Opioid use disorder (OUD) is characterized by a lack of control in opioid use, resulting in psychological distress and deficits in interpersonal and social functioning. OUD is often associated with psychiatric comorbidities that increase the severity of the disorder. The consequences of OUD are dramatic in terms of increased morbi-mortality. Specific medications and psychotherapies are essential tools not only in the treatment of OUD but also in the prevention of suicide and overdoses. In our review, we assess the different types of psychotherapies (counseling, motivational interviewing, contingency management, cognitive-behavioral therapy, and dialectical-behavior therapy) that are delivered to opioid users, either associated or un-associated with OUD medications and/or medications for psychiatric disabilities. We describe the application of these therapies first to adult opioid users and then to adolescents. This work led us to propose a stepped-care model of psychotherapies for OUD which provided information to assist clinicians in decision-making regarding the selection of psychotherapeutic strategies according to patients’ OUD severity.

阿片类药物使用障碍（OUD）的特点是对阿片类药物的使用缺乏控制，导致心理困扰以及人际和社会功能缺陷。OUD 通常与精神合并症相关，这些合并症会增加疾病的严重程度。OUD 的后果是显着增加发病率。特定药物和心理治疗不仅是治疗 OUD 的重要工具，也是预防自杀和药物过量的重要工具。在我们的综述中，我们评估了向阿片类药物使用者提供的不同类型的心理治疗（咨询、动机访谈、应急管理、认知行为治疗和辩证行为治疗），无论是与 OUD 药物相关还是无关，和/或治疗精神障碍的药物。我们首先描述这些疗法对成年阿片类药物使用者的应用，然后对青少年进行描述。这项工作使我们提出了 OUD 心理治疗的阶梯式护理模型，该模型提供了信息，帮助临床医生根据患者 OUD 的严重程度选择心理治疗策略。