Anesthesiology

The researches find that the effectiveness of medications to treat adults with opioid use disorder has been well established, there has been little research about how or even if such treatment works in adolescents. Now, a new review of the literature suggests that, in addition to adults; adolescents with severe opioid use disorder can be treat with one of three medications: methadone; buprenorphine (Subutex/Suboxone) or extended-release naltrexone (Vivitrol). The study was published in the latest issue of the Journal of Studies on Alcohol and Drugs.

Opioid use disorder

“In 2017, 900 adolescents started misusing opioid pain relievers each day;” the authors write. In addition to abusing prescription medication, some of these teens “initiate heroin use because of its ready availability; lower cost, and strong potency.” “Adolescents with severe opioid use disorder may benefit from a medication as part of a larger comprehensive treatment plan;” says lead author Deepa R. Camenga, M.D., M.H.S., of the Yale School of Medicine. Further ;t may benefit their child.”

In their research, Camenga and colleagues searched the scientific literature for investigations of the effects of medication in the treatment of opioid use disorder in adolescents. They identified 14 reports; published between 1973 and 2018. The number of adolescents in each study ranged from just a handful to several hundred. Overall, the researchers report that the dangers of untreated opioid use disorder “far outweigh the risks” of treatment with methadone, buprenorphine; or naltrexone. However; few adolescents receive such therapy: Only about 2 to 5% of adolescents with an opioid use disorder receive treatment with one of these medications; compared with 12 to 26 percent of adults.

Risks” of treatment with methadone

In general, methadone, buprenorphine and extended-release naltrexone improved the number of adolescents who remained in treatment, decreased opioid use, and led to more abstinence. But, the authors say; “research is still need to understand the optimal treatment duration and how to retain adolescents in treatment.” The medications do have their challenges. For methadone, the authors say; the use of these medications needs to be closely monitor due to known side effects with high doses, including slow breathing and sedation, as well as heart rhythm problems.

Further, methadone needs to be administered by a federally certified opioid treatment program; which can cause difficulty for adolescents who don’t have transportation to such locations. Also; adolescents must receive special dispensation to receive it, and there is the risk that methadone itself can be abused.