Predictors of abstinence: National Institute of Drug Abuse multisite buprenorphine/naloxone treatment trial in opioid-dependent youth.

Prescription opioids are second only to marijuana as the most commonly used illicit substances among high school seniors. Buprenorphine, a partial mu-agonist, has shown promise in treating opioid-dependent youth in two recent NIDA-funded studies, including a multisite trial in the National Drug Abuse Treatment Clinical Trials Network (CTN-0010, “Buprenorphine/Naloxone-Facilitated Rehabilitation for Opioid Dependent Adolescents/Young Adults”). This ancillary investigation of data from that study, which compared 12 weeks of extended buprenorphine/naloxone (Bup/Nal) therapy to 2 weeks of Bup/Nal detoxification in youth ages 15-21, aimed to examine predictors of opioid abstinence in Bup/Nal-assisted psychosocial treatment for opioid-dependent youth. Results found that youth presenting to treatment with previous 30-day injection drug use and more active medical/psychiatric problems were less likely to have a week-12 opioid-positive urine (OPU). Those with early treatment abstinence (i.e., weeks 1 and 2) and those who received additional nonstudy treatments during the study were less likely to have a week-12 OPU and those not completing 12 weeks of treatment were more likely to have an OPU.

Conclusions: Youth with advanced illness (i.e., reporting injection drug use and additional health problems) and those receiving ancillary treatments to augment study treatment were more likely to have lower opioid use. Treatment success in the first 2 weeks and completion of 12 weeks of treatment were associated with lower rates of opioid-positive urines. These findings suggest that youth with advanced illness respond well to Bup/Nal treatment and identify options for tailoring treatment for opioid-dependent youth presenting at community-based settings.

Related protocols: CTN-0010