.003","article-title":"Peer-delivered recovery support services for addictions in the United States: a systematic review.","volume":"63","author":"Bassuk","year":"2016","journal-title":"J Subst Abuse Treat"},{"issue":"Pt B","key":"zoi260550r26","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109123","article-title":"Effectiveness of peer recovery support services on stages of the opioid use disorder treatment cascade: a systematic review.","volume":"229","author":"Gormley","year":"2021","journal-title":"Drug Alcohol Depend"},{"key":"zoi260550r27","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001643","article-title":"Testing the efficacy of an adaptive approach to delivering psychosocial interventions in office-based buprenorphine treatment.","author":"Dugosh","year":"2026","journal-title":"J Addict Med"},{"issue":"9","key":"zoi260550r32","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.34540","article-title":"Buprenorphine dose and time to discontinuation among patients with opioid use disorder in the era of fentanyl.","volume":"6","author":"Chambers","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"1","key":"zoi260550r33","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1093\/biomet\/73.1.13","article-title":"Longitudinal data analysis using generalized linear models.","volume":"73","author":"Liang","year":"1986","journal-title":"Biometrika"},{"issue":"3","key":"zoi260550r36","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/ADM.0b013e3182596492","article-title":"Counseling and directly observed medication for primary care buprenorphine maintenance: a pilot study.","volume":"6","author":"Moore","year":"2012","journal-title":"J Addict Med"},{"issue":"10","key":"zoi260550r37","doi-asserted-by":"publisher","first-page":"1788","DOI":"10.1111\/add.12266","article-title":"Comparison of behavioral treatment conditions in buprenorphine maintenance.","volume":"108","author":"Ling","year":"2013","journal-title":"Addiction"},{"issue":"4","key":"zoi260550r38","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1056\/NEJMoa055255","article-title":"Counseling plus buprenorphine\u2013naloxone maintenance therapy for opioid dependence.","volume":"355","author":"Fiellin","year":"2006","journal-title":"N Engl J Med"},{"issue":"14","key":"zoi260550r39","doi-asserted-by":"publisher","first-page":"2181","DOI":"10.1080\/10826084.2021.1975749","article-title":"Intervention stigma toward medications for opioid use disorder: a systematic review.","volume":"56","author":"Madden","year":"2021","journal-title":"Subst Use Misuse"},{"issue":"5","key":"zoi260550r40","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1080\/10911359.2019.1573711","article-title":"Lifetime exposure to abuse, current stressors, and health in federally qualified health center patients.","author":"Richard","year":"2019","journal-title":"J Hum Behav Soc Environ"},{"key":"zoi260550r41","doi-asserted-by":"publisher","DOI":"10.2196\/69538","article-title":"Digital psychosocial interventions tailored for people in opioid use disorder treatment: scoping review.","volume":"27","author":"Scialanca","year":"2025","journal-title":"J Med Internet Res"},{"issue":"3","key":"zoi260550r42","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1080\/1533256X.2018.1485574","article-title":"A systematic review of psychosocial interventions in treatment of opioid addiction.","volume":"18","author":"Brown","year":"2018","journal-title":"J Soc Work Pract Addict"},{"issue":"1","key":"zoi260550r43","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1080\/10550887.2016.1100960","article-title":"Retention in medication-assisted treatment for opiate dependence: a systematic review.","volume":"35","author":"Timko","year":"2016","journal-title":"J Addict Dis"},{"issue":"1","key":"zoi260550r44","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1080\/10550887.2011.642758","article-title":"Effect of buprenorphine dose on treatment outcome.","volume":"31","author":"Fareed","year":"2012","journal-title":"J Addict Dis"},{"issue":"8","key":"zoi260550r45","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1097\/MLR.0000000000000564","article-title":"Characteristics and service use of Medicare beneficiaries using federally qualified health centers.","volume":"54","author":"Chang","year":"2016","journal-title":"Med Care"},{"issue":"5","key":"zoi260550r46","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1001\/jamainternmed.2016.0705","article-title":"Changes in demographics of patients seen at federally qualified health centers, 2005-2014.","volume":"176","author":"Nath","year":"2016","journal-title":"JAMA Intern Med"},{"issue":"6","key":"zoi260550r47","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1037\/a0035039","article-title":"Behavioral health in federally qualified health centers: what practitioners and researchers need to know.","volume":"44","author":"Auxier","year":"2013","journal-title":"Prof Psychol Res and Pract"},{"key":"zoi260550r12","volume-title":"Medications for Opioid Use Disorder Save Lives","author":"National Academies of Sciences, Engineering, and Medicine","year":"2019"},{"key":"zoi260550r28","volume-title":"A Cognitive-Behavioral Approach: Treating Cocaine Addiction","author":"Carroll","year":"1998"},{"key":"zoi260550r29","volume-title":"Cognitive Therapy of Substance Abuse","author":"Beck","year":"1993"},{"key":"zoi260550r30","volume-title":"Cognitive-Behavioral Therapy (CBT) for the Treatment of Opioid Use Disorder","author":"Festinger","year":"2022"},{"key":"zoi260550r34","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198524847.001.0001","volume-title":"Analysis of Longitudinal Data","author":"Diggle","year":"2002","edition":"2nd ed"},{"key":"zoi260550r35","volume-title":"Applied Longitudinal Analysis","author":"Fitzmaurice","year":"2012"},{"key":"zoi260550r1","unstructured":"Centers for Disease Control and Prevention. Injuries and violence are leading causes of death. CDC.gov. Published 2024. https:\/\/wisqars.cdc.gov\/animated-leading-causes\/"},{"key":"zoi260550r6","doi-asserted-by":"crossref","unstructured":"Cunningham? C, Edlund? MJ, Fishman? M, . The ASAM national practice guideline for the treatment of opioid use disorder: 2020 focused update.? J Addict Med. 2020;14(2S Suppl 1):1\u201391. doi:10.1097\/ADM.0000000000000633","DOI":"10.1097\/ADM.0000000000000633"},{"key":"zoi260550r10","unstructured":"Budick? S. Barriers limit access to medication for opioid use disorder in Philadelphia. The Pew Charitable Trusts. March 21, 2022. Accessed February 4, 2026. https:\/\/www.pew.org\/en\/research-and-analysis\/reports\/2022\/03\/barriers-limit-access-to-medication-for-opioid-use-disorder-in-philadelphia"},{"key":"zoi260550r31","unstructured":"The Council of Southeast Pennsylvania. Certified recovery support specialist training. Accessed February 4, 2026. https:\/\/www.councilsepa.org\/prevention-training-and-education\/"},{"key":"zoi260550r48","unstructured":"Health Resources and Services Administration. Health center program: impact and growth. Reviewed August 2025. Accessed February 4, 2026. https:\/\/bphc.hrsa.gov\/about\/healthcenterprogram\/index.html"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2850598\/lent_2026_oi_260550_1781541880.68144.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T15:25:09Z","timestamp":1782228309000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2850598"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2026,6,23]]},"references-count":48,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.19826","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,23]]}}}