Buprenorphine, Individual Counseling, Opioid Use, Policy, Research, Treatment



  1. Mariolis, Tara PhD, RN, CNE
  2. Wilson, Amanda MD
  3. Chiodo, Lisa M. PhD


Abstract: In 2018, more than 67,000 people died because of drug overdoses, and of that number, approximately 69.5% involved an opioid, making it a leading cause of death in the United States. Additionally concerning is that 40 states have reported increased overdose deaths and opioid-related deaths since the start of the COVID-19 global pandemic. Presently, many insurance companies and healthcare providers require patients to receive counseling during medication treatment for opioid use disorder (OUD), despite the lack of evidence that it is necessary for all patients. To inform policy and improve quality of treatment, this nonexperimental, correlational study examined the relationship between individual counseling status and treatment outcomes in patients receiving medication treatment for OUD. Treatment outcome variables (treatment utilization, medication use, and opioid use) were extracted from the electronic health records of 669 adults who received treatment between January 2016 and January 2018. Study findings suggest women in our sample were more likely to test positive for benzodiazepines (t = -4.3, p < .001) and amphetamines (t = -4.4, p < .001), whereas men used alcohol at higher rates than women (t = 2.2, p = .026). In addition, women were more likely to report having experienced Post-Traumatic Stress Disorder/trauma ([chi]2 = 16.5, p < .001) and anxiety ([chi]2 = 9.4, p = .002). Regression analyses revealed concurrent counseling was unrelated to medication utilization and ongoing opioid use. Patients who had prior counseling utilized buprenorphine more frequently ([beta] = 0.13, p < .001) and used opioids less often ([beta] = -0.14, p < .001); however, both relationships were weak. These data do not provide evidence that counseling during OUD outpatient has a significant impact on treatment outcomes. These findings provide further evidence that barriers to medication treatment such as mandatory counseling can and should be removed.