Differences In Treatment Outcomes Between Prescription Opioid-Dependent And Heroin-Dependent Adolescents

Objective: This Study was designed to examine the extent to which heroin-dependent and prescription opioid-dependent adolescents experienced differential outcomes during a clinical trial designed to evaluate combined behavioral-pharmacological treatment.Methods: Participants were a volunteer sample of 36 adolescents who met DSM-IV criteria for opioid-dependence (ages 13-18 years eligible) 53% of which were heroin-dependent and 47% of which were dependent on prescription opioids used for nonmedical put-poses. Participants received a 28-day, Outpatient, medication-assisted withdrawal with the partial opioid agonist, buprenorphine, or the centrally active A-adrenergic blocker, clonidine, along with behavioral counseling and incentives contingent on opioid abstinence. Heroin-dependent and prescription opioid-dependent participants were compared on baseline characteristics and treatment Outcomes, which included retention, opioid abstinence, HIV risk behavior, opioid withdrawal, and medication effects.Results: Heroin-dependent and prescription opioid-dependent youth had similar characteristics at intake. Heroin-dependent youth had hi-her baseline rates of drug-related HIV risk, behavior and greater opioid withdrawal before receiving medication during treatment; however, this same group showed markedly greater improvements on these domains during treatment relative to prescription opioid-dependent youth. Both participant groups showed comparable Outcomes based on clinically meaningful measures of treatment retention and opioid abstinence. Both heroin-dependent and prescription opioid-dependent youth who received buprenorphine experienced markedly better treatment Outcomes relative to those who received clonidine.Conclusions: These results demonstrate that combined behavioral and buprenorphine treatment seems safe and efficacious in the treatment of both heroin-dependent and prescription opioid-dependent adolescents and provide novel information relating to treatment outcomes for these Subgroups of opioid-dependent youth.