Brief Cognitive-Behavioural Therapy for Methamphetamine Use among Methadone-Maintained Women: A Multicentre Randomised Controlled Trial

Objective: Addressing co-existing methamphetamine (MA) use disorder in methadone treatment services can improve treatment adherence and outcomes. This study aimed to assess the feasibility and efficacy of brief cognitive-behavioural therapy (BCBT) on MA use disorder among a group of methadone-maintained women. Methods: In this multicentre randomised controlled trial, women who had been stabilised on at least three months of methadone treatment and reported at least weekly MA use were enrolled from four methadone treatment centres in Iran and randomly assigned (1:1) to receive either BCBT or standard drug information for four weeks. The primary outcome was self-reported number of days of MA use over the treatment period. Outcomes were assessed at weeks 0, 4 and 12. Urinalysis was used to confirm self-reported abstinence from MA at weeks 4 and 12. Results: Overall, 120 women were enrolled and randomised; 60 were assigned to the BCBT group and 60 to the control group. Only 16 women were lost to 12 week follow-up. The BCBT group had significant reductions in number of days of MA use, quantity/frequency of MA use and severity of MA dependence at week four. MA use reduction was accompanied with significant improvements in readiness to change MA use, psychological well-being and social functioning following intention-to-treat analysis. All results remained significant at 12 week follow-up. Conclusion: The study results supported the feasibility and efficacy of BCBT in reducing MA use disorder and improving the health and social contexts of the participants. The findings of this study may assist methadone treatment providers to better understand the role of BCBT for co-existing MA use disorder among women in methadone treatment services.