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Buprenorphine Treatment for Adolescents and Young Adults With Opioid Use Disorders

A Narrative Review

Borodovsky, Jacob T., BA; Levy, Sharon, MD, MPH; Fishman, Marc, MD; Marsch, Lisa A., PhD

doi: 10.1097/ADM.0000000000000388
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In the past decade, a new cohort of adolescents and young adults with opioid use disorders (OUD) has emerged. While medications and psychosocial treatments are available, few adolescents and young adults with OUD can access and remain in treatment. Effective, practical, and scalable treatment paradigms for this young population are needed. Buprenorphine is a medication with unique pharmacological and regulatory characteristics that make it a promising component of adolescent and young adult OUD treatment models. Three randomized controlled trials and multiple observational studies have evaluated the use of buprenorphine to treat this population. However, data from these studies have not been consolidated into an up-to-date summary that may be useful to clinicians. The objective of this narrative review is to inform clinical practice by summarizing results of primary and secondary analyses from randomized controlled clinical trials and observational studies that have evaluated the use of buprenorphine to treat adolescents and young adults with OUD. Based on results from these studies, we encourage the conceptualization of OUD among youth as a chronic medical condition requiring a long-term management strategy. This includes treatment with buprenorphine in conjunction with medication-prescribing protocols that do not necessarily require daily clinic attendance for observed medication adherence. However, more study of treatment delivery models, addressing such issues as medication adherence and intensity requirements, is needed to determine practices that optimize outcomes for youth.

Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, NH (JTB, LAM); The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Geisel School of Medicine, Lebanon, NH (JTB); Adolescent Substance Abuse Program, Boston Children's Hospital, Boston, MA (SL); Department of Pediatrics, Harvard Medical School, Boston, MA (SL); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (MF); Maryland Treatment Centers, Baltimore, MD (MF).

Send correspondence to Jacob T. Borodovsky, BA, Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Lebanon, NH 03766. E-mail: Jacob.t.borodovsky.gr@dartmouth.edu.

Received 12 August, 2016

Accepted 8 January, 2018

JTB is a PhD candidate funded by NIH T32 training grant: 5T32DA037202-02. LAM recently joined an addiction and pain scientific advisory board at Purdue Pharma. MF is a consultant for Alkermes and US World Meds.

Portions of this work were presented at the 2015 College on Problems of Drug Dependence Conference in Phoenix AZ.

The funding sources had no involvement in the study design; collection, analysis, and interpretation of data; writing of the report; or in the decision to submit the article for publication.

The authors report no conflicts of interest.

Ā© 2018 American Society of Addiction Medicine