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Improvement in Psychopathology Among Opioid-dependent Adolescents During Behavioral-pharmacological Treatment

Moore, Sarah K. PhD; Marsch, Lisa A. PhD; Badger, Gary J. MS; Solhkhah, Ramon MD; Hofstein, Yariv PhD

Journal of Addiction Medicine:
doi: 10.1097/ADM.0b013e3182191099
Original Research
Abstract

Objective: To examine changes in behavioral and emotional problems among opioid-dependent adolescents during a 4-week combined behavioral and pharmacological treatment.

Methods: We examined scales of behavioral and emotional problems in youth using the Youth Self-Report measure at the time of substance abuse treatment intake and changes in scale scores during treatment participants were 36 adolescents (aged 13–18 years, eligible) who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for opioid dependence. Participants received a 28-day outpatient, medication-assisted withdrawal with either buprenorphine, or clonidine, as part of a double-blind, double dummy comparison of these medications. All participants received a common behavioral intervention, composed of 3 individual counseling sessions per week, and incentives contingent on opioid-negative urine samples (collected 3 times/week) attendance and completion of weekly assessments.

Results: Although a markedly greater number of youth who received buprenorphine remained in treatment relative to those who received clonidine, youth who remained in treatment showed significant reductions during treatment on 2 Youth Self-Report grouping scales (internalizing problems and total problems) and 4 of the empirically based syndrome scales (somatic, social, attention, and thought). On Youth Self-Report competence and adaptive scales, no significant changes were observed. There was no evidence that changes in any scales differed across medication condition.

Conclusions: Youth who were retained demonstrated substantive improvements in a number of clinically meaningful behavioral and emotional problems, irrespective of pharmacotherapy provided to them.

Author Information

From the National Development and Research Institutes, Inc (SKM, LAM), New York, NY; Medical Biostatistics (GJB), University of Vermont, Burlington, VT; Department of Psychiatry, Jersey Shore University Medi-cal Center; and the Department of Psychiatry, UMDNJ—Robert Wood Johnson Medical School (RS), Department of Psychiatry, Brooklyn, NY; and The Child and Family Institute (YH), St Lukes-Roosevelt Hospital, New York, NY.

Send correspondence and reprint requests to Sarah K. Moore, PhD, National Development and Research Institutes, Inc, 71 W 23rd St, 8th Floor, New York, NY 10010. E-mail: Moore@ndri.org.

Portions of this article were presented at the annual conference of the College on Problems of Drug Dependence on June 16, 2010, in Scottsdale, AZ.

Supported by grants from the National Institute on Drug Abuse, National Institutes of Health (Grants R03 DA 14570, 1R01 DA 018297; Principal Investigator: Lisa A. Marsch, PhD).

Received July 09, 2010

Accepted March 01, 2011

© 2011 American Society of Addiction Medicine