Substance abuse rehabilitation needs to be guided by well-developed practice model(s)

Adapting behavioural interventions to compensate for cognitive dysfunction in persons with opioid use disorder

“…Future work should aim to develop a screening measure that targets both cognitive performance indicators and capture of pertinent background information that can be collectively used to develop cognitive profiles that may predict the ability to engage in and benefit from various treatment strategies. 11 Future research should also endeavour to tailor and test specific strategies to accommodate cognitive dysfunction among patients with OUD to determine how best to optimise treatment outcomes.…”

“…10 This may be partially explained by poor behavioural intervention effects on patients with OUD, as the strategies used in behavioural interventions for OUD treatments may not be ideally tailored to meet the levels/forms of cognitive dysfunction among this population. 11 Therefore, cognitive dysfunction and tailored accommodation strategies must be better understood and carefully matched in order to improve OUD treatment outcomes. 12 Several behavioural intervention approaches are used among patients with OUD, including cognitive-behavioural therapy (CBT), contingency management (CM), motivational interviewing (MI) and psychoeducation techniques.…”

“…12 Several behavioural intervention approaches are used among patients with OUD, including cognitive-behavioural therapy (CBT), contingency management (CM), motivational interviewing (MI) and psychoeducation techniques. 11 13 14 While efficacious, these approaches also place significant cognitive demands on patients, [14][15][16] which may limit their efficacy unless appropriate accommodation strategies are incorporated. 17 In fact, the Substance Abuse and Mental Health Services Administration (SAMHSA) recently published the Treatment Improvement Protocol to provide treatment recommendations and accommodations for substance use disorder (SUD) treatment targeting people with cognitive dysfunction.…”

“… 10 This may be partially explained by poor behavioural intervention effects on patients with OUD, as the strategies used in behavioural interventions for OUD treatments may not be ideally tailored to meet the levels/forms of cognitive dysfunction among this population. 11 Therefore, cognitive dysfunction and tailored accommodation strategies must be better understood and carefully matched in order to improve OUD treatment outcomes. 12 …”

The role of occupational therapy in substance use

“…The occupational perspective of substance use is slightly different from the medical model view. OT aims to enhance the quality of life of people with substance use and prevent them from relapsing (Tsui & Li, 2020). Alternately, the OT view is that substance abuse is unique to each individual, and only that individual can define the meaning of substance use in their life and the impact on activities of daily living (Narain et al, 2018).…”