Medications for opioid use disorder among young people : evidence to improve treatment experiences and outcomes in Vancouver, Canada
department or school: Graduate and Postdoctoral Studies
data provider: DSpace
degree campus: UBCV
creator: Pilarinos, Andreas
issued: 2023-01-05T17:02:45Z
issued: 2022
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: Background: Adolescents and young adults (AYA) continue to be impacted by the toxic drug crisis. This dissertation sought to examine AYAs’ experiences with opioid agonist treatment (OAT) to inform treatment programming and improve health outcomes and well-being among AYA who use opioids. Methods: A systematic review of literature examining access to medications for opioid use disorder (MOUD), including prescription and non-prescription opioids, was conducted from electronic database inception until May 3, 2021. Quantitative analyses derived data from the At-Risk Youth Study, an open, prospective cohort of street-involved AYA who use drugs in Vancouver, Canada, to examine OAT access and outcomes, interest in buprenorphine-naloxone, and factors associated with methadone maintenance therapy (MMT) discontinuation between December 2005 and June 2018. Longitudinal qualitative exploration into experiences navigating OAT and barriers to engagement, retention, and completion were conducted with AYA between January 2018 and August 2020. Results: Systematic review findings suggest AYA are less likely to access MOUD versus adults, and that adolescents are more likely to be prescribed partial opioid agonists. In before and after analysis of OAT outcomes among 454 AYA, greater reductions in daily illicit opioid were observed among AYA retained in OAT versus AYA who did not initiate OAT (-1.83 vs. -0.63, p=0.015), but no other reductions were observed. Low levels of initial buprenorphine-naloxone interest were reported (n=60, 13.4%), which was negatively associated with self-reported Indigenous identity, and racial or ethnic identity, while later study follow-up period was negatively associated with buprenorphine-naloxone interest over time. A majority of 160 AYA who initiated MMT over the study period discontinued MMT (n=102, 63.8%), which was found to be positively associated with crystal methamphetamine use. Lastly, qualitative findings demonstrate barriers experienced by AYA n…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/83576
note: Medications for opioid use disorder among young people: evidence to improve treatment experiences and outcomes in Vancouver, Canada by Andreas Pilarinos B.Sc., Simon Fraser University, 2013 M.P.P., Simon Fraser University, 2016 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Interdisciplinary Studies) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) December 2022 © Andreas Pilarinos, 2022 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: Medications for opioid use disorder among young people: evidence to improve treatment experiences and outcomes in Vancouver, Canada submitted by Andreas Pilarinos in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Interdisciplinary Studies Examining Committee: Dr. Jane Buxton, Professor, School of Population and Public Health, UBC Co-Supervisor Dr. Kora DeBeck, Associate Professor, School of Public Policy, Simon Fraser University Co-Supervisor Dr. Danya Fast, Assistant Professor, Department of Medicine, UBC Supervisory Committee Member Dr. Patricia Sptittal, Professor, School of Population and Public Health, UBC University Examiner Dr. Carolyn Szostak, Associate Professor, Department of Psychology, UBC Okanagan University Examiner iii Abstract Background: Adolescents and young adults (AYA) continue to be impacted by the toxic drug crisis. This dissertation sought to examine AYAs’ experiences with opioid agonist treatment (OAT) to inform treatment programming and improve health outcomes and well-being among AYA who use opioids. Methods: A systematic review of literature examining access to medications for opioid use disorder (MOUD), including prescription and non-prescription opioids, was conducted from electronic database inception until May 3, 2021. Quantitative analyses derived da…
has type: Thesis/Dissertation
date issued: 2023-05
is shown at: 10.14288/1.0422978
language: eng
degree discipline: Interdisciplinary Studies
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Buxton, Jane A.
contributor: DeBeck, Kora
type: Text
identifier URI: http://hdl.handle.net/2429/83576