Youth Opioid Recovery Support: Improving Care Systems
Condition: Opioid-Related Disorders
MeSH terms: Opioid-Related Disorders
Study type: Interventional

Summary: 
      Opioid addiction, also referred to as opioid use disorder, among young people is a growing
      health concern for patients and their families. Overdose deaths related to opioids have been
      steadily increasing in number and are at an all-time high. Opioid addiction has serious
      consequences such as getting HIV, legal problems, relationship problems, and unemployment.

      Currently, there are two standard of care office-based medications available to treat opioid
      use disorder, buprenorphine and naltrexone. Naltrexone has been available for several years
      as an extended-release monthly injectable formulation, and more recently buprenorphine is as
      well. Both of these medications are typically administered in the medical office setting.
      Long-acting injection medications like these help people that may otherwise forget doses,
      skip doses, and relapse.

      MAT that are FDA-approved such as these paired with counseling can help sustain recovery, but
      retention to treatment is a concern, especially among young adults. Many barriers arise for
      attending office-based treatment (e.g., transportation) often resulting in falling away from
      treatment and relapsing. Involvement of family members is often challenged by health care
      provider concerns about patient privacy, and existing relationship strain between patients
      and their families.

      The Youth Opioid Recovery Support (YORS) treatment delivery model hopes to address barriers
      to retention to substance treatment among those with opioid use disorder who have already
      decided to get treatment with either extended-release naltrexone or extended-release
      buprenorphine. The YORS model involves: 1) home-delivery of standard-of-care medication and
      individual/family counseling services; 2) assertive outreach efforts by the treatment team;
      and 3) contingency management incentives upon receipt of treatment.

      This service model has already shown promise in addressing barriers to treatment retention
      particularly difficulties with medication adherence in patients who were prescribed monthly
      injectable extended-release naltrexone. Now that extended-release buprenorphine is also
      available, broader MAT options provided in an assertive service delivery model may maximize
      treatment retention and recovery outcomes. Further, transitioning participants from
      home-based receipt of treatment to clinic-based care begins the translation to sustainable
      health care.
    


Intervention name(s): Youth Opioid Recovery Support service model
Intervention type(s): Behavioral
Intervention description(s): see arm 1 description
Intervention MeSH terms: Analgesics, Opioid
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Buprenorphine; Central Nervous System Depressants; Chemically-Induced Disorders; Community Mental Health Services; Drug Partial Agonism; Heroin Dependence; Medication Adherence; Mental Disorders; Naltrexone; Narcotic Antagonists; Narcotics; Opioid-Related Disorders; Opioid Substitution Treatment; Patient Compliance