Special Problems of Adolescents with Opioid Use Disorders

Roots of Adolescent Opioid Use and Abuse

Addressing the roots of opioid use disorders is vital to successful treatment of opioid dependence, since failure to do so will reduce the chance of successful treatment and increase the risk of relapse (Hird et al., 1997). While most primary care physicians are neither prepared nor trained to troubleshoot these issues, they are in a position to refer adolescent patients to services that are (SAMHSA, 1999).

The following have been identified as important risk factors for adolescent opioid use disorders:

• Drug use by family or peers (Broome et al., 2001)
• Lack of social and/or family support (Broome et al., 2001)
• Living in a high-crime area (Broome et al., 2001)
• Poor school performance (Broome et al., 2001)
• History of physical or sexual abuse (SAMHSA, 1999)
• Psychiatric disorders (Hopfer et al., 2003)
• Polysubstance misuse (Hird et al., 1997)

Physicians should consider screening for opioid misuse in adolescents who exhibit these risk factors, especially since few adolescent substance misusers present with overt signs of drug use (Hird et al., 1997).

Additional Needs of Adolescents in Treatment for Opioid Use

Adolescents in treatment for opioid use disorders frequently have a number of other problems that need to be addressed. While primary care physicians are not typically equipped to handle these (with the exception of medical treatment), they are in an excellent position to refer adolescent patients to supportive services.

Some important issues include the following:

• Legal problems
• Employment and education assistance
• Medical treatment