The impact of family engagement in opioid assisted treatment: Results from a randomised controlled trial.

Al Ghafri, Hamad; Hasan, Nael; Elarabi, Hesham Farouk; Radwan, Doa; Shawky, Mansour; Al Mamari, Samya; Abdelgawad, Tarek; El Rashid, Abuelgasim; Kodera, Ayman; Al Kathiri, Helal; Lee, Amanda J; Wanigaratne, Shamil

BACKGROUND Family interventions in substance use disorders (SUD) treatment is limited despite the evidence for benefits. Providing family interventions is hampered by patient resistance, social stigma, logistics and factors related to the capacity of the treatment programmes. AIMS The purpose of the study was to examine the association between family engagement in treatment, and opioid use defined by percentage negative opioid screen and rate retention in treatment defined by completion of study period. METHODS Data from a 16-week outpatient randomised controlled trial (RCT) of 141 adults with opioid use disorder (OUD) receiving Opioid Assisted Treatment (OAT) using buprenorphine/naloxone film (BUP/NX-F) was, used to examine the association between family engagement in and opioid use and rate of retention in treatment. Multiple logistic regression was, applied to examine the independent prediction of family engagement on opioid use and rate retention in treatment. RESULTS Family engagement was significantly associated with retention in treatment (Spearman's rho 0.25, p < 0.01) and was subsequently found to increase the likelihood of retention in treatment by approximately 3-fold (adjusted odds ratio (OR) 2.95, 95% CI 1.31-6.65). CONCLUSION Family engagement in treatment is an independent predictor of retention in treatment but not opioid use in adults receiving OAT. It is, recommended that SUD treatment programmes integrate family related interventions in mainstream treatment. Delivering a personalised multicomponent family programme using digitised virtual communications that has been increasingly utilised during the Covid-19 pandemic is highly suggested.