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Comparative Study
. 2009 Apr 1;101(1-2):13-9.
doi: 10.1016/j.drugalcdep.2008.10.015. Epub 2008 Dec 9.

Clinical characteristics of treatment-seeking prescription opioid vs. heroin-using adolescents with opioid use disorder

Affiliations
Comparative Study

Clinical characteristics of treatment-seeking prescription opioid vs. heroin-using adolescents with opioid use disorder

Geetha A Subramaniam et al. Drug Alcohol Depend. .

Abstract

Objectives: 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.

Method: 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.

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Figures

Figure 1
Figure 1
Self-reported “Drug of First Choice” Among Prescription-using and Heroin-using Adolescents with Opioid Use Disorder Rx Opioid = Prescription opioids

References

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