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Engagement, initiation, and retention in medication treatment for opioid use disorder among young adults: A narrative review of challenges and opportunities.

Authors :
Fishman, Marc
Wenzel, Kevin
Gauthier, Phoebe
Borodovsky, Jacob
Murray, Owen
Subramaniam, Geetha
Levy, Sharon
Fredyma, Emma
McLeman, Bethany
Marsch, Lisa A.
Source :
Journal of Substance Use & Addiction Treatment. Nov2024, Vol. 166, pN.PAG-N.PAG. 1p.
Publication Year :
2024

Abstract

Opioid Use Disorder (OUD) is a catastrophic public health problem for young adults (YAs) and their families. While medication for OUD (MOUD) is safe, effective, and recognized as the standard of care, its' uptake and success have been limited in YAs compared to older adults. This narrative review summarizes the existing literature and highlights select studies regarding barriers to YA MOUD, potential explanations for those barriers, and strategies to overcome them. Barriers are prominent along the entire cascade of care, including: treatment engagement and entry, MOUD initiation, and MOUD retention. Hypothesized explanations for barriers include: developmental vulnerability, inadequate treatment system capacity, stigma against MOUD, among others. Interventions to address barriers include: promotion of family involvement, increasing provider capacity, integration of MOUD into primary care, assertive outreach, and others. Integrating an adapted version of family coaching from the Community Reinforcement Approach and Family Training (CRAFT) and other models into YA MOUD treatment serves as an example of an emerging novel practice that holds promise for broadening the funnel of engagement in treatment and initiation of MOUD, and enhancing treatment outcomes. This and other developmentally-informed approaches should be evaluated as part of a high-priority clinical and research agenda for improving OUD treatment for YAs. • Standard-of-care MOUD has faced challenges to uptake and success in treatment of YAs. • Barriers include lack of capacity, misconception, stigma, developmental vulnerability. • Solutions include provider training, primary care integration, assertive outreach. • Family coaching and other developmentally-informed approaches have great promise. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
29498767
Volume :
166
Database :
Academic Search Index
Journal :
Journal of Substance Use & Addiction Treatment
Publication Type :
Academic Journal
Accession number :
179529988
Full Text :
https://doi.org/10.1016/j.josat.2024.209352