title: Clinical characteristics of treatment-seeking prescription opioid vs. heroin-using adolescents with opioid use disorder.
abstract: OBJECTIVE
  To compare the clinical characteristics of treatment-seeking prescription opioid-using adolescents with DSM-IV opioid use disorder (OUD) to those with heroin-using OUD adolescents.
  
  
  METHODS
  We analyzed the data on OUD adolescents (94, ages 14-18 years) extracted from the parent study dataset comparing clinical characteristics of treatment-seeking OUD to non-OUD adolescents from a adolescent substance abuse treatment program in Baltimore, MD. The sample consisted of 41 non-heroin prescription opioid-using and 53 heroin-using OUD adolescents who were assessed cross-sectionally using standardized interviews and self-reports. Chi-square and t-tests were performed to determine group differences on demographic, substance use, psychiatric and HIV-risk behaviors.
  
  
  RESULTS
  Both groups were older (mean 17 years), predominantly Caucasian, and had a suburban residence; they had high rates of co-occurring psychiatric disorders (83%) and they reported moderately high depression symptoms. The heroin-using sample was more likely to have dropped out of school, be dependent on opioids and inject drugs using needles. The prescription opioid-using OUD youth were more likely to meet criteria for multiple SUDs (including prescription sedatives and psychostimulants), current ADHD and report selling drugs; and more likely to be court ordered to current treatment and report prior psychiatric treatment.
  
  
  CONCLUSIONS
  Both groups of treatment-seeking OUD adolescents had multiple comorbidities but there were substantial differences between prescription opioid-users and heroin-users. These differences may suggest different prognoses and treatment implications. Future research may shed light on the factors leading to differences in choice of opioids and their impact on treatment outcomes; and assess the role of agonist assisted treatments and integrated psychiatric care.
authors.affiliation: Department of Psychiatry, Johns Hopkins University, Mountain Manor Treatment Center, 3800 Frederick Ave, Baltimore, MD 21229, USA. gsubram@jhmi.edu
authors.forename: Geetha A
authors.initials: GA
authors.lastname: Subramaniam
authors.forename: Maxine A
authors.initials: MA
authors.lastname: Stitzer
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D003415:Crime / Q000706:statistics & numerical data; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006556:Heroin Dependence / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D009293:Opioid-Related Disorders / Q000523:psychology* / Q000534:rehabilitation*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D055553:Prescription Drugs; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous; D047568:Unsafe Sex
chemical_list: D055553:Prescription Drugs