ISSN: 2642-6250
Authors: Harper K, Cannella J, Bhatt NV, Gentile JP* and Johnson JA
Substance use disorders (SUD) remain a long-standing problem for adolescents. Medication assisted treatment (MAT) is now standard treatment for adult SUD but less common in adolescents. This article provides a brief summary of the available psychotropics used to treat SUD in adolescent patients; psychotropics should be considered as one part of a multi-disciplinary approach to treatment of SUD. Due to the growing impact of the opioid public health crisis in the adolescent population, pediatricians have an expanding role in identifying and treatment of opioid use disorders, in addition to other substance use disorders. Pediatricians and adolescent medicine physicians are critically important in the solution to the addiction problem. There is expanding evidence that treatment of SUDs must be integrated into multiple parts of the delivery care system, including primary care settings. Medications Used to Treat Opioid Use Disorders (OUD): Methadone and buprenorphine are the two primary methods of MAT available to treat OUD. Methadone is highly regulated and only available to patients over age 18 in the United States. Buprenorphine/naloxone is FDA-approved for patients age ≥16, with the American Academy of Pediatrics Committee on Substance Use and Prevention (2016) recommending improved pediatrician access to buprenorphine training and MAT consideration for adolescents. Buprenorphine/Naloxone (Suboxone) and Buprenorphine (Subutex): Buprenorphine is a schedule III drug, requiring additional prescriber trainings and requirements. Buprenorphine is a mu-opioid partial agonist with greater safety margins than full agonists and less withdrawal. It is often combined 4:1 with naloxone, an antagonist; Alho, et al. found that this combination reduced “street value”, likely decreasing abuse potential.
Keywords: Treatment of SUDs; Buprenorphine/Naloxone; Buprenorphine
