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Suboxone for Teens. Teenage Opiate Detox and Buprenorphine Maintenance - Success Rates, Risks and Research
Can teens use Suboxone? Is treatment with buprenorphine recommended for a teen with a short history of addiction? Do other forms of treatment, such as conventional detox and therapy work better than Suboxone for teens with opiate addictions?
The first drug that most teens will experiment with is no longer marijuana – it is now a prescription opiate type pain pill, and more than 30% of teens surveyed by the federal govt. said that opiate type pain pills were very easy to get in their schools.
It is not at all surprising therefore that the numbers of teens becoming addicted to opiates has been rising steadily over the last decade. And teens addicted to opiates are at a very high risk to progress to IV administration and at very high risk (higher than for adult users) for HIV or hepatitis infection.
So it is critical to intervene at an early stage – but what type of treatment is best suited to teen heroin or opiate pain pill users?
Methadone is very rarely recommended as a treatment option for teens. Doctors seem reluctant to prescribe a maintenance course of (Full Agonist) opiates to an adolescent with a still developing brain, and the daily reporting often necessary for methadone administration can be hard for school-aged teens. There are very few clinics in the US that offer methadone treatment to adolescent substance abusers.
Methadone is unlikely an option for teen users.
Detox, Drug Rehab and Counseling?
The most commonly recommended form of treatment for teenage opiate addicts is a conventional period of detox followed by psychosocial counseling and therapy. This detox and therapy can be offered on either an inpatient or an outpatient basis.
Detox and counseling is an abstinence based form of therapy, and strives to teach young drug users how to live completely drug free. Teens are often given the medication clonidine while going through detox to lessen the severity of the side effects.
Following the cessation of severe withdrawal pains, teens are enrolled in group and individual therapy, and cognitive or other therapies, and taught life skills and relapse avoidance techniques.
Because teens tend to have much shorter histories of opiate addiction, parents and caregivers tend to prefer the detox and counseling approach.
Unfortunately, the long and even short term relapse rates of abstinence based therapies for opiate users (even teens) is quite high.
Also unfortunate, is that the drop out rate for these types of programs is also quite high.
A recent study compared the success rates of teens given clonidine while detoxing and then given therapy, to teens given a maintenance dosage of buprenorphine (Suboxone) and it was found that the teens given Suboxone were far more likely to stay in treatment and far more likely to stay off of opiates (As tested in the urine).
Research on Teen Suboxone Treatments
- NIDA summary of clonidine study
A study comparing the relapse rates of detox and medication with clonidine and with buprenorphine.
- U of Penn study on detox vs. buprenorphine treatment for teens
- SAMHSA Buprenorphine
An overview of current research on Buprenorphine usage by adolescents.
- SAMHSA Buprenorphine Guidelines (PDF)
It is the view of most adolescent substance abuse experts (according to SAMHSA) that buprenorphine treatment is the best choice for most teen opiate addicts.
Suboxone may be prescribed to adolescent users. In some states teens will need parental consent to receive the medication, but in many states doctors can prescribe this medication without needing parental consent.
The recommended treatment protocol is:
- To try to detox teens off of opiates using a very short course of Suboxone combined with therapy
- If that doesn't work (if they relapse) to put teens onto a longer term maintenance dosage of Suboxone, and continue with the therapy.
Unfortunately, teenage usage of Suboxone has received limited clinical study. One major study has shown that teens on Suboxone do a whole lot better than teens detoxed using clonidine. But that same study showed that although teens did very well while on the Suboxone, most of these teens relapsed at the end of the 6 week suboxone maintenance stage. Experts are calling for more research on how well teens will do when given a very slow tapering down off of the medication.
- Suboxone is safe for teens.
- Suboxone is recommended by most experts as the best treatment for teens with shorter histories of drug use.
- Teens should try to detox using Suboxone and if they relapse they should be placed on long term Suboxone maintenance.
Far more research is needed, but the available research indicates that Suboxone is a very viable option for teen opiate addicts.