TY - JOUR
AU - C. Buchholz
AU - L. A. Bell
AU - S. Adatia
AU - S. M. Bagley
AU - T. E. Wilens
AU - A. Nurani
AU - S. E. Hadland
A1 - 
AB - PURPOSE: Clinical trial data support use of medications for opioid use disorder (MOUD) in adolescents and young adults ("youth"), but qualitative data are lacking on the acceptability and importance of MOUD to youth, caregivers, and clinicians. We assessed how these stakeholders viewed the role of MOUD in treatment and recovery. METHODS: We recruited youth aged from 15 to 25 years with opioid use disorder who had received buprenorphine, naltrexone, or methadone and caregivers from a primary care-based youth addiction treatment program. We also recruited clinicians with addiction expertise from social work, nursing, pediatrics, internal medicine, and psychiatry. We conducted semistructured interviews assessing special considerations for MOUD use in youth. Three coders performed inductive and deductive thematic analysis of transcripts. RESULTS: Among 37 participants, including 15 youth (age range, 17-25 years), nine caregivers, and 13 clinicians, we identified three themes. (1) Medications support recovery in the short term: Youth described MOUD as beneficial in managing withdrawal symptoms. Notably, some youth and caregivers preferred to limit MOUD duration. (2) Medication adherence is affected by type of medication, dosing regimen, and route of administration. Participants endorsed long-acting, injectable MOUD for ease of use and youth's ability to continue engagement in "normal activities" without daily medication. (3) Caregiver involvement can support medication decisions and adherence. Youth and some clinicians described the need to assess caregiver involvement before incorporating them into treatment; caregivers and other clinicians described caregivers as critical in supporting accountability. DISCUSSION: MOUD is evidence-based, and its provision should be developmentally responsive and youth- and family-centered, incorporating caregivers when appropriate.
AD - Division of Adolescent and Young Adult Medicine, Mass General for Children, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.; Department of Pediatrics-Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana.; Department of Family Medicine, McGill University, Montreal, Quebec, Canada.; Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts.; Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.; Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, Massachusetts.; Division of Adolescent and Young Adult Medicine, Mass General for Children, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Electronic address: shadland@mgh.harvard.edu.
AN - 37815763
BT - J Adolesc Health
C5 - Opioids & Substance Use; Healthcare Disparities
CP - 2
DA - Feb
DO - 10.1016/j.jadohealth.2023.08.047
DP - NLM
ET - 20231009
IS - 2
JF - J Adolesc Health
LA - eng
N2 - PURPOSE: Clinical trial data support use of medications for opioid use disorder (MOUD) in adolescents and young adults ("youth"), but qualitative data are lacking on the acceptability and importance of MOUD to youth, caregivers, and clinicians. We assessed how these stakeholders viewed the role of MOUD in treatment and recovery. METHODS: We recruited youth aged from 15 to 25 years with opioid use disorder who had received buprenorphine, naltrexone, or methadone and caregivers from a primary care-based youth addiction treatment program. We also recruited clinicians with addiction expertise from social work, nursing, pediatrics, internal medicine, and psychiatry. We conducted semistructured interviews assessing special considerations for MOUD use in youth. Three coders performed inductive and deductive thematic analysis of transcripts. RESULTS: Among 37 participants, including 15 youth (age range, 17-25 years), nine caregivers, and 13 clinicians, we identified three themes. (1) Medications support recovery in the short term: Youth described MOUD as beneficial in managing withdrawal symptoms. Notably, some youth and caregivers preferred to limit MOUD duration. (2) Medication adherence is affected by type of medication, dosing regimen, and route of administration. Participants endorsed long-acting, injectable MOUD for ease of use and youth's ability to continue engagement in "normal activities" without daily medication. (3) Caregiver involvement can support medication decisions and adherence. Youth and some clinicians described the need to assess caregiver involvement before incorporating them into treatment; caregivers and other clinicians described caregivers as critical in supporting accountability. DISCUSSION: MOUD is evidence-based, and its provision should be developmentally responsive and youth- and family-centered, incorporating caregivers when appropriate.
PY - 2024
SN - 1054-139X (Print); 1054-139x
SP - 320
EP - 326+
ST - Medications for Opioid Use Disorder for Youth: Patient, Caregiver, and Clinician Perspectives
T1 - Medications for Opioid Use Disorder for Youth: Patient, Caregiver, and Clinician Perspectives
T2 - J Adolesc Health
TI - Medications for Opioid Use Disorder for Youth: Patient, Caregiver, and Clinician Perspectives
U1 - Opioids & Substance Use; Healthcare Disparities
U3 - 10.1016/j.jadohealth.2023.08.047
VL - 74
VO - 1054-139X (Print); 1054-139x
Y1 - 2024
ER -