UBC Faculty Research and Publications

Treatment Approaches and Outcome Trajectories for Youth With High-Risk Opioid Use : A Narrative Review Westenberg, Jean; Tai, Andy Men Yeung; Elsner, Julie; Kamel, Mostafa M.; Wong, James S. H.; Azar, Pouya; Vo, Dzung X.; Moore, Eva; Mathew, Nickie; Seethapathy, Vijay; Choi, Fiona; Vogel, Marc; Krausz, Reinhard

Abstract

Aim: First use of opioids often happens in adolescence and an increasing number of opioid overdoses are being reported among youth. The purpose of this narrative review was to pre-sent the treatment approaches for youth with high-risk opioid use, determine whether the lit-erature supports the use of opioid agonist treatment among youth, and identify evidence for better treatment outcomes in the younger population. Methods: A search of the literature on PubMed® using MeSH terms specific to youth, opi-oid use, and treatment approaches generated 1,436 references. Following a screening process, 137 papers were found to be relevant to the treatment of high-risk opioid use among youth. After full-text review, 19 eligible studies were included: four randomized controlled trials, nine observational studies, and six reviews. Results: Research for the different treatment options among youth is limited. The available evidence shows better outcomes in terms of retention in care and cost-effectiveness for opioid agonist treatment than abstinence-based comparisons. Integrating psychosocial interventions into the continuum of care for youth can be an effective way of addressing comorbid psychi-atric conditions and emotional drivers of substance use, leading to improved treatment trajec-tories. Conclusions: From the limited findings, there is no evidence to deny youth with high-risk opioid use the same treatment options available to adults. A combination of pharmacological and youth-specific psychosocial interventions is required to maximize retention and survival. There is an urgent need for more research to inform clinical strategies towards appropriate treatment goals for such vulnerable individuals.

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