Lopez 2021

This review analyzes 50 methodologically rigorous studies on group treatments for drug use disorders.
Evaluated treatments for substances: cocaine, methamphetamine, marijuana, opioids, and mixed substances, including co-occurring psychiatric conditions.

Cognitive Behavioral Therapy (CBT) and Contingency Management (CM) are effective for cocaine reduction compared to Treatment as Usual (TAU).
CM shows efficacy for methamphetamine reduction as well.
Relapse prevention, motivational interviewing, and social support groups reduce marijuana use more than delayed treatment control.
Group therapy combined with pharmacotherapy is superior to pharmacotherapy alone for opioid use.
An HIV harm reduction program effectively reduces illicit opioid use.
Effective treatments for mixed substance use include group CBT, CM, and women’s recovery groups.
Certain therapies (e.g., behavioral skills group, dialectical behavior therapy) are more effective at reducing substance use than TAU.

Public Health Concern: Drug use disorders significantly affect public health in the U.S.
Prevalence: Lifetime prevalence of DSM-5 drug use disorders is reported at 9.9%.
Economic Impact: Estimated costs of drug use exceed $193 billion, with approximately $78.5 billion attributed to opioids alone.
Consequences of Drug Use: Overdose, mental health issues, and medical complications like infections from needle use.

EBP defined as the “conscientious, explicit, and judicious use of current best evidence” (Sackett et al., 1996).
A shift toward EBP in substance use treatment focuses on safe, cost-effective treatment implementations.
Surveys indicate widespread use of group therapy, but non-EBT practices are also common among clinicians.

Discrepancy between clinical practice (substantial group therapy use) and research literature on group treatment efficacy noted by researchers.
Limited empirical inquiry on group treatments underscores the need for comprehensive literature reviews.
Previous reviews lack focus on the context and formats of group treatments leading to difficulties in understanding their outcomes.

Comprehensive search through PsycINFO and MedLine until 2020, filtering through abstracts for relevance.
50 studies were identified, focusing on cocaine, methamphetamine, marijuana, opioids, mixed substances, or SUD with psychiatric problems.

Contingency Management (CM): Behavioral therapy focusing on reinforcement for positive behavioral changes.
Cognitive-Behavioral Therapy (CBT): Targets thoughts and behaviors associated with substance use disorders.
Dialectical Behavior Therapy (DBT): Incorporates CBT elements in treating BPD and includes mindfulness and emotional regulation strategies.
Motivational Interviewing (MI): Supports patients in achieving behavior change through acceptance and collaboration.
Relapse Prevention (RP): Focuses on cognitive, behavioral, and emotional mechanisms that contribute to relapse.
Social Support (SS): Provides psychological support through social networks for coping with stress.
Psychoeducational Therapy: Aimed at imparting knowledge about substance use disorders.

19 studies focused on group therapy for cocaine users.
All modalities effectively reduced cocaine use compared to TAU.
CM shows a superior outcome in reducing cocaine use.
Results varied across individual studies; specific details extracted reveal varying outcomes for different therapy combinations sampled in the studies.

Identified only five studies focusing on group treatments for methamphetamine use.
Significant findings support CM and combined treatment methods as effective.

Two studies indicated effective outcomes with relapse prevention and individual motivational interviewing strategies over delayed treatment controls.

Five studies confirmed that adding group therapy to pharmacotherapy is effective; participants showed improved outcomes and adherence.

Treatments varied and included recommendations for gender-specific and culturally appropriate approaches.

Studies addressing co-occurring psychiatric disorders demonstrated varied effectiveness depending on the treatment modality used, focusing on group CBT, DBT, and psychoeducational strategies.

Studies explored effectiveness variation for genders; some indicated that women had better outcomes in certain group treatments.

Impact of race/ethnicity on treatment outcomes was explored; initial evaluations showed similar effectiveness for different racial groups in treatment interventions, with minority participants facing greater challenges in quality of life measures.

Overall evidence suggests that group treatments for drug use disorders yield greater improvement compared to TAU.
The need for well-conducted randomized controlled trials to establish more definitive therapeutic strategies and their efficacy for diverse patient backgrounds is evident.

Investigate other group treatment modalities with rigorous standards and sufficient sample diversity.
Explore mediators and moderators influencing treatment outcomes in group settings for SUD.