In the ongoing battle against opioid addiction, one of the most daunting challenges remains ensuring consistent engagement with medication-assisted treatments. Medications for opioid use disorder (MOUD) have transformed the landscape of addiction therapy, offering a scientifically validated path to recovery. Yet, despite their proven efficacy, patient retention in these treatments remains alarmingly low, limiting their potential impact. Amidst this backdrop, a novel approach that bolsters support systems surrounding individuals undergoing treatment has captured the attention of researchers and clinicians alike. A recent study brings forward compelling evidence about the role of Community Reinforcement and Family Training (CRAFT) interventions, specifically targeting the “concerned significant others” (CSOs) of individuals on MOUD, highlighting new avenues for enhancing treatment adherence and outcomes.
CRAFT, an evidence-based behavioral intervention, uniquely focuses on empowering family members and close friends—those who care deeply for individuals battling substance use disorder. Unlike traditional interventions that center solely on the patient, CRAFT recognizes the powerful influence of social support networks, turning concerned significant others into active allies in the recovery process. The intervention offers training to CSOs on how to effectively communicate, encourage treatment compliance, and manage their own stress, thereby fostering a healthier environment for recovery. Although CRAFT has been documented to boost treatment engagement among people with various substance use disorders, its availability remains limited, particularly within the context of opioid use disorder and MOUD programs.
The study, published in the 2025 volume of BMC Psychiatry, sets out with a distinctive goal: to not only gauge interest among CSOs in participating in a CRAFT-informed group intervention but also to unravel their preferences regarding the format and content of such a program. The investigation unravels a critical question—how willing are family members and friends of patients receiving office-based MOUD to engage in structured, skills-based group support, and what might optimize their involvement?
Researchers began their inquiry by recruiting patients receiving MOUD from outpatient clinics. These patients were asked to identify CSOs who might be interested in participating in a group designed around the CRAFT model. This initial phase revealed a striking figure: over half the patients listed a concerned significant other, emphasizing the pervasive presence of supportive networks in this patient population. This identification served as a portal into a deeper examination of CSO perspectives.
Out of 36 CSOs contacted, 14 agreed to participate in virtual interviews, based on a semi-structured guide aimed at elucidating both reasons behind interest in participation and specific preferences for the intervention’s delivery. The use of virtual interviews in this study not only ensured accessibility but also reflected an increasingly digital approach to healthcare communication—a factor that itself may influence future intervention designs.
The data emerging from these interviews painted a unified picture: every participant expressed a keen interest in joining the proposed group intervention. Central motivations included a desire to acquire practical skills—ranging from communication techniques to managing the challenging behaviors associated with opioid use disorder—as well as the need for evidence-based education about addiction and recovery. Beyond knowledge acquisition, participants emphasized the emotional value of connecting with others navigating similar familial struggles, highlighting a crucial peer support dimension.
Notably, preferences regarding the logistics of group sessions leaned heavily towards virtual meetings scheduled in the evenings or on weekends. This preference suggests that flexibility and convenience play a pivotal role in engaging CSOs, who often juggle multiple responsibilities including work, childcare, and caregiving demands. The virtual format also holds promise for scaling such interventions beyond traditional geographic constraints, potentially reaching a broader demographic of concerned family members.
This investigation carries significant implications for clinical practice and public health strategies addressing the opioid crisis. By affirming substantial interest and clarifying preferences among CSOs, it supports the integrative approach of incorporating family and friends into treatment paradigms. Moreover, it underscores the feasibility of implementing such group interventions led by MOUD nurse care managers, positioning them as accessible points of contact in the continuum of care.
Beyond the immediate parameters of the study, these findings dovetail with an evolving understanding of addiction treatment as an ecosystem involving patients, caregivers, and healthcare providers. Empowering CSOs not only harnesses untapped sources of support but also potentially mitigates feelings of isolation and helplessness often experienced by families grappling with substance misuse disorders.
The significance of this research extends further, providing a template for the development of pilot studies examining CRAFT-based group interventions at scale. The methodical identification of participant priorities and barriers lays the groundwork for tailoring programs that resonate with real-world needs, thereby enhancing acceptability and sustainability.
Importantly, the research invites reflection on the systemic challenges that have historically limited CSO involvement in addiction care. Institutional and resource constraints, stigma, and lack of targeted programming have all contributed to underutilization of family-based interventions. This study’s clear demonstration of CSO interest presents a compelling argument for expanding resources and training to support this dimension of care.
While further investigation is warranted to assess the quantitative impact on patient retention and recovery outcomes, the evidence provided here seeds optimism. Integrating CRAFT-informed group support for CSOs can foster a more resilient and informed care network and may ultimately translate to improved treatment retention and patient well-being.
As the opioid epidemic continues to exact a heavy toll worldwide, innovative strategies addressing the human and social facets of addiction are critically needed. This emerging paradigm, which amplifies the voices and capacities of those who stand beside individuals struggling with opioid use disorder, heralds a promising horizon. By embracing family and friends as vital partners in the recovery journey, healthcare systems can aspire to not only better clinical metrics but also more compassionate, effective care.
Subject of Research: Interest and preferences of concerned significant others (CSOs) in a Community Reinforcement and Family Training (CRAFT)-based group intervention targeting individuals receiving office-based medications for opioid use disorder (MOUD).
Article Title: “All I want is the best for my brother”: interest in a Community Reinforcement and Family Training (CRAFT)-based group intervention among concerned significant others of individuals on office-based medications for opioid use disorder
Article References:
Owens, M.D., Adwell, A., Singh, S. et al. “All I want is the best for my brother”: interest in a Community Reinforcement and Family Training (CRAFT)-based group intervention among concerned significant others of individuals on office-based medications for opioid use disorder. BMC Psychiatry 25, 748 (2025). https://doi.org/10.1186/s12888-025-07132-4
Image Credits: AI Generated
DOI: https://doi.org/10.1186/s12888-025-07132-4
