Youth Opioid Recovery Support: Improving Care Systems

Youth Opioid Recovery Support: Improving Care Systems

Publication date: Jul 10, 2019

Opioid addiction, also referred to as opioid use disorder, among young people is a growing health concern for patients and their families. Overdose deaths related to opioids have been steadily increasing in number and are at an all-time high. Opioid addiction has serious consequences such as getting HIV, legal problems, relationship problems, and unemployment. Currently, there are two standard of care office-based medications available to treat opioid use disorder, buprenorphine and naltrexone. Naltrexone has been available for several years as an extended-release monthly injectable formulation, and more recently buprenorphine is as well. Both of these medications are typically administered in the medical office setting. Long-acting injection medications like these help people that may otherwise forget doses, skip doses, and relapse. MAT that are FDA-approved such as these paired with counseling can help sustain recovery, but retention to treatment is a concern, especially among young adults. Many barriers arise for attending office-based treatment (e.g., transportation) often resulting in falling away from treatment and relapsing. Involvement of family members is often challenged by health care provider concerns about patient privacy, and existing relationship strain between patients and their families. The Youth Opioid Recovery Support (YORS) treatment delivery model hopes to address barriers to retention to substance treatment among those with opioid use disorder who have already decided to get treatment with either extended-release naltrexone or extended-release buprenorphine. The YORS model involves: 1) home-delivery of standard-of-care medication and individual/family counseling services; 2) assertive outreach efforts by the treatment team; and 3) contingency management incentives upon receipt of treatment. This service model has already shown promise in addressing barriers to treatment retention particularly difficulties with medication adherence in patients who were prescribed monthly injectable extended-release naltrexone. Now that extended-release buprenorphine is also available, broader MAT options provided in an assertive service delivery model may maximize treatment retention and recovery outcomes. Further, transitioning participants from home-based receipt of treatment to clinic-based care begins the translation to sustainable health care.

Concepts Keywords
Addiction Buprenorphine
Buprenorphine Addiction
Contingency Management Naltrexone
Counseling Opioid use disorder
DSM Substance dependence
Extended Release Phenols
FDA Ethers
HIV Morphinans
Maryland RTT
Naltrexone Chemical compounds
Nurse Practitioner Organic compounds
Opioid Opioids
Opioids Criteria opioid disorder
Physician Counseling
Privacy HIV
Relapse Strain
Unemployment G transportation

Semantics

Type Source Name
disease MESH medication adherence
pathway BSID Translation
gene UNIPROT NR4A2
gene UNIPROT ALG3
disease MESH Opioid-Related Disorders
gene UNIPROT ACAT1
gene UNIPROT MAT1A
disease MESH relapse
gene UNIPROT INPP5K
gene UNIPROT PLEKHM2
gene UNIPROT SPHKAP
gene UNIPROT SNW1
pathway BSID Release
drug DRUGBANK Naltrexone
drug DRUGBANK Buprenorphine
disease MESH unemployment

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