title: Relapse prevention medications in community treatment for young adults with opioid addiction.
abstract: Despite the well-known effectiveness and widespread use of relapse prevention medications such as extended release naltrexone (XR-NTX) and buprenorphine for opioid addiction in adults, less is known about their use in younger populations.
  
  
  
  This was a naturalistic study using retrospective chart review of N = 56 serial admissions into a specialty community treatment program that featured the use of relapse prevention medications for young adults (19-26 years old) with opioid use disorders. Treatment outcomes over 24 weeks included retention and weekly opioid-negative urine tests.
  
  
  
  Patients were of mean age 23.1, 70% male, 86% Caucasian, 82% with history of injection heroin use, and treated with either buprenorphine (77%) or XR-NTX (23%). The mean number of XR-NTX doses received was 4.1. Retention was approximately 65% at 12 weeks and 40% at 24 weeks, and rates of opioid-negative urine were 50% at 12 weeks and 39% at 24 weeks, with missing samples imputed as positive. There were no statistically significant differences in retention (t = 1.87, P = .06) or in rates of weekly opioid-negative urine tests (t = 1.96, P = .06) between medication groups, over the course of 24 weeks. The XR-NTX group had higher rates of weekly negative urine drug tests for other nonopioid substances (t = 2.83, P < .05) compared with the buprenorphine group. Males were retained in treatment longer and had higher rates of opioid-negative weeks compared with females.
  
  
  
  These results suggest that relapse prevention medications including both buprenorphine and XR-NTX can be effectively incorporated into standard community treatment for opioid addiction in young adults with good results. Specialty programming focused on opioid addiction in young adults may provide a promising model for further treatment development.
authors.affiliation: a Maryland Treatment Centers , Baltimore , Maryland , USA.
authors.forename: Hoa T
authors.initials: HT
authors.lastname: Vo
authors.affiliation: a Maryland Treatment Centers , Baltimore , Maryland , USA.
authors.forename: Erika
authors.initials: E
authors.lastname: Robbins
authors.affiliation: a Maryland Treatment Centers , Baltimore , Maryland , USA.
authors.forename: Meghan
authors.initials: M
authors.lastname: Westwood
authors.affiliation: a Maryland Treatment Centers , Baltimore , Maryland , USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Lezama
authors.affiliation: a Maryland Treatment Centers , Baltimore , Maryland , USA.|b Johns Hopkins School of Medicine , Baltimore , Maryland , USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Fishman
mesh_terms: D000328:Adult; D000367:Age Factors; D002047:Buprenorphine / Q000627:therapeutic use; D003692:Delayed-Action Preparations / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D009271:Naltrexone / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000517:prevention & control*; D012008:Recurrence; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods*; D012727:Sex Characteristics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003692:Delayed-Action Preparations; D002047:Buprenorphine; D009271:Naltrexone
keywords: Buprenorphine; Vivitrol; community treatment; extended release naltrexone; medication-assisted therapy; opioid dependence; relapse prevention medication; young adults