Addressing the opioid epidemic with behavioral interventions for adolescents and young adults: A quasi-experimental design.

Abstract

While several behavioral interventions have shown efficacy in opioid use disorder treatment, little is known regarding which behavioral interventions work best for youth, and if treatment responses vary by developmental age or sex. We explored latency to first episode of opioid use among adolescents and young adults following opioid use disorder treatment initiation with: (a) adolescent community reinforcement approach (A-CRA), (b) motivational enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) or CBT alone (MET/CBT or CBT alone), or (c) treatment as usual (TAU; 12-step facilitation, supportive therapy). Adolescents and young adults (N = 785) entering treatment for opioid use disorder were followed for 1 year. Survival analysis was used to assess variation in latency to first episode of opioid use by treatment received, as well as moderation by age group and sex. Those receiving MET/CBT or CBT alone, and TAU fared better than those receiving A-CRA. For adolescent males, those receiving TAU or A-CRA had poorer outcomes compared with those receiving MET/CBT or CBT alone, while no differences were found between treatments for female adolescents. Female young adults receiving TAU had lower hazard of opioid use compared with those receiving A-CRA, and MET/CBT or CBT alone, and male young adults receiving A-CRA had higher hazard than those receiving TAU, and MET/CBT or CBT alone. Findings highlight different treatments may be more efficacious for youth based on developmental age and sex. Clinicians working with young people with opioid use disorder should consider patients' developmental stage and sex when considering treatment approaches. (PsycINFO Database Record (c) 2019 APA, all rights reserved).