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Medication for Opioid Use Disorder (MOUD) to promote opioid abstinence and treatment retention in transition-age youth
Summary of the evidence
MOUD to promote opioid abstinence (negative urine screens) and treatment retention in transition-age youth was investigated in a systematic review of four RCT, assessing a combination of buprenorphine (studies evaluated sublingual, short-term buprenorphine) plus cognitive behavioral therapy versus a comparison condition. It was found that buprenorphine or buprenorphine-naloxone was more effective than clonidine:
- to promote abstinence at the 1-month follow-up, measured as percent of patients with negative urine screens (OR = 4.00, 95% CI: 1.00, 16.00),
- when augmented by memantine at three months (OR 9.2 95% CI: 2.7, 31.5),
- when tapered over longer rather than shorter durations (in two studies, OR 7.1 95%CI: 2.9 , 17.3; Cohen's d = 0.57, 95%CI: 0.02, 1.13.
Because of ethical challenges, few trials with young people exist, yet further long-term studies are urgently needed to assess relapse after treatment and social functioning.
Details
Note: this evidence summary is only valid for the outcomes, target groups, settings and substances/patterns of use described below.
