Effectiveness of Psychosocial Interventions for Drug Use Disorders in Inpatient Settings: A Systematic Review.

Background

Drug use disorders are a major public health concern. Although inpatient care can reduce exposure to drug-related cues, the effectiveness of psychosocial interventions is unclear. This systematic review synthesized randomized controlled trials (RCTs) of inpatient psychosocial interventions for drug use disorders.

Methods

Following the PRISMA 2020 guidelines, we searched PubMed, Embase, the Cochrane Library, and PsycINFO from inception to August 20, 2024, for RCTs of psychosocial interventions for drug use disorders and then screened for trials conducted in inpatient settings. Reviewer pairs screened records, extracted data, and assessed risk of bias. Given heterogeneity in interventions and outcomes, we synthesized findings narratively.

Results

Eleven RCTs evaluated cognitive-behavioral, motivational, mindfulness-based, emotion-regulation, pharmacotherapy-supported psychosocial, and activity-based approaches in diverse clinical settings and populations. One trial was interpreted cautiously because the participants' primary substances were not identified. Several trials reported beneficial effects on short-term or proximal outcomes (e.g., craving and treatment motivation), especially when intervention components extended beyond discharge, whereas other trials showed no benefit or worse outcomes. Study quality was variable; small sample sizes, lack of blinding, and inconsistent follow-up were common issues.

Conclusions

Inpatient psychosocial interventions may contribute to improvements in short-term or proximal outcomes (e.g., motivation/engagement and craving) and may support linkage to continuing care, but the evidence for sustained post-discharge abstinence or relapse prevention is limited and mixed. Larger, methodologically robust trials with standardized outcomes and longer follow-up are needed.