Adult Opioid Treatment Doesn't Work for Teens

Teen Opioid Treatment - Freedom From Addiction

Both medically and mentally, adults and teens differ, so why should we offer them the same form of rehabilitation? According to a recent article on NPR, we shouldn’t. The story starts with that of a young teen who, as an athlete, got addicted to painkillers and then heroin, as a cheaper and easier way to feed his addiction. He was in and out of rehab for years, constantly relapsing after his 30 days here and there. Sadly, in the two years he tried to get clean, he had a fatal relapse. It’s a story we’re hearing more and more. Perhaps part of the problem is the way in which we are helping these teens get help. Sending an adolescent to adult rehab just isn’t working.

The article points out, “When substance use disorders occur in adolescence, they affect key developmental and social transitions, and they can interfere with normal brain maturation,” the National Institute on Drug Abuse reported in 2014. “These potentially lifelong consequences make addressing adolescent drug use an urgent matter.” With those types of facts, it’s obvious teens need a different type of recovery program.

Enter Serenity Mesa, a long-term treatment center for youths in Albuquerqu, which opened just last year.

But along with centers like these, we need to rethink the way in which we diagnose, even recognize teen addicts. Physicians, as the article highlights, trained to diagnose and treat addiction are a must. They need to recognize the signs of teen addiction. The article even mentions making addiction medicine mandatory in med school. Engaging people earlier in their addiction improves their chances of recovery and overall better health,” says Dr. David E. Smith, an addiction medical specialist who founded the Haight Ashbury Free Clinics in San Francisco. “Meanwhile, costs for the health care system are dramatically reduced.”

But getting kids to treatment is part of the problem. The article points out that “The 2012 National Survey on Drug Use and Health found that 90 percent of drug-addicted youth ages 12 to 17 get no treatment at all.” Teens rarely enter rehab on their own, which is why clinicians rely on juvenile justice systems and schools to connect teams to treatment.

Treatment for teens many times includes engaging the entire family. Functional Family Therapy, as it’s called, uses “a dozen or more one-hour sessions to defuse negativity, then teaches skills training in family communication, parenting, problem solving and conflict management. Later sessions strengthen a family’s capacity to navigate community resources, which can prevent relapse.” For now, Dr. Holly Waldron, a senior scientist at the Oregon Research Institute who studies adolescent behavior, is hoping to integrate videoconferencing into the process, because in small towns, cars parked in lots where therapy takes place can lead to gossip, which teens may find hurtful or damaging.

Along with family therapy, drugs are also being administered. While methadone is effective for adults, it’s not a perfect fit for teens. As Dr. Ako Jacintho, the medical director for HealthRIGHT 360, explains, methadone can only be administered at methadone clinics. It must also be taken daily. For teens, whose mobility may be reliant on others, that’s not always an option. As well, teens may encounter other addicts at said clinics, may even be given a chance to buy drugs. Instead, Jacintho supports the administration of Suboxone, a combination of buprenorphine, an opiate substitute that eliminates craving, and naloxone, which blocks euphoric effects. “Suboxone doesn’t cause drowsiness, and, the equilibrium it provides can make it easier to identify and treat co-occurring disorders like depression or anxiety. The dosage is eventually tapered,” Jacintho says. The article also points out, “A 2014 Yale School of Medicine study showed that ongoing maintenance treatment with Suboxone is more effective than detoxification and abstinence alone.”

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