Mehran Motamed1, Lisa A Marsch, Ramon Solhkhah, Warren K Bickel, Gary J Badger. 1. From the Department of Psychiatry (MM, LAM, RS), St. Luke's-Roosevelt Hospital Center, New York, NY; National Development and Research Institutes (LAM), New York, NY; University of Arkansas for Medical Sciences (WKB), Little Rock, AR; and Department of Medical Biostatistics (GJB), University of Vermont, Burlington, VT.
Abstract
OBJECTIVE: : This study was designed to examine the extent to which heroin-dependent and prescription opioid-dependent adolescents experienced differential outcomes during a clinical trial designed to evaluate combined behavioral-pharmacological treatment. METHODS: : Participants were a volunteer sample of 36 adolescents who met DSM-IV criteria for opioid-dependence (ages 13-18 years eligible), 53% of which were heroin-dependent and 47% of which were dependent on prescription opioids used for nonmedical purposes. Participants received a 28-day, outpatient, medication-assisted withdrawal with the partial opioid agonist, buprenorphine, or the centrally active μ-adrenergic blocker, clonidine, along with behavioral counseling and incentives contingent on opioid abstinence. Heroin-dependent and prescription opioid-dependent participants were compared on baseline characteristics and treatment outcomes, which included retention, opioid abstinence, HIV risk behavior, opioid withdrawal, and medication effects. RESULTS: : Heroin-dependent and prescription opioid-dependent youth had similar characteristics at intake. Heroin-dependent youth had higher baseline rates of drug-related HIV risk behavior and greater opioid withdrawal before receiving medication during treatment; however, this same group showed markedly greater improvements on these domains during treatment relative to prescription opioid-dependent youth. Both participant groups showed comparable outcomes based on clinically meaningful measures of treatment retention and opioid abstinence. Both heroin-dependent and prescription opioid-dependent youth who received buprenorphine experienced markedly better treatment outcomes relative to those who received clonidine. CONCLUSIONS: : These results demonstrate that combined behavioral and buprenorphine treatment seems safe and efficacious in the treatment of both heroin-dependent and prescription opioid-dependent adolescents and provide novel information relating to treatment outcomes for these subgroups of opioid-dependent youth.
OBJECTIVE: : This study was designed to examine the extent to which heroin-dependent and prescription opioid-dependent adolescents experienced differential outcomes during a clinical trial designed to evaluate combined behavioral-pharmacological treatment. METHODS: : Participants were a volunteer sample of 36 adolescents who met DSM-IV criteria for opioid-dependence (ages 13-18 years eligible), 53% of which were heroin-dependent and 47% of which were dependent on prescription opioids used for nonmedical purposes. Participants received a 28-day, outpatient, medication-assisted withdrawal with the partial opioid agonist, buprenorphine, or the centrally active μ-adrenergic blocker, clonidine, along with behavioral counseling and incentives contingent on opioid abstinence. Heroin-dependent and prescription opioid-dependent participants were compared on baseline characteristics and treatment outcomes, which included retention, opioid abstinence, HIV risk behavior, opioid withdrawal, and medication effects. RESULTS: : Heroin-dependent and prescription opioid-dependent youth had similar characteristics at intake. Heroin-dependent youth had higher baseline rates of drug-related HIV risk behavior and greater opioid withdrawal before receiving medication during treatment; however, this same group showed markedly greater improvements on these domains during treatment relative to prescription opioid-dependent youth. Both participant groups showed comparable outcomes based on clinically meaningful measures of treatment retention and opioid abstinence. Both heroin-dependent and prescription opioid-dependent youth who received buprenorphine experienced markedly better treatment outcomes relative to those who received clonidine. CONCLUSIONS: : These results demonstrate that combined behavioral and buprenorphine treatment seems safe and efficacious in the treatment of both heroin-dependent and prescription opioid-dependent adolescents and provide novel information relating to treatment outcomes for these subgroups of opioid-dependent youth.
Authors: Diane Warden; Geetha A Subramaniam; Thomas Carmody; George E Woody; Abu Minhajuddin; Sabrina A Poole; Jennifer Potter; Marc Fishman; Michael Bogenschutz; Ashwin Patkar; Madhukar H Trivedi Journal: Addict Behav Date: 2012-05-08 Impact factor: 3.913
Authors: Stacey C Sigmon; Kelly E Dunn; Kathryn Saulsgiver; Mollie E Patrick; Gary J Badger; Sarah H Heil; John R Brooklyn; Stephen T Higgins Journal: JAMA Psychiatry Date: 2013-12 Impact factor: 21.596
Authors: Geetha A Subramaniam; Diane Warden; Abu Minhajuddin; Marc J Fishman; Maxine L Stitzer; Bryon Adinoff; Madhukar Trivedi; Roger Weiss; Jennifer Potter; Sabrina A Poole; George E Woody Journal: J Am Acad Child Adolesc Psychiatry Date: 2011-11 Impact factor: 8.829