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The Carlat Addiction Treatment Report

Psychotherapy for Addiction | 2025

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Learning Objectives, Psychotherapy For Addiction, CATR, July/August/September 2025

July 1, 2025

After reading these articles, you should be able to…

Note From the Editor-in-Chief

July 31, 2025

Noah Capurso, MD, MHS

Drug overdose mortality has increased nearly every year since the overdose epidemic began three decades ago. However, 2024 saw an unprecedented drop in overdose deaths across the country. Researchers are working to better understand this change, but it is almost certain that increasing availability of naloxone, widespread adoption of harm reduction practices, and improving rates of MOUD treatment played important roles in this encouraging shift.

Substance Use Disorder Treatment: Medication or Psychotherapy?

July 1, 2025

Noah Capurso, MD, MHS

Psychotherapy and medication management are the two cornerstones of addiction treatment, but they are not equally effective across different substance use disorders. This article reviews evidence from both therapeutic approaches and introduces the concept of a treatment spectrum, with medication on one end and therapy on the other. This spectrum can be a useful framework when discussing treatment options with patients and in treatment planning.

Motivational Interviewing

July 1, 2025

Steve Martino, PhD

Dr. Martino breaks down the basic principles of motivational interviewing and gives us an insight into how it helps patients across the spectrum of substance use disorders.

Supporting Sobriety With 12-Step Facilitation

July 1, 2025

Joseph Nowinski, PhD

Dr. Nowinski explains the rationale behind the development of twelve-step facilitation (TSF) and how it blends traditional models of psychotherapy with peer support. He provides compelling evidence for its efficacy and presents data that TSF can even be superior to cognitive behavioral therapy and motivational enhancement therapy.

Brixadi: A New Long-Acting Buprenorphine Option for Opioid Use Disorder

July 1, 2025

Crystal Obiozor, MD and Noah Capurso, MD, MHS

A new long-acting injectable formulation of buprenorphine, Brixadi, is now available for the treatment of opioid use disorder. It is the second one to hit the market, after Sublocade. The two formulations share similarities, but there are some important differences to consider when choosing which medication to prescribe.

Buprenorphine Induction Using Long-Acting Injection

July 1, 2025

Noah Capurso, MD, MHS

Buprenorphine induction typically requires that a patient experience moderate opioid withdrawal before starting the medication in order to avoid precipitating severe withdrawal symptoms. This waiting period is uncomfortable and can be a treatment barrier. In this study, researchers develop and test an induction protocol using injectable buprenorphine that gets around this initial waiting period.

Starting Long-Acting Buprenorphine During Medical Hospitalization

July 31, 2025

Monthe Kofos, DO

Long-acting injectable formulations of buprenorphine can be a good treatment option for patients with opioid use disorder, particularly for those with poor adherence. However, starting long-acting injectable medications typically requires the patient to be on a stable dose of sublingual buprenorphine. Here, researchers demonstrate the feasibility of starting buprenorphine with a microinduction approach followed shortly by administration of a long-acting injection.