Inpatient Buprenorphine-Assisted Withdrawal for Treatment of Vulnerable Adolescents with Opioids Use Disorder in Zahedan, Iran: An Observational Study

Abstract

Background: There are limited data supporting the effectiveness of buprenorphine treatment for opioid use disorder among adolescents. Objectives: The aim of this study was to investigate the outcomes of using buprenorphine for inpatient medically assisted withdrawal of vulnerable adolescents with opioid use disorder. Methods: Twelve consecutive vulnerable adolescents due to working or living in streets were admitted to the Child and Adolescent Psychiatric Ward of Ali Ibn-e-Abi Talib Hospital for treatment of opioid use disorder using buprenorphine-assisted withdrawal. The clinical chart abstraction of patients' files was made to provide the baseline situation of the patients, as well as treatment progress at discharge and one and three months post-discharge. Results: All the complaints of pain and other withdrawal signs and symptoms decreased dramatically within the first four days of treatment. At one-month follow-up, all study participants were still in the foster care and the urine tests for morphine and methamphetamine were negative. At the three-month follow-up, the older sister of the only one 15-year-old adolescent took the responsibility of his guardianship. The urine tests of all study participants were negative in month 3. Conclusions: Medically managed opioid withdrawal must be considered only as a part of a comprehensive psychosocial program providing a stable living environment, adolescent welfare, and custody services. The treatment program also proved its safety and effectiveness for the management of pain and other opioid withdrawal signs and symptoms among adolescents.