Personality Targeted Interventions: Potential to Reduce Polysubstance Use and Improve Mental Health Among People Receiving Opioid Agonist Therapy (OAT)

The four-factor personality model for substance use includes traits (i.e., impulsivity, sensation seeking, anxiety sensitivity, and negative thinking) that are robustly implicated in harmful patterns of substance use amongst teens, adolescents, and young adults. Previous evidence supports the effectiveness of brief psychosocial interventions that target these four personality traits. These interventions have been shown to reduce substance use, anxiety, depression, and criminal behaviour in a series of randomized controlled trials conducted around the world. Expanding access to such personality-based interventions offers an opportunity to improve health outcomes for Canadian adults struggling with substance use.


The toxic drug crisis continues to devastate individuals, families, and communities across Canada, with more than 30,000 opioid-related deaths recorded from January 2016 to March 2023. Dangerous patterns of prescription opioid use remain a major health threat, and opioid use disorder (OUD) is now one of the greatest challenges facing the Canadian health care system. Clients with OUD frequently present with concurrent risky use of numerous other drugs and high rates of comorbid alcohol, anxiolytic/sedative, stimulant (cocaine/ amphetamines, and cannabis use disorders.
Treatment for OUD generally involves pharmacological treatments such as opioid agonist therapy (OAT). While OAT has had well-documented positive harm reduction effects in decreasing illicit opioid use, overdose mortality, and bloodborne infections (HIV/HCV), adjunct psychosocial approaches may curb polysubstance use, increase OAT retention, and reduce overdose events, providing new solutions to the ongoing toxic drug crisis. Clinical practice guidelines for management of OUD, released by the Canadian Psychological Association’s Opioid Taskforce and the Canadian Research Initiative on Substance Misuse network (CRISM) have advocated for the implementation of psychosocial treatments as adjunctive interventions in opioid addiction medicine.
PreVenture, a psychosocial intervention for targeting polysubstance use, has recently been adapted to OUD clients in the OAT clinic context; this adaptation has been named “OpiVenture”. The U.S. National Institute of Health’s (NIH’s) ORBIT model for psychosocial and behavioral treatment development provides guidance through four phases for improving the systematic development of new behavioral interventions.


Phase 1 - Development and Intervention Adaptation

Phase 1a focused on establishing whether the four-factor model’s personality traits are related to harmful substance use patterns in OAT clients. It also aimed to gather information from clients and service providers on the steps that need to be taken to adapt existing interventions for this population. We also gathered stories from clients to use as the basis for creating realistic scenarios and artwork in the adapted manuals. Once the personality model was validated for use in this population (i.e., showing that personality was related to polysubstance use, motives for use, and mental health concerns in this population), we could move to Phase 1b of intervention adaptation. Due to the clear need for more effective psychosocial interventions to supplement OAT, we adapted a well-supported personality-targeted intervention program, PreVenture, to OUD clients in the OAT clinic context (i.e., “OpiVenture”).


  1. Validate the four-factor personality model for substance use among OAT clients.
  2. Gather relevant information, analyze, and strategize the effective adaptation of an existing intervention plan to use with OAT clients.
  3. Adapting intervention manuals based on information obtained from (1) and (2)


Phase 1a: CRISM – Canadian Research Initiative in Substance Misuse Quebec-Atlantic
Phase 1b: Strategy for Patient-Oriented Research -CIHR


Phase 2 & 3 - Feasibility and Pilot Study

Preliminary testing of the feasibility of the intervention, OpiVenture, takes place in phase 2 and pilot testing in phase 3 which we combined into a single step. The feasibility criteria of acceptability, demand, practicality, adaptation, and integration will be evaluated using a set of author-compiled questionnaires and semi-structured qualitative interviews with OAT clients and facilitators, and clinic directors. The interventions are pilot tested with the intended clients and pre-to-post change is measured on outcomes such as polysubstance use and mental health.

  1. Determine the adapted psychosocial intervention’s (a) preliminary effect and (b) feasibility in an OAT client setting using both quantitative and qualitative methods.
  2. Inform the feasibility of a future, full-scale randomized control trial.

CIHR Project Grant
Canadian Research Initiative in Substance Misuse (CRISM) Atlantic Demonstration Project


Phase 4 - Randomized Control Trial (Phase 2/3 completion dependent)

After successful implementation and confirmed feasibility and preliminary effectiveness of the program in previous phases, the next step would be to evaluate the program using a randomized controlled trial with an adequately large sample size to inform decision-making on the program’s efficacy.




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