Objectives: Opioid abuse and dependence rates continue to rise among US adolescents. Medication-assisted treatment with buprenorphine/naloxone (BUP/NAL) has been shown to be effective up to 12 weeks. Few data are available regarding extended treatment outcomes. The objective of this study was to describe 1-year retention and compliance of a specific pediatric, outpatient BUP/NAL treatment program for opioid-dependent adolescents and young adults.
Methods: Retrospective chart review was conducted of all opioid-dependent adolescents and young adults (N = 103) who sought treatment from January 12, 2010, to January 9, 2011. Participants were classified as prescription opioid-dependent or combined heroin/prescription opioid-dependent. Opioid abstinence and BUP/NAL compliance were assessed by urine drug screen (UDS) at each visit. A Kaplan-Meier curve was fit to describe patients' retention time over 1 year.
Results: Mean age was 19.2 ± 1.6 years, 50.5% male, 98.1% white non-Hispanic, and 31.9% prescription opioid-dependent. Overall rates of opioid abstinence and BUP/NAL compliance were high (85.2% and 86.6%, respectively). Seventy-five percent of patients returned for a second visit. Patient retention was 45% at 60 days and 9% at 1 year. Female sex (P < 0.05), negative UDS for opioids (P < 0.001) or tetrahydrocannabinol (P < 0.001), and positive UDS for BUP/NAL (P < 0.001) were associated with longer retention time.
Conclusions: Although patient retention was the largest barrier to success, a subset of opioid-dependent adolescents and young adults achieved long-term sobriety in our specific clinic program with continued outpatient BUP/NAL therapy. Retention correlated with UDS negative for opioids, negative for tetrahydrocannabinol, and positive for BUP/NAL.
From the Department of Pediatrics (SCM, AEB), The Ohio State University College of Medicine, Columbus, OH; Division of Adolescent Health Medicine (SCM, AEB), Nationwide Children's Hospital, Columbus, OH; Center for Clinical and Translational Research (GH, AEB), The Research Institute at Nationwide Children's Hospital, Columbus, OH; and Center for Biostatistics (MAR), The Ohio State University, Columbus, OH.
Send correspondence and reprint requests to Steven C. Matson, MD, Department of Clinical Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Division of Adolescent Health, 700 Children's Drive, G353 Timken Hall, Columbus, OH 43205. E-mail: firstname.lastname@example.org.
Funding/Support: None reported.
Poster presented at the Society for Adolescent Health and Medicine, March 14, 2013, Atlanta, GA.
Conflict of interest disclosures: None reported.
Received November 25, 2013
Accepted February 20, 2014