Journal of Addiction Medicine最新文献

{"title":"A Pharmacologic Evaluation of Buprenorphine in Pregnancy and the Postpartum Period.","authors":"Steve N Caritis, Raman Venkataramanan","doi":"10.1097/ADM.0000000000001380","DOIUrl":"10.1097/ADM.0000000000001380","url":null,"abstract":"<p><strong>Background: </strong>The dosing regimen in the package insert for sublingual buprenorphine is similar for pregnant and nonpregnant people despite the physiologic changes seen during pregnancy.</p><p><strong>Aims: </strong>To compare plasma buprenorphine pharmacokinetics during and after pregnancy and relate buprenorphine concentration to the pharmacodynamic endpoints of pupil diameter, Clinical Opioid Withdrawal Scale (COWS), and craving scores.</p><p><strong>Study design: </strong>Prospective cohort of 22 pregnant people undergoing 33 pharmacologic studies (6-8 hours each) during pregnancy or postpartum. Participants were on a stable daily dose of 2-8 mg sublingual buprenorphine every 6 or 8 hours. The dosing frequency was selected by the participant. On study day, baseline measurements of plasma buprenorphine, pupil diameter, COWS, and craving scores were obtained, then the usual morning dose was taken, and measurements were repeated several times over 1 dosing interval.</p><p><strong>Findings: </strong>The dose-normalized area under the plasma buprenorphine concentration time curve was significantly ( P = 0.036) lower during pregnancy (155 ± 52 ng × min/mL) than postpartum (218 ± 113 ng × min/mL). Buprenorphine trough concentrations were similar at the start (1.1 ± 0.7 ng/mL) and end of a dosing cycle (1.2 ± 0.8 ng/mL) regardless of dosing frequency. Pupillary diameter, COWS, and craving scores returned to baseline as buprenorphine concentrations approached ~1 ng/mL.</p><p><strong>Conclusions: </strong>Pregnant people require a higher dose of buprenorphine to achieve concentrations comparable to nonpregnant people. There is a temporal relationship between the plasma buprenorphine concentration and the pharmacodynamic markers of pupillary diameter, COWS, and craving scores. An average plasma concentration of ~1 ng/mL was associated with the lowest level of COWS and craving scores.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"129-134"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Xylazine Positivity in Opioid-positive Drug Screens on an Inpatient Labor Unit.","authors":"Cassandra Trammel, Vahid Azimi, Bridgit Crews, Stephen Roper, Nandini Raghuraman, Ebony B Carter, Antonina Frolova, Anthony O Odibo, Megan Lawlor, Jeannie C Kelly","doi":"10.1097/ADM.0000000000001396","DOIUrl":"10.1097/ADM.0000000000001396","url":null,"abstract":"<p><strong>Objective: </strong>Untreated opioid use disorder (OUD) is associated with significant morbidity in pregnancy. Recent reports have highlighted the rise of xylazine in the nonprescribed fentanyl supply. The frequency with which pregnant people with OUD are exposed to xylazine has not been characterized. We sought to describe the rate of xylazine detection in urine drug screens (UDS) from pregnant people admitted to a labor unit.</p><p><strong>Methods: </strong>We performed a cross sectional study of all UDS results from an inpatient obstetric unit at an urban tertiary care center from December 2022, when xylazine was added to the detection panel, through July 2023. We perform universal verbal drug screening, with subsequent urine drug screening only performed after a positive verbal screen and consent. The trend of opioid-positive urine drug screens also positive for xylazine from December to July was measured with the Cochran-Armitage test.</p><p><strong>Results: </strong>Of 5662 people admitted to Labor and Delivery during the study period, 138 UDS were sent for 123 unique individuals. Ninety-eight (71%) of UDS were positive for nonprescribed substances. Of positive UDS, 36 (37%) were positive for nonprescribed opioids, and of these, 17 (47.2%) were positive for xylazine among 14 pregnant people. The trend of UDS positive for opioids that were also positive for xylazine increased significantly over time ( P = 0.030), from 0% in December 2022 to 100% in July 2023.</p><p><strong>Conclusions: </strong>Over 8 months, xylazine positivity significantly increased in UDSs positive for nonprescribed opioids in an urban Midwestern hospital. These results underscore the critical need to study the impact of xylazine on obstetric outcomes.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"233-235"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician and Practice Characteristics Associated With Support of Office-based Methadone: Findings From a National Survey.","authors":"Minhee L Sung, Anne C Black, Derek Blevins, Brandy F Henry, Kathryn Cates-Wessel, Michael A Dawes, Holly Hagle, Paul J Joudrey, Todd Molfenter, Frances R Levin, David A Fiellin, E Jennifer Edelman","doi":"10.1097/ADM.0000000000001388","DOIUrl":"10.1097/ADM.0000000000001388","url":null,"abstract":"<p><strong>Background: </strong>Alternative models for methadone delivery outside of federal and state-regulated opioid treatment programs may improve access. We determined factors associated with clinician support for continuing office-based methadone.</p><p><strong>Methods: </strong>We used data from the electronic Opioid Use Disorder Provider COVID-19 Survey conducted among X-waivered clinicians who were providing outpatient, longitudinal treatment of opioid use disorder (OUD) from July 2020 to August 2020. The outcome variable was selecting \"The opportunity for patients to receive office-based methadone\" when asked \"Which pandemic-related policy changes or new policy changes would you like to be continued or started after the pandemic?\" Using sequential multivariable logistic regression modeling, we estimated the association between clinician and practice characteristics and support for office-based methadone.</p><p><strong>Results: </strong>Of 1900 respondents, 728 met the inclusion criteria. Twenty-eight percent indicated support for office-based methadone. Clinician characteristics associated with support for office-based methadone were being Black or African American versus White (adjusted odds ratio [AOR] [95% confidence interval (CI)], 2.88 [1.19-6.98]), having provided medications for OUD (MOUD) for >15 years versus ≤15 years (AOR [95% CI], 1.66 [1.02-2.68]), treating 51 to 100 patients with MOUD monthly versus <25 patients (AOR [95% CI], 1.79 [1.04-3.09]), providing methadone (AOR [95% CI], 1.71 [1.03-2.85]) versus not providing MOUD previously, and working in an academic medical center versus other settings (AOR [95% CI], 1.88 [1.11-3.16]).</p><p><strong>Conclusions: </strong>A minority of surveyed X-waivered clinicians supported office-based methadone. Efforts to expand access to methadone via office-based settings should address implementation barriers.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"150-156"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the PROMOTE Screener to Identify Psychosocial Risk Factors for Prenatal Substance Use.","authors":"Ayesha Azeem, Marci Lobel, Cassandra Heiselman, Heidi Preis","doi":"10.1097/ADM.0000000000001427","DOIUrl":"10.1097/ADM.0000000000001427","url":null,"abstract":"<p><strong>Introduction: </strong>There is an urgent need to improve the identification of psychosocial vulnerabilities in clinical practice (eg, stress, unstable living conditions) and examine their contribution to prenatal substance use, especially for legal substances such as alcohol, tobacco, and recently, cannabis.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of 1842 patients who completed the PROMOTE screening instrument during their first prenatal visit to outpatient clinics of a New York State health system in 6/2019-11/2020. The PROMOTE includes 18 core items to assess psychosocial vulnerabilities including the NIDA Quick Screen assessing past year substance use. Outcomes were tobacco, cannabis, and alcohol use during pregnancy based on electronic medical record abstraction including clinical notes, self-report, or urine toxicology.</p><p><strong>Results: </strong>A total of 188 (10.2%) patients used at least 1 substance prenatally, including 132 (7.2%) tobacco, 50 (2.7%) cannabis, and 45 (2.4%) alcohol. Two of the NIDA Quick Screen items (past year tobacco use and past year illegal drug use) were associated in the bivariate analysis with greater use risk of all 3 substances. Additional risk factors uniquely associated with specific prenatal substance use variables include low education predicting tobacco use (adjusted odds ratio [AOR] = 2.74, 95% confidence interval [CI] = 1.43-5.23), being unpartnered predicting cannabis use (AOR = 3.37, 95% CI = 1.21-9.39), and major life events predicting alcohol use (AOR = 3.25, 95% CI = 1.439-7.38).</p><p><strong>Conclusions: </strong>Utilizing brief psychosocial self-screening instruments such as the PROMOTE can help identify and refer at-risk patients to appropriate care. Particular attention should be paid to life context including partner support, emotional health, stress, and past year substance use.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"216-222"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal Experiences With Xylazine and Behavior Change: A Qualitative Content Analysis of Reddit Posts.","authors":"Omeid Heidari, Olivia K Sugarman, Abigail K Winiker, Sabrina Gattine, Vivian Flanagan, Roham Razaghi, Brendan K Saloner","doi":"10.1097/ADM.0000000000001383","DOIUrl":"10.1097/ADM.0000000000001383","url":null,"abstract":"<p><strong>Objectives: </strong>Xylazine is a rapidly spreading adulterant in the United States' drug supply and is increasingly associated with overdoses and severe wounds, but there is a dearth of information about the clinical presentation or means of treatment for human xylazine exposure. The objective of this study was to explore personal attitudes about xylazine in the drug supply and experiences with xylazine-related use among people who reported using drugs and contributed content to social media site Reddit.</p><p><strong>Methods: </strong>To conduct a retrospective qualitative content analysis, the study team extracted all posts and comments from Reddit, which mentioned the terms \"xylazine\" or \"tranq.\" Content was extracted from 10 Reddit forums, or subreddits, specific to drug use, and included content created on or before the extraction date of January 2023. In total, 3284 posts were identified and 1803 were qualitatively coded using an inductive approach until meaning saturation was reached.</p><p><strong>Results: </strong>Three themes emerged across comments and posts: (1) personal experiences with xylazine, including a negative impact on overdose, withdrawal, and wounds; (2) behavior changes in response to xylazine in the drug supply, including devising and sharing new harm reduction and detection tips, and reducing or abstaining from drug use altogether; (3) a perceived lack of treatment options for xylazine withdrawal and information sharing to help others self-treat withdrawal symptoms, most often with clonidine.</p><p><strong>Conclusions: </strong>This study of people who reported using drugs with xylazine provides new insights into how xylazine is perceived, possible treatment modalities, and potential clinical research approaches.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"135-142"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Medication for Opioid Use Disorder During Pregnancy, 7 Clinical Sites, MATernaL and Infant clinical NetworK (MAT-LINK), 2014-2021.","authors":"Emmy L Tran, Amanda N Dorsey, Kathryn Miele, Suzanne M Gilboa, Lucas Gosdin, Mishka Terplan, Pilar M Sanjuan, Neil S Seligman, Tanner Wright, Elisha M Wachman, Marcela Smid, Michelle Henninger, Lawrence Leeman, Patrick D Schneider, Kara Rood, Judette M Louis, Sarah Caveglia, Autumn Davidson, Julie Shakib, Hira Shrestha, Dana M Meaney-Delman, Shin Y Kim","doi":"10.1097/ADM.0000000000001426","DOIUrl":"10.1097/ADM.0000000000001426","url":null,"abstract":"<p><strong>Objectives: </strong>To describe patterns of medication for opioid use disorder (MOUD) during pregnancies in the opioid use disorder (OUD) cohort of MAT-LINK, a sentinel surveillance network of pregnancies at US clinical sites.</p><p><strong>Methods: </strong>Seven clinical sites providing care for pregnant people with OUD collected electronic health record data. Pregnancies were included in this analysis if (1) the pregnancy outcome occurred between January 2014 and August 2021, (2) the person had OUD, and (3) there was any electronic health record-documented MOUD during pregnancy. Analyses describing MOUD type, demographic characteristics, and timing during pregnancy were performed.</p><p><strong>Results: </strong>Among 3911 pregnancies with any documented MOUD, more than 90% of pregnancies with methadone were to publicly insured people, which was greater than percentages for pregnancies with other MOUD. Buprenorphine with naloxone and naltrexone were two MOUD types that were increasingly common among pregnant people in recent years. In most pregnancies, prenatal care and MOUD were first documented in the same trimester. During the first, second, and third trimesters, there were 37%, 61%, and 91% of pregnancies with MOUD, respectively. Approximately 87% (n = 3412) had only 1 documented MOUD type, versus 2 or 3 types. However, discontinuity in MOUD across trimesters was still observed.</p><p><strong>Conclusions: </strong>In MAT-LINK's OUD cohort, the overall frequency of MOUD improved over the course of pregnancy. Contextual factors, such as insurance status and year of pregnancy outcome, might influence MOUD type. Prenatal care and MOUD might be facilitators for one another; however, there are still opportunities to improve early linkage and continuous access to both prenatal care and MOUD during pregnancy.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"208-215"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"30-Month Impact of Medications for Opioid Use Disorder on Acute Care Utilization in Rural Communities.","authors":"Daniel Maeng, Holly A Russell, Kenneth R Conner, Jade Malcho, Wendi Cross, Hochang B Lee","doi":"10.1097/ADM.0000000000001385","DOIUrl":"10.1097/ADM.0000000000001385","url":null,"abstract":"<p><strong>Purpose: </strong>To assess both the short- and longer-term impact of offering medications for opioid use disorder (MOUD, ie, methadone, buprenorphine, or naltrexone) on rates of all-cause emergency department (ED) visits and acute inpatient admissions (IP) over a 30-month period among Medicaid enrollees with opioid use disorder (OUD) residing in rural communities.</p><p><strong>Methods: </strong>A quasi-experimental retrospective analysis of longitudinal Medicaid claims data among continuously enrolled adult patients with OUD residing in 71 predominantly rural counties in the United States between 2018 and 2020. A cohort of patients receiving MOUD treatment was compared against a contemporaneous propensity score-matched comparison group consisting of those who received no MOUD during the period.</p><p><strong>Findings: </strong>The sample included 5370 patients with OUD in each group. At the index period (ie, the month in which any MOUD was used for the first time), buprenorphine was the most commonly used MOUD (82% of the MOUD treatment group). By the eighth month since the index period, MOUD use dropped below 60% among the MOUD treatment group. Over the 30-month post-MOUD period, MOUD treatment was associated with 24% (112 vs 148 per 1000 per month) and 52% (21 vs 44) lower rates of ED visit and IP admission rates, respectively ( P < 0.001), relative to the comparison group. Moreover, the reductions persisted well after the 18th month period.</p><p><strong>Conclusions: </strong>Receipt of MOUD was associated with both immediate- and long-term lower rates in acute care utilization rates among adult Medicaid beneficiaries with OUD residing in rural communities despite significant treatment discontinuation.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"143-149"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Severity and Progression of Illicitly Manufactured Fentanyl Withdrawal: A Quasi-experimental Comparison.","authors":"Anjalee Sharma, Kelly E Dunn, Katja Schmid-Doyle, Sarah Dowell, Narie Kim, Eric C Strain, Cecilia Bergeria","doi":"10.1097/ADM.0000000000001395","DOIUrl":"10.1097/ADM.0000000000001395","url":null,"abstract":"<p><strong>Objective: </strong>Illicitly manufactured fentanyl has largely replaced heroin throughout the United States. Characteristics of fentanyl-specific withdrawal are not well understood compared to traditional opioid withdrawal. This study examines opioid withdrawal severity among 2 cohorts of study participants who underwent identical morphine stabilization procedures before and after fentanyl was introduced to the local drug market.</p><p><strong>Methods: </strong>The Non-Fentanyl study (n = 103) included participants testing positive for non-fentanyl opioids, and the Fentanyl study (n = 30) included participants testing positive for fentanyl. Both studies completed a 7-day morphine stabilization protocol (30 mg subcutaneous, 4 times daily) and multiple daily self-report and observer-rated assessments of opioid withdrawal and vital signs. Two-way repeated-measures analyses of variance (ANOVAs) examined the effects of study, time, and study × time on daily peak ratings for each outcome.</p><p><strong>Results: </strong>There were significant elevations in self-report and observer-rated withdrawal scores among the Fentanyl versus Non-Fentanyl study (study × time, P < 0.05) during stabilization days 2-5 and days 2-6, respectively. There was a higher rate of tachycardia among the Fentanyl group compared to the Non-Fentanyl study, and peak diastolic blood pressure was greater among the Fentanyl study compared to the Non-Fentanyl study.</p><p><strong>Conclusions: </strong>Individuals with fentanyl exposure were less stabilized by morphine and experienced more severe opioid withdrawal via several metrics compared to persons with non-fentanyl opioid exposure. Withdrawal also remained elevated for several days despite morphine initiation. Adjustments to existing treatment induction protocols may be needed given the permeation of fentanyl into the heroin supply.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"172-178"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Obstetric and Child Outcomes of Prenatal Exposure to Inhalants in the Context of a Use Disorder.","authors":"Emily Southida Kounlavong, Charles W Schauberger, Jamie L Conklin, Hendree E Jones","doi":"10.1097/ADM.0000000000001382","DOIUrl":"10.1097/ADM.0000000000001382","url":null,"abstract":"<p><strong>Objectives: </strong>Inhalants are often used for their psychoactive effects, producing feelings of euphoria. Inhalant and solvent use is a serious public health concern, yet little is known about their effects on perinatal, fetal, and child outcomes. The aim of our review is to evaluate the impact of inhalant use by pregnant people on maternal, fetal, neonatal, and early childhood outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted on March 1, 2023, in 6 databases using relevant keywords. Bias assessment was performed using JBI Critical Appraisal Tools. Studies were included if they described a prenatal exposure to an inhalant; focused on maternal, fetal, neonatal, or early childhood outcomes; and were published as peer-reviewed reports in English.</p><p><strong>Results: </strong>The search yielded 1101 unique references with 22 studies meeting eligibility criteria and representing 205 pregnancies and 171 infants.The most common symptom of inhalant use reported in pregnant people was altered mentation, followed by renal tubular acidosis (RTA) reported with toluene use. Most common fetal outcomes included fetal growth restriction and preterm delivery (<37 weeks), while neonatal outcomes were withdrawal symptoms, such as jitteriness, trouble feeding, and dystonia. Child outcomes included developmental delays, including cognitive and speech impairments, and postnatal growth restriction, including microcephaly.</p><p><strong>Conclusion: </strong>Perinatal, fetal, and child outcomes associated with inhalant use among pregnant individuals are largely based on case reports and series. Prospective studies are needed to better characterize these outcomes, reduce stigma, increase equitable access to treatment, and identify potential interventions to reduce use and potential harm.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"121-128"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report on Outpatient Treatment of Adolescent Opioid Use Disorder.","authors":"Sivabalaji Kaliamurthy, Emma Straton, Prianka Kumar, Anna Carleen","doi":"10.1097/ADM.0000000000001391","DOIUrl":"10.1097/ADM.0000000000001391","url":null,"abstract":"<p><strong>Objectives: </strong>Adolescents are experiencing an increase in substance-related overdose fatalities, with most attributed to fentanyl and an increase in the prevalence of opioid use disorder (OUD). We know little about the characteristics of adolescents who use fentanyl, develop OUD, and seek addiction treatment. Here, we present demographic data and retention data on adolescent patients (≤18 years) who were treated at a pediatric addiction clinic.</p><p><strong>Methods: </strong>We included all patients who presented to an intake appointment at the pediatric addiction clinic between January 3, 2023, and October 17, 2023, and were diagnosed with OUD. We collected data on demographics, decision to start medicine for OUD (MOUD), choice of MOUD, and retention in treatment based on clinic visits at 1 month and 3 months postintake.</p><p><strong>Results: </strong>Patients are consisted of 24 adolescents ( Mage at intake = 16.8 ± 1.0 years, 67% Hispanic/Latinx, 75% public insurance) who met the criteria for moderate to severe OUD with known fentanyl use. All were offered MOUD, and 21 patients agreed to MOUD treatment; 16 adolescents selected buprenorphine/naloxone, and 5 selected naltrexone. At 3 months postintake, 14 patients (58%) were retained in treatment.</p><p><strong>Conclusions: </strong>Adolescent and family acceptance of MOUD treatment was high, and most patients were retained in treatment at 3 months postintake. More studies are needed to understand how to retain and support adolescent patients in outpatient treatment for OUD given the emergence of fentanyl.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"230-232"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}