TY - JOUR
KW - medication treatment
KW - Stigma
KW - Young adults
AU - Scott E. Hadland
AU - Tae Woo Park
AU - Sarah M. Bagley
A1 - 
AB - BACKGROUND: Opioid-related overdose deaths have risen sharply among young adults. Despite this increase, access to evidence-based medication for opioid agonist treatment (OAT) for youth remains low. Among older adults, barriers to OAT include the paucity of buprenorphine-waivered prescribers and low rates of prescribing among waivered physicians. We have increasingly found in our clinical practice significant stigma related to using OAT to treat addiction for young adults. In this series, we describe three cases of young adults who faced significant stigma related to their treatment. CASE PRESENTATIONS: The first case is a young male with a history of significant trauma and a severe opioid use disorder. He started buprenorphine and has found a job, stayed abstinent, and began a healthy relationship. At each step in his recovery, he has faced resistance to taking medication from other treatment providers, directors of sober houses, and his parents. The second case is a young woman who presented to a substance use treatment program after a relapse. She was unable to restart buprenorphine despite our calling to ask that it be restarted. Ultimately, she left against medical advice and was stabilized as an outpatient on buprenorphine. The final case is a young woman who stopped buprenorphine after being told she was "not sober" while attending 12-step group but restarted after conversations with her clinical team. In each case, the patient has continued their medication treatment and are stable. CONCLUSIONS: Opioid-related deaths continue to rise among all age groups, including young adults. Stigma related to medication treatment can be a substantial barrier for many young adult patients but there are concrete steps that providers and communities can take to address this stigma.
AD - Division of General Academic Pediatrics, Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.; Grayken Center for Addiction, Boston Medical Center, Boston, USA.; Department of Psychiatry, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.; Grayken Center for Addiction, Boston Medical Center, Boston, USA.; Division of General Academic Pediatrics, Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA. sarah.bagley@bmc.org.; Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University/School of Medicine, Boston Medical Center, Boston, MA, USA. sarah.bagley@bmc.org.; Grayken Center for Addiction, Boston Medical Center, Boston, USA. sarah.bagley@bmc.org.
BT - Addiction science & clinical practice
C5 - Education & Workforce; Opioids & Substance Use
CP - 1
CY - England
DO - 10.1186/s13722-018-0116-2
IS - 1
JF - Addiction science & clinical practice
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Opioid-related overdose deaths have risen sharply among young adults. Despite this increase, access to evidence-based medication for opioid agonist treatment (OAT) for youth remains low. Among older adults, barriers to OAT include the paucity of buprenorphine-waivered prescribers and low rates of prescribing among waivered physicians. We have increasingly found in our clinical practice significant stigma related to using OAT to treat addiction for young adults. In this series, we describe three cases of young adults who faced significant stigma related to their treatment. CASE PRESENTATIONS: The first case is a young male with a history of significant trauma and a severe opioid use disorder. He started buprenorphine and has found a job, stayed abstinent, and began a healthy relationship. At each step in his recovery, he has faced resistance to taking medication from other treatment providers, directors of sober houses, and his parents. The second case is a young woman who presented to a substance use treatment program after a relapse. She was unable to restart buprenorphine despite our calling to ask that it be restarted. Ultimately, she left against medical advice and was stabilized as an outpatient on buprenorphine. The final case is a young woman who stopped buprenorphine after being told she was "not sober" while attending 12-step group but restarted after conversations with her clinical team. In each case, the patient has continued their medication treatment and are stable. CONCLUSIONS: Opioid-related deaths continue to rise among all age groups, including young adults. Stigma related to medication treatment can be a substantial barrier for many young adult patients but there are concrete steps that providers and communities can take to address this stigma.
PP - England
PY - 2018
SN - 1940-0640; 1940-0632
SP - 15
T1 - Stigma associated with medication treatment for young adults with opioid use disorder: a case series
T2 - Addiction science & clinical practice
TI - Stigma associated with medication treatment for young adults with opioid use disorder: a case series
U1 - Education & Workforce; Opioids & Substance Use
U2 - 29730987
U3 - 10.1186/s13722-018-0116-2
VL - 13
VO - 1940-0640; 1940-0632
Y1 - 2018
Y2 - May 7
ER -