Literature Collection

Introduction -- MAT implementation or expansion -- Getting started -- Billing insurance coverage and telemedicine -- Clinical considerations -- The ASAM criteria -- Screening, assessment and treatment -- Drug testing -- Understanding and preventing Buprenorphine diversion -- Patient communications -- Medications -- Overview of opioid use disorder medications -- Buprenorphine -- Extended-release Naltrexone (Vivitrol) -- Overview of alcohol -- Targeted topics and populations -- Practicing MAT during a public health emergency -- Patients with pain -- Harm reduction and polysubstance use -- MAT in rural Alaska -- Patients with co-occurring mental health disorders -- Hepatitis C treatment -- Pregnancy -- Criminal justice -- Youth -- Appendices -- Abbreviations -- MAT quality planning tool -- Finding substance use disorder treatment in Alaska -- MAT resources

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.