Opioid substitution treatment and heroin dependent adolescents: reductions in heroin use and treatment retention over twelve months

摘要

Opioid dependence is a major health concern across the world and does also occur in adolescents. While opioid substitution treatment (OST) has been thoroughly evaluated in adult populations, very few studies have examined its use in adolescents. There are concerns that OST is underutilised in adolescents with heroin dependence. We sought to measure changes in drug use among adolescents receiving OST and also to examine treatment attrition during the first 12?months of this treatment. We included all heroin dependent patients aged under 18.5?years commencing OST at one outpatient multidisciplinary adolescent addiction treatment service in Dublin, Ireland. Psycho-social needs were also addressed during treatment. Drug use was monitored by twice weekly urine drugs screens (UDS). Change in the proportion of UDS negative for heroin was examined using the Wilcoxon signed rank test. Attrition was explored via a Cox Regression multivariate analysis. OST was commenced by 120 patients (51% female and mean age 17.3?years). Among the 39 patients who persisted with OST until month 12, heroin abstinence was 21% (95% confidence interval [CI]?=?9–36%) at month three and it was 46% (95% CI?=?30–63%) at month 12. Heroin use declined significantly from baseline to month three (p?