Determining the Effectiveness of Acceptance and Commitment Therapy on the Substance Use Tendency and the Difficulties in Emotion Regulation of Patients Addicted to Opiates

Opioid addiction has become a global concern in recent years. It is estimated that 26.8 million people worldwide have an opioid use disorder. In addition, there are more than 100000 opioid overdose deaths each year. Over time, repeated use of addictive substances activates neural pathways related to reward processing, and the individuals become sensitive and conditioned to the symptoms associated with substance use. As a result, exposure to drug–related cues stimulates a person's mental craving. Also, studies report a high rate of psychological problems in drug users, such as difficulties in emotion regulation. One of the treatments recommended today in the field of substance abuse is acceptance and commitment therapy. Studies have shown the effectiveness of this treatment in reducing the substance use tendency and the difficulties in emotion regulation of people addicted to opioids. This study aimed to determine the efficacy of acceptance and commitment therapy on substance use tendencies and the difficulties in emotion regulation of patients addicted to opiates.

The present quasi–experimental study employed a pretest–posttest and a two–month follow–up design with a control group. The study's statistical population included all people with drug abuse who were referred to addiction treatment centers in Rasht City, Iran, in 2021. A sample of 30 qualified volunteers was included in the study by cluster random sampling and divided into the intervention and control groups. Data were collected using the addiction potential scale (Weed et al., 1992) and difficulties in emotion regulation scale (Gratz & Roemer, 2004). The "addiction acknowledgment" scale was used to measure the simultaneous criterion validity of the "addiction potential" scale, and the correlation was reported as 0.75. Also, the test–retest reliability values were 0.69 in men and 0.77 in women. Furthermore, six subscales were identified in the measurement of construct validity by confirmatory factor analysis in Gertz and Romer's study. Also, reliability was obtained by calculating the Cronbach alpha coefficient in subscales, which was found between 0.85 and 0.89. The "acceptance and commitment therapy" intervention was performed on the experimental group for 12 90–minute sessions once a week. The control group did not undergo any psychotherapy at the same time. After administering the posttest and follow–up, the research data were analyzed using repeated measures analysis of variance and Bonferroni post hoc test in the SPSS23 software (α=0.05).

The group*time interaction effect in the analysis of variance was significant for the variables of substance use tendency and difficulties in emotion regulation (p<0.05). These results indicate that the control and experimental groups differed substantially in the pretest, posttest, and follow–up phases. The findings showed that in the pretest, there was no difference between the acceptance and commitment therapy group and the control group in the score of substance use tendency (p>0.05). Therefore, the two groups were similar. In the posttest, a significant difference was found between the acceptance and commitment therapy group and the control group in the substance use tendency score (p<0.05). This finding implies that the acceptance and commitment therapy outperformed the control group in decreasing the substance use tendency of patients to opiates. In the pretest, there was no difference in the difficulties in emotion regulation between the acceptance and commitment therapy group and the control group (p>0.05). Therefore, the two groups were similar. In the posttest, a significant difference was found between the acceptance and commitment therapy group and the control group in the difficulties in emotion regulation score (p<0.05). This finding implies that the acceptance and commitment therapy outperformed the control group in decreasing difficulties in emotion regulation of patients addicted to opiates. Finally, at the follow–up, all changes were still stable in the experimental group (p<0.05).

acceptance and commitment therapy is effective on the substance use tendency and the difficulties in emotion regulation of patients addicted to opiates. It is suggested that addiction therapists use the above method to improve and prevent relapse of patients with opiates.