Emerging adult age status predicts poor buprenorphine treatment retention

Abstract

Emerging adults (18-25 years old) are often poorly retained in substance use disorder treatment. Office-based buprenorphine often enhances treatment retention among people with opioid dependence. In this study, we examined the records of a collaborative care buprenorphine treatment program to compare the treatment retention rates of emerging adults versus older adults. Subjects were 294 adults, 71 (24%) aged 18-25, followed in treatment with buprenorphine, nurse care management, and an intensive outpatient program followed by weekly psychosocial treatment. Compared to older adults, emerging adults remained in treatment at a significantly lower rate at 3 months (56% versus 78%) and 12 months (17% versus 45%), and were significantly more likely to test positive for illicit opioids, relapse, or drop out of treatment. Further research into factors associated with buprenorphine treatment retention among emerging adults is needed to improve treatment and long-term outcomes in this group.

Keywords: Buprenorphine; Development; Emerging adult; Opioid dependence; Outcome; Retention; Toxicology; Treatment; Young adult.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

Fig. 1

Consort diagram.

Fig. 2

Retention over time during 12 months of collaborative care buprenorphine treatment.

Fig. 3

Emerging adults versus older adults compared on reasons for program disenrollment by 12 months after admission.

Fig. 4

Emerging adults versus older adults compared on presence of a positive toxicology for illicit use of (a) opioids and (b) cocaine during each treatment month.