title: Differences in Treatment Outcomes between Prescription Opioid-Dependent and Heroin-Dependent Adolescents.
abstract: 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 purposes. Participants received a 28-day, outpatient, medication-assisted withdrawal with the partial opioid agonist, buprenorphine, or the centrally active μ-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 higher 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.
authors.affiliation: From the Department of Psychiatry (MM, LAM, RS), St. Luke's-Roosevelt Hospital Center, New York, NY; National Development and Research Institutes (LAM), New York, NY; University of Arkansas for Medical Sciences (WKB), Little Rock, AR; and Department of Medical Biostatistics (GJB), University of Vermont, Burlington, VT.
authors.forename: Mehran
authors.initials: M
authors.lastname: Motamed
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Marsch
authors.forename: Ramon
authors.initials: R
authors.lastname: Solhkhah
authors.forename: Warren K
authors.initials: WK
authors.lastname: Bickel
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Badger