Effects of Interim Buprenorphine Treatment for opioid use disorder among emerging adults

Peck, Kelly R.; Ochalek, Taylor A.; Badger, Gary J.; Sigmon, Stacey C.

doi:10.1016/j.drugalcdep.2020.107879

Cited by 5 publications

(13 citation statements)

References 24 publications

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“…Emerging adult men also had a stronger preference for buprenorphine compared with older men. This is consistent with research demonstrating low‐barrier buprenorphine treatment as an effective and acceptable treatment for emerging adults 7 ; however, a comparison of rates of relapse between emerging and older adults is needed in the current trial in order to assess potential implications of preference. Preference for buprenorphine in emerging adult men may also indicate a need for better education on the availability of buprenorphine, better research on patient understanding of treatment options or perceptions of different medications for OUD, as well as research on provider perception of patient characteristics suited to medications for OUD (eg, providers may be less likely to prescribe buprenorphine to older patients or patients who have previous treatment episodes or have other concerns or preferences).…”

Section: Discussionsupporting

confidence: 82%

“…While psychiatric comorbidity is typically high among this population compared with the general population, especially among women, younger men may be more vulnerable to using opioids to cope with negative psychiatric symptoms at greater rates. Previous research with emerging adults with OUD has demonstrated that emerging adults enter treatment with more severe psychiatric problems compared with older adults, but they also demonstrate significant improvements in psychiatric and psychosocial (employment and legal) functioning during buprenorphine treatment 7 . This developmental phase of emerging adulthood is a critical period where substance use and mental health issue onset and exacerbation may occur, 6 As this population ages, we may see increased overall psychological comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, this study also adds to the existing research by examining whether any gender differences are similar (or different) between emerging and older adults. While the opioid overdose death rate is higher for older adults, 4 emerging adults in buprenorphine treatment appear to have unique characteristics and treatment needs 5,7 . Therefore, the aim of the present study was to explore gender differences in baseline demographic and clinical characteristics in emerging adult vs older adult individuals with OUD.…”

Section: Introductionmentioning

confidence: 97%

“…During emerging adulthood, individuals have the highest rates of residential instability compared with other age groups and do not identify as adolescents nor entirely as adults 3 . These characteristics may contribute to continued illicit opioid use during treatment and lower levels of buprenorphine treatment retention; however, not all studies have found buprenorphine treatment outcomes differ between emerging and older adults 7 . Large studies have demonstrated that emerging adults have inferior treatment retention and outcomes when compared with other age groups in multiple contexts, for example, with treatment outcomes for alcohol in comparison to older adults 8 and adolescents, 9 as well as higher rates of drug dependence and higher psychiatric symptoms compared with older adults 10 .…”

Section: Introductionmentioning

confidence: 99%

“…Large studies have demonstrated that emerging adults have inferior treatment retention and outcomes when compared with other age groups in multiple contexts, for example, with treatment outcomes for alcohol in comparison to older adults 8 and adolescents, 9 as well as higher rates of drug dependence and higher psychiatric symptoms compared with older adults 10 . Related to opioid use disorder (OUD), emerging adults enter treatment with more severe employment, legal, and psychiatric problems compared with older adults 7 …”

Section: Introductionmentioning

confidence: 99%

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Substance Use and Mental Health in Emerging Adult Vs Older Adult Men and Women With Opioid Use Disorder

et al. 2020

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Background and Objectives We examined age differences across genders in clinical characteristics in emerging adult (≤25 years) vs older adult patients (26+ years) with opioid use disorder (OUD). Methods Participants (N = 570; 30% female) entering a comparative effectiveness medication trial of buprenorphine vs extended‐release naltrexone. Results Differences in clinical characteristics in emerging adult vs older participants were similar across genders. However, women 26+ years reported more mental health problems compared with women ≤25, while men ≤25 years reported more mental health problems compared with men 26+ years. Discussion and Conclusion Different strategies for emerging adult and older patients seeking OUD treatment may be necessary to address psychiatric comorbidities that differ across genders in this population. Scientific Significance Comprehensive psychiatric assessment should be systematically included in OUD treatment for all genders. Treatment should focus on the emerging adult developmental phase when appropriate, with psychiatric treatment tailored for women and men, separately, across the lifespan. (Am J Addict 2020;29:536–542)

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Substance Use and Mental Health in Emerging Adult Vs Older Adult Men and Women With Opioid Use Disorder

et al. 2020

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Patient-Reported Goals of Youths in Canada Receiving Medication-Assisted Treatment for Opioid Use Disorder

et al. 2021

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IMPORTANCEIn the literature on opioid use disorder (OUD), opioid abstinence is used as an outcome measure for individuals receiving medication-assisted treatment (MAT), without consideration of patient-reported goals (PRGs).OBJECTIVES To identify common PRGs for youths receiving MAT for OUD and assess whether these patients achieve their stated goals. DESIGN, SETTING, AND PARTICIPANTSThis prospective cohort study examined data from 152 individuals aged 16 to 25 years (noninclusive) recruited between May 22, 2018, and March 11, 2020, from 45 outpatient MAT clinics in the Pharmacogenetics of Opioid Substitution Treatment Response study. Youths receiving MAT for OUD were included and were followed up for 3 months. EXPOSURES Medication-assisted treatment for OUD. MAIN OUTCOMES AND MEASURES The frequency of each PRG; the success of goal attainment, compared between those who reported specific PRGs and those who did not; and associations between reporting certain goals and achieving them. RESULTS Among the 152 youths in the study, 82 were male (53.9%), and the mean (SD) age was 22.8 (1.8) years. Ten overarching goals were identified, with the most common being to taper the dose of or stop MAT (96 [63.2%]), avoid use of recreational substances (71 [46.7%]), manage OUD symptoms (25 [16.4%]), live a normal life (14 [9.2%]), improve mental health (11 [7.2%]), and gain employment (8 [5.3%]). Overall, individuals who reported PRGs had similar odds of achieving themas those who did not for the goals of taper dose of or stop MAT (OR, 1.98; 95% CI, 0.88-4.46; P = .10), avoid recreational substances (OR, 1.34; 95% CI, 0.65-2.74; P = .43), manage OUD symptoms (β coefficient, -0.93; 95% CI, -4.24 to 2.38; P = .58), and improve mental health (β coefficient, -0.76; 95% CI, -6.31 to 4.78; P = .79). Furthermore, multivariable logistic regression showed that goals to taper the dose of or stop MAT (odds ratio, 1.90; 95% CI, 0.78-4.63; P = .16) or avoid recreational substances (odds ratio, 1.27; 95% CI, 0.60-2.67; P = .53) were not associated with achieving these respective outcomes. CONCLUSIONS AND RELEVANCEThis study suggests that youths have highly variable PRGs regarding MAT for OUD and that reporting a goal may not mean one is at higher odds of achieving it.There is a need to develop treatment plans that effectively incorporate PRGs. In addition, the finding that most youths aim to minimize or stop their MAT dose warrants the creation of a tapering protocol to guide clinicians. Because a diagnosis of OUD has substantial psychosocial implications in this population, clinicians must ensure that these dimensions of care are part of routine clinical practice.

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A Neuropharmacological Model to Explain Buprenorphine Induction Challenges

Greenwald

Herring²,

Perrone³

et al. 2022

Annals of Emergency Medicine

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Effects of Interim Buprenorphine Treatment for opioid use disorder among emerging adults

Cited by 5 publications

References 24 publications

Substance Use and Mental Health in Emerging Adult Vs Older Adult Men and Women With Opioid Use Disorder

Substance Use and Mental Health in Emerging Adult Vs Older Adult Men and Women With Opioid Use Disorder

Patient-Reported Goals of Youths in Canada Receiving Medication-Assisted Treatment for Opioid Use Disorder

A Neuropharmacological Model to Explain Buprenorphine Induction Challenges

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