Differences in treatment outcomes between prescription opioid-dependent and heroin-dependent adolescents
Differences in treatment outcomes between prescription opioid-dependent and heroin-dependent adolescents
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DOI：
10.1097/adm.0b013e31816b2f84
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发表时间：
2008-09-01
影响因子：
5.5
通讯作者：
Badger, Gary J.
中科院分区：
文献类型：
--
作者：
Motamed, Mehran;Marsch, Lisa A.;Badger, Gary J.
目的：本研究旨在检验海洛因依赖和处方阿片依赖青少年在临床试验中经历的不同结果。方法：研究对象为36名符合DSM-IV阿片依赖标准的青少年志愿者(年龄13-18岁)，其中53%的青少年海洛因依赖，47%的青少年依赖处方阿片类药物用于非药物治疗。参与者接受了为期28天的门诊药物辅助戒断，使用部分阿片激动剂丁丙诺啡或中枢活性A肾上腺素能阻滞剂可乐定，以及行为咨询和激励措施，视阿片类药物戒断而定。比较海洛因依赖者和处方阿片依赖者的基线特征和治疗结果，包括滞留、阿片类药物戒断、HIV危险行为、阿片类药物戒断和药物效果。结果：海洛因依赖者和处方阿片依赖者在摄入时具有相似的特征。海洛因依赖青年在治疗期间接受药物治疗之前，与药物相关的艾滋病毒风险、行为和更多阿片类药物戒断的基线比率较高；然而，与处方阿片依赖青年相比，这一组在治疗期间在这些领域的改善明显更大。两组参与者在治疗保留和阿片类药物戒断的临床有意义的措施基础上显示出可比的结果。接受丁丙诺啡治疗的海洛因依赖和处方阿片依赖青少年的治疗结果明显好于接受克罗尼定治疗的青少年。结论：这些结果表明，行为治疗和丁丙诺啡联合治疗海洛因依赖和处方阿片依赖青少年是安全有效的，并为这些阿片依赖青少年亚组的治疗结果提供了新的信息。
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.