TY - JOUR
T1 - Clinical characteristics of treatment-seeking prescription opioid vs. heroin-using adolescents with opioid use disorder
AU - Subramaniam, Geetha A.
AU - Stitzer, Maxine A.
N1 - Funding Information:
The authors express their gratitude to Drs. Woody and Fishman, Melinda Tracy for their assistance in the development of this manuscript and support of our work. We also thank the National Institute of Drug Abuse (NIDA) Clinical Trials Network and the K-12 NIDA-American Academy of Child and Adolescent Psychiatry (AACAP) Physician Scientist Career Development Award for funding this research.
Funding Information:
Dr. Subramaniam receives salary support from Mountain Manor Treatment Center. Dr. Stitzer receives research funding from Pfizer Pharmaceuticals Inc and is a consultant for Baltimore Substance Abuse Services and Aradigm, Inc.
Funding Information:
Funding for this study was provided by NIDA grants: AACAP-K12 DA 000357 (Subramaniam, P.I.) and NIDA Clinical Trials Network U10 DA 13034 (Stitzer, P.I.). NIDA had no further role in study design; in the collection, analysis and interpretation of data; or in the decision to submit the paper for publication. The manuscript was reviewed and approved for submission by the NIDA CTN publications committee.
PY - 2009/4/1
Y1 - 2009/4/1
N2 - 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.
AB - 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.
KW - Adolescents
KW - Clinical characteristics
KW - Heroin use
KW - Opioid dependence
KW - Prescription opioids
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U2 - 10.1016/j.drugalcdep.2008.10.015
DO - 10.1016/j.drugalcdep.2008.10.015
M3 - Article
C2 - 19081205
AN - SCOPUS:60249102352
SN - 0376-8716
VL - 101
SP - 13
EP - 19
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
IS - 1-2
ER -