Scoping review of intervention studies to improve opioid and alcohol use outcomes and links to care following inpatient detoxification

Abstract

Background

Treatment following detoxification is recommended to promote recovery from alcohol (AUD) and opioid use disorder (OUD) yet less than half of detoxification patients attend follow-up treatment post-discharge. The current scoping review focused on the landscape of interventions designed to improve post-detoxification outcomes. The aim was to guide next steps in research and intervention development.

Methods

Of 6,419 articles screened, 100 met inclusion criteria. Studies’ participant diagnoses, intervention type, design, and other methodological features including outcomes were extracted and compared.

Results

Studies focused on OUD (51%), AUD (36%), or both (13%), and on improving substance use and/or treatment engagement/linkage to care. Medication was the most common intervention (55%), followed by psychological (26%), combined approaches (14%), technology (4%), or mutual help (1%). These proportions differed significantly between OUD and AUD studies and over time (medication was more common for OUD). Significant variability was found regarding research design, statistical power, measured outcomes, and exclusion criteria across AUD/OUD-focused studies.

Discussion

Studies’ focus on OUD is consistent with the rise of OUD and opioid overdose, but inconsistent with the higher prevalence and social impact of AUD. Although medication and psychological interventions were most common, emerging new intervention types, such as technology, warrant further attention. We provide recommendations to support future research based on the findings.

Keywords:

• Detoxification
• alcohol use disorder
• opioid use disorder
• treatment
• scoping review

Acknowledgements

The third and fourth author’s work on this project was funded by the Office of Academic Affiliations, U.S. Department of Veteran Affairs. The last author’s work was funded by VA HSR&D (RCS 00-001).

Disclosure statement

The authors report no conflicts of interest.