Time-lagged association between counseling and/or 12-Step attendance with subsequent opioid use in a secondary analysis from a randomized, clinical trial of medications for opioid use disorder

•Counseling and 12-Step attendance were associated with later reduced opioid use.•Associations between psychosocial support and use grew over weeks of the trial.•12-Step had a larger association with reduced opioid use for those on naltrexone.•Group counseling had larger association with reduced use for buprenorphine-naloxone.•Relationship between psychosocial support and use are not causal; may be reciprocal.