Opiate-dependent adolescents in Ireland: a descriptive study at treatment entry

Abstract

Objectives: To describe the drug history and co-existing psycho-social problems among under-19 year olds accessing treatment for opiate dependency, including methadone maintenance, and examine for any gender differences.Method: A descriptive study of under-19 years assessed at the largest drug treatment clinic in Dublin, Ireland, between October 2000 and September 2006. Data was obtained through review of case notes, assessment questionnaires and urine drug screens.Results: Eighty-six young people were included. Their mean age was 16.8 years. Forty-six (54%) were female. Only 26 (30%) reported an intact family of origin. Twenty-three (27%) had been in care. Mean age for first use of any illicit drug was 12.4 years, and for heroin was 14.8 years. The mean age of leaving school was 14.4 years; 42 (49%) first tried heroin after leaving school. Forty-one (48%) had a history of homelessness. Forty-four (51%) had previously injected; 26 (30%) were currently injecting. Fifty-six (65%) had not been screened for blood-borne diseases; twenty-one (24%) subsequently tested positive for hepatitis C. Thirty-eight (48%) had previous convictions; 33 (38%) were facing charges. Forty-five (52%) had previously seen a psychiatrist; nine (11%) had received inpatient psychiatric treatment. Boys were more likely to leave school early, have a substance-abusing sibling, and to have a past conviction. Girls were more likely to have a partner, and have taken a deliberate overdose.Conclusions: This study highlights the multiple and complex needs of teenagers abusing opiates. Services seeking to meet their needs will require a broad range of interventions and excellent interagency co-operation.

Access to Medications for Opioid Use Disorder and Associated Factors Among Adolescents and Young Adults

“…Among the 37 studies, 17 were cohort studies, 15 were cross-sectional studies, and 5 were qualitative studies. Twenty-four studies were conducted in the US, 4 in Canada, 3 in Australia, 2 in England, 2 in Ireland, and 1 in Italy, whereas 1 study derived data from Austria, Canada, and the US . Details on study design, setting, sample characteristics, inclusion and exclusion criteria, and study quality are presented in eTable 6 in the Supplement.…”

“…Fourteen studies included participants with an opioid use disorder (OUD) diagnosis, 9 examined heroin and other opioid use, and 7 examined any opioid use . In addition, 2 studies examined primary opioid use, 1 evaluated nonmedical prescription opioid use, and 1 reviewed any injection drug use .…”

“…In addition, 2 studies examined primary opioid use, 1 evaluated nonmedical prescription opioid use, and 1 reviewed any injection drug use . Sixteen studies included any opioid use during the study period, 9 examined current opioid use, 3 examined past 30-day opioid use, 2 examined past year opioid use, and 1 examined past 6-month opioid use . The remaining studies included opioid use in the 3 months before and 1 month after an opioid-related overdose, upon imprisonment, and in the 3 days and 8 or more years before treatment admission …”

“…Thirty studies examined access to methadone, 26 examined access to buprenorphine, and 10 examined access to naltrexone, whereas 2 studies did not specify the type of MOUD being investigated . In addition, 2 studies reviewed access to buprenorphine-naloxone, 1 reviewed access to lofexidine, 1 reviewed access to disulfiram and acamprosate, and 1 reviewed access to slow-release oral morphine and injectable OAT, while 3 studies examined MOUD-based detoxification .…”

“…Five studies found an association between sex and MOUD access: women were more likely to access MOUD in 4 studies, whereas men were more likely to access MOUD in 1 study . In addition, 3 studies compared MOUD access between women and men. One study found that women were more likely to report having a history of attempting suicide by overdose and being in a relationship, and men were more likely to report having a sibling with alcohol use disorder, having a past criminal conviction, and being a younger age at school dropout when entering a methadone program.…”