During the past 15 years, the United States has seen a rapid increase in the rates of chronic prescription opioid and heroin use.
During the past 15 years, the United States has seen a rapid increase in the rates of chronic prescription opioid and heroin use.
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In the scope of this growing problem, emerging adults, ages 18 – 25, stand out for two reasons:
While opioid replacement therapy (i.e.,buprenorphine/naloxone or “suboxone”) is considered first-line treatment for opioid use disorders, a recent study showed emerging adults are less likely to remain in treatment, and have poorer outcomes relative to their older adult counterparts.
Schuman-Olivier and colleagues compared 292 emerging adults in residential treatment for a substance use disorder by their opioid use status:
to evaluate substance use and continuing care participation in the year following discharge from the treatment program.
Treatment was based on the 12-step Minnesota Model and also used motivational enhancement, cognitive-behavioral therapy, and family-based therapeutic approaches. Patients were assessed at baseline, end of treatment, and 3, 6, and 12 months after discharge. The average length of stay in treatment was 26 days, and 84% of discharges were staff approved. The three groups were similar on all demographic characteristics at the start of the study. 95% of participants were Caucasian, about 75% were male, and all were single. The average age was 20 years.
Regarding clinical variables at admission, OD had significantly higher levels of dependence severity than both OM and NO, and OM was significantly more likely to meet the criteria for polysubstance dependence than the other two groups. OD was more likely to report heroin as the only form of opioid used recently, while OM was more likely to have recently only used prescription opioids.
During treatment, all groups showed significant beneficial increases in psychological variables which are often the target of psychosocial treatment, such as levels of commitment to sobriety, abstinence self-efficacy, coping skills, and intention to attend 12-step mutual help organizations, as well as significant decreases in psychiatric symptoms (see figure below).
The opioid dependence (OD) group attended significantly more outpatient sessions than no misuse (NO) during follow-up. Non-dependent misuse (OM) reported more substance use and lower abstinence rates than the other two groups during the 12-month follow-up period.
Additionally, the use of substances (e.g., cannabis, alcohol) for all participants increased significantly over time, suggesting that the benefits of single episodes of acute treatment diminish over time, and more effective ways of engaging young adults in some form of continuing care are needed.
In light of the recent opioid epidemic, it is important to consider all potentially effective treatment options as some individuals might not want to try medications like suboxone. They also may have other risks (e.g., suicidal intent) or be suffering from additional psychiatric problems that may necessitate a residential stay.
The current study showed that an extended-release naltrexone implant may provide an evidence-based strategy to increase treatment retention and reduce relapse. Importantly, it provides a longer window of protection relative to the month-long injection formulation approved by the US Food and Drug Administration (i.e, Vivitrol).
Those who misuse opioids but do not meet dependence criteria may require special clinical attention. These individuals had higher addiction severity and consequences relative to those without opiate use – associated with heightened relapse risk – but less than those with dependence, suggesting limited insight about this increased risk.
l
In the scope of this growing problem, emerging adults, ages 18 – 25, stand out for two reasons:
While opioid replacement therapy (i.e.,buprenorphine/naloxone or “suboxone”) is considered first-line treatment for opioid use disorders, a recent study showed emerging adults are less likely to remain in treatment, and have poorer outcomes relative to their older adult counterparts.
Schuman-Olivier and colleagues compared 292 emerging adults in residential treatment for a substance use disorder by their opioid use status:
to evaluate substance use and continuing care participation in the year following discharge from the treatment program.
Treatment was based on the 12-step Minnesota Model and also used motivational enhancement, cognitive-behavioral therapy, and family-based therapeutic approaches. Patients were assessed at baseline, end of treatment, and 3, 6, and 12 months after discharge. The average length of stay in treatment was 26 days, and 84% of discharges were staff approved. The three groups were similar on all demographic characteristics at the start of the study. 95% of participants were Caucasian, about 75% were male, and all were single. The average age was 20 years.
Regarding clinical variables at admission, OD had significantly higher levels of dependence severity than both OM and NO, and OM was significantly more likely to meet the criteria for polysubstance dependence than the other two groups. OD was more likely to report heroin as the only form of opioid used recently, while OM was more likely to have recently only used prescription opioids.
During treatment, all groups showed significant beneficial increases in psychological variables which are often the target of psychosocial treatment, such as levels of commitment to sobriety, abstinence self-efficacy, coping skills, and intention to attend 12-step mutual help organizations, as well as significant decreases in psychiatric symptoms (see figure below).
The opioid dependence (OD) group attended significantly more outpatient sessions than no misuse (NO) during follow-up. Non-dependent misuse (OM) reported more substance use and lower abstinence rates than the other two groups during the 12-month follow-up period.
Additionally, the use of substances (e.g., cannabis, alcohol) for all participants increased significantly over time, suggesting that the benefits of single episodes of acute treatment diminish over time, and more effective ways of engaging young adults in some form of continuing care are needed.
In light of the recent opioid epidemic, it is important to consider all potentially effective treatment options as some individuals might not want to try medications like suboxone. They also may have other risks (e.g., suicidal intent) or be suffering from additional psychiatric problems that may necessitate a residential stay.
The current study showed that an extended-release naltrexone implant may provide an evidence-based strategy to increase treatment retention and reduce relapse. Importantly, it provides a longer window of protection relative to the month-long injection formulation approved by the US Food and Drug Administration (i.e, Vivitrol).
Those who misuse opioids but do not meet dependence criteria may require special clinical attention. These individuals had higher addiction severity and consequences relative to those without opiate use – associated with heightened relapse risk – but less than those with dependence, suggesting limited insight about this increased risk.
l
In the scope of this growing problem, emerging adults, ages 18 – 25, stand out for two reasons:
While opioid replacement therapy (i.e.,buprenorphine/naloxone or “suboxone”) is considered first-line treatment for opioid use disorders, a recent study showed emerging adults are less likely to remain in treatment, and have poorer outcomes relative to their older adult counterparts.
Schuman-Olivier and colleagues compared 292 emerging adults in residential treatment for a substance use disorder by their opioid use status:
to evaluate substance use and continuing care participation in the year following discharge from the treatment program.
Treatment was based on the 12-step Minnesota Model and also used motivational enhancement, cognitive-behavioral therapy, and family-based therapeutic approaches. Patients were assessed at baseline, end of treatment, and 3, 6, and 12 months after discharge. The average length of stay in treatment was 26 days, and 84% of discharges were staff approved. The three groups were similar on all demographic characteristics at the start of the study. 95% of participants were Caucasian, about 75% were male, and all were single. The average age was 20 years.
Regarding clinical variables at admission, OD had significantly higher levels of dependence severity than both OM and NO, and OM was significantly more likely to meet the criteria for polysubstance dependence than the other two groups. OD was more likely to report heroin as the only form of opioid used recently, while OM was more likely to have recently only used prescription opioids.
During treatment, all groups showed significant beneficial increases in psychological variables which are often the target of psychosocial treatment, such as levels of commitment to sobriety, abstinence self-efficacy, coping skills, and intention to attend 12-step mutual help organizations, as well as significant decreases in psychiatric symptoms (see figure below).
The opioid dependence (OD) group attended significantly more outpatient sessions than no misuse (NO) during follow-up. Non-dependent misuse (OM) reported more substance use and lower abstinence rates than the other two groups during the 12-month follow-up period.
Additionally, the use of substances (e.g., cannabis, alcohol) for all participants increased significantly over time, suggesting that the benefits of single episodes of acute treatment diminish over time, and more effective ways of engaging young adults in some form of continuing care are needed.
In light of the recent opioid epidemic, it is important to consider all potentially effective treatment options as some individuals might not want to try medications like suboxone. They also may have other risks (e.g., suicidal intent) or be suffering from additional psychiatric problems that may necessitate a residential stay.
The current study showed that an extended-release naltrexone implant may provide an evidence-based strategy to increase treatment retention and reduce relapse. Importantly, it provides a longer window of protection relative to the month-long injection formulation approved by the US Food and Drug Administration (i.e, Vivitrol).
Those who misuse opioids but do not meet dependence criteria may require special clinical attention. These individuals had higher addiction severity and consequences relative to those without opiate use – associated with heightened relapse risk – but less than those with dependence, suggesting limited insight about this increased risk.
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