Preparation of Literature Review on Psychosocial Interventions. For the 2015 publication, a review of the literature on the efficacy of psychosocial treatment delivered in conjunction with medications for the treatment of opioid use disorder was conducted. This review was partially supported by funding from the National Institute on Drug Abuse. Articles were identified for inclusion in the review through searches conducted in two bibliographic databases (e.g., PsycINFO and PubMed) using predefined search terms and established selection criteria. Titles and abstracts were reviewed for inclusion by two members of the research team. To increase the overall relevance of the review, the search was limited to articles in the 6-year period from January 2008 to December 2014. If the article reflected a secondary analysis of data from a relevant study, the original study was included in the literature review. In addition, findings from three prominent systematic reviews (i.e., 2007 review on psychosocial interventions in pharmacotherapy of opioid dependence prepared for the Technical Development Group for the World Health Organization, Guidelines for Psychosocially Assisted Pharmacotherapy of Opioid Dependence, and two 2011 Cochrane reviews examining psychosocial and pharmacological treatments for opioid withdrawal management and psychosocial interventions combined with agonist treatment) were summarized.26–28 The literature search yielded 938 articles. The titles and abstracts were reviewed to determine if the study met the inclusion/exclusion criteria, and those that did not (n ¼ 787) were removed. The remaining 151 articles were then reviewed for inclusion, and 27 articles were ultimately retained for use in the literature review as the others did not meet the predetermined inclusion/exclusion criteria. These articles, along with the relevant systematic reviews of the literature, are described in the literature review in the next section.

Criteria for inclusion in the focused update included new evidence and guidelines that were considered a) clinically meaningful and applicable to a broad range of clinicians treating addiction involving opioid use, and b) urgently needed to ensure the guideline reflects the current state of the science for the existing recommendations, aligns with other relevant practice guidelines, and reflects newly approved medications and formulations. Relevant evidence and current practices not meeting these criteria will be reviewed and incorporated into the full update as appropriate. Reasons for Exclusion: Case Study, Abstract, Brief Report, Commentary/Editorial, More Recent Available, More Recent Review Available, Not English, Original Research Included, Wrong Intervention, Wrong Population, Wrong Condition/Disorder, Wrong Outcome, Wrong Timing, Wrong Setting.

A search of Medline’s PubMed database from January 1, 2014 to September 27, 2018 was conducted to identify new practice guidelines and relevant systematic reviews addressing the use of medications and psychosocial treatments in the treatment of opioid use disorders, including in special populations. The archives of the Clinical Guideline Clearinghouse, and key agency and society websites, including the Substance Abuse and Mental Health Services Administration (SAMHSA), the Agency for Healthcare Research and Quality, and the National Institute of Mental Health were also searched for additional guidelines. The FDA website was searched for recent relevant drug approvals and mandated label changes since publication of this Practice Guideline in 2015. A predefined set of inclusion and exclusion criteria (consistent with the 2015 process but meeting the above criteria for the focused update) were applied to identify practice guidelines and systematic reviews for inclusion in the 2019 Focused Update. Included guidelines and systematic reviews were not independently (i.e. outside of what was performed by the authors) assessed for risk of bias.

Two independent reviewers screened article abstracts and the full text of articles for inclusion. Articles were included if they were about the psychosocial treatment.

The quality of the evidence represented by each research article was rated by two independent reviewers; systematic reviews and other qualitative articles were rated by one reviewer. Comparative trials were evaluated using the Cochrane Risk of Bias tool. Systematic reviews were rated using the AMSTAR-2. Other qualitative articles were evaluated using the AACODS Checklist for Grey Literature. Study methods and results were extracted by two independent reviewers. A document summarizing the findings of the literature review and the quality of sources used was prepared for the Guideline Committee Members to refer to during the statement rating process. Sources were included in the summary document if they were randomized controlled trials (RCT)s, systematic reviews of RCTs, or guidelines based on systematic reviews. In the absence of such evidence, lower quality evidence sources were included.