Young adults who are addicted to opioid drugs may be better served initially by residential, in-patient treatment rather than outpatient treatment that is the current standard of care.
John Kelly, PhD, of the Center for Addiction Medicine at Massachusetts General Hospital (MGH) in Boston, and colleagues found that a month-long, 12-step residential program with links to community-based follow-up care led nearly 30% of opioid-dependent patients to remain drug-free one year later. In comparison, another recent study found that 83% of those who entered an opioid-treatment outpatient program had dropped out a year later.
The researchers enrolled nearly 200 young adults diagnosed with either opioid dependence, opioid misuse, or addiction to other drugs such as alcohol, cocaine, or marijuana in a 12-step program that emphasizes detoxification, psychotherapy and engagement with community-based support groups following discharge.
A year after the residential treatment, 29% of the opioid-dependent users had remained abstinent from using, compared with 22% for the opioid misusers, even though the former had more severe addiction when entering the program, the researchers reported in the journal Drug and Alcohol Dependence. Opioid misusers were also least likely to complete outpatient care and used more marijuana and alcohol in the follow-up period.
"Our findings indicate that opioid-dependent young adults might benefit from starting out with residential treatment and then linking up with continuing outpatient care after discharge," Zev Schuman-Olivier, MD, a study co-author also with MGH, said in a statement. "In contrast, many non-dependent opioid misusers may not be ready to benefit fully from the time spent in 12-step residential treatment."
Residential treatment may be an appropriate first-line option for young adults who are dependent on opioid drugs — including prescription painkillers and heroin — and may result in higher levels of abstinence than does the outpatient treatment that is currently the standard of care.
A study from the Massachusetts General Hospital (MGH) Center for Addiction Services found that a month-long, 12-step-based residential program with strong linkage to community-based follow-up care, enabled almost 30% of opioid-dependent participants to remain abstinent a year later. Another recent study found that 83% of those who entered an office-based opioid treatment program had dropped out a year later.