Immunity to Hepatitis B is Undetectable in the Majority of Adolescents and Young Adults Seeking Outpatient Medication Treatment for Opioid Use Disorder

Limited guidance on opioid use exists in the pediatric population, causing medication safety concerns for pain management in children and adolescents. Opioid misuse and use disorder continue to greatly affect adolescents and young adults in the United States, furthering the apprehension of their use. Pediatric Pharmacy Advocacy Group (PPAG) recommends pharmacists contribute their knowledge to pain management in children, including the discussion of appropriate use of non-opioid alternatives for pain and when to recommend coprescribing of naloxone. PPAG also supports the review of electronic prescription drug–monitoring programs prior to opioid prescribing and dispensing by both prescribers and pharmacists. Education by pharmacists of children and their families regarding proper administration, storage, and disposal, as well as the awareness of opioid misuse and use disorder among adolescents and young adults, is key to prevention. If opioid use disorder is diagnosed, PPAG encourages improved access among adolescents to evidence-based medications including methadone, buprenorphine, and naltrexone. Furthermore, pharmacists should assist in screening and referral to evidence-based treatment.

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Adherence to and Retention in Medications for Opioid Use Disorder Among Adolescents and Young Adults

Epidemiologic Reviews ◽

10.1093/epirev/mxaa001 ◽

2020 ◽

Author(s):

Adam Viera ◽

Daniel J Bromberg ◽

Shannon Whittaker ◽

Bryan M Refsland ◽

Milena Stanojlović ◽

...

Keyword(s):

Young Adults ◽

Opioid Use Disorder ◽

Adolescents And Young Adults ◽

Outcome Variable ◽

Opioid Use ◽

Younger Age ◽

Full Text Review ◽

The Individual ◽

Negative Health Outcomes

Abstract The volatile opioid epidemic is associated with higher levels of opioid use disorder (OUD) and negative health outcomes in adolescents and young adults. Medications for opioid use disorder (MOUD) demonstrate the best evidence for treating OUD. Adherence to and retention in MOUD, defined as continuous engagement in treatment, among adolescents and young adults, however, is incompletely understood. We examined the state of the literature regarding the association of age with adherence to and retention in MOUD using methadone, buprenorphine, or naltrexone among persons aged 10–24 years, along with related facilitators and barriers. All studies of MOUD were searched for that examined adherence, retention, or related concepts as an outcome variable and included adolescents or young adults. Search criteria generated 10,229 records; after removing duplicates and screening titles and abstracts, 587 studies were identified for full-text review. Ultimately, 52 articles met inclusion criteria for abstraction and 17 were selected for qualitative coding and analysis. Younger age was consistently associated with shorter retention, although the overall quality of included studies was low. Several factors at the individual, interpersonal, and institutional levels, such as concurrent substance use, MOUD adherence, family conflict, and MOUD dosage and flexibility, appeared to have roles in MOUD retention among adolescents and young adults. Ways MOUD providers can tailor treatment to increase retention of adolescents and young adults are highlighted, as is the need for more research explaining MOUD adherence and retention disparities in this age group.

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Medication Improves Age Disparities in Six-Month Treatment Retention for Opioid Use Disorder

10.1101/2020.02.21.20023143 ◽

2020 ◽

Author(s):

Carrie M. Mintz ◽

Ned J. Presnall ◽

John M. Sahrmann ◽

Jacob T. Borodovsky ◽

Paul E.A. Glaser ◽

...

Keyword(s):

Older Adults ◽

Young Adults ◽

Age Groups ◽

Opioid Use Disorder ◽

Treatment Retention ◽

Opioid Use ◽

Medication Treatment ◽

Psychosocial Services ◽

Treatment Type ◽

Age Disparities

AbstractBackground and AimsAdolescents with opioid use disorder (OUD) are an understudied and vulnerable population. We examined the association between age and six-month treatment retention, and whether any such association was moderated by medication treatment.MethodsIn this retrospective cohort study, we used an insurance database with OUD treatment claims from 2006-2016. We examined 261,356 OUD treatment episodes in three age groups: adolescents (ages 12-17), young adults (18-25) and older adults (26-64). We used logistic regression to estimate prevalence of six-month retention before and after stratification by treatment type (buprenorphine, naltrexone, or psychosocial services only). Insurance differences (commercial vs Medicaid) in medication treatment prevalence were also assessed.ResultsAdolescents were far less likely to be retained compared to adults (17.6%; 95% CI 16.5-18.7% for adolescents; 25.1%; 95% CI 24.7-25.4% for young adults; 33.3%; 95% CI 33.0-33.5% for older adults). This disparity was markedly reduced after adjusting for treatment type. For all ages, buprenorphine was more strongly associated with retention than naltrexone or psychosocial services. Adolescents who received buprenorphine were more than four times as likely to be retained in treatment (44.5%, 95% CI 40.6-49.0) compared to those who received psychosocial services (9.7%, 95% CI 8.8-10.8). Persons with commercial insurance were more likely to receive medication than those with Medicaid (73.3% vs 36.4%, χ2 =57,870.6, (p<.001).ConclusionsAge disparities in six-month treatment retention are strongly related to age disparities in medication treatment. Results point to need for improved implementation of medication treatment for persons with OUD, regardless of age or insurance status.

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