Adolescent Clients Treated with Methadone and Buprenorphine for Heroin Addiction
James Bell, Carolyn Mutch, Jozef Blaszczyk, The Langton Centre

For a copy of the presentation, please contact:

James Bell
The Langton Centre
591 South Dowling St
Surry Hills NSW 2010
Australia

Phone: 612-933-28702
Fax: 612-933-28711
E-mail: BellJ@SESAHS.NSW.GOV.AU

Abstract

The Langton Centre is a specialist facility for treatment of people with problems related to use of alcohol and other drugs. The Centre formerly treated only adults, but in 1999 began discussions with other community services about offering treatment programs for adolescents, and established a Family and Adolescent Team. Prior to January 2001, opioid-dependent people seeking maintenance treatment received methadone, but buprenorphine was introduced in January 2001 as the first-line treatment for adolescents.

This report outlines the experience of all 61 adolescents (age range 14-17 at time of commencing treatment) treated for heroin addiction at The Langton Centre since January 2000. 35% reported having been diagnosed with a psychiatric order in addition to drug problems – most commonly, depression (21%) and ADHD (14%). Mean age of initiation of heroin use was 14 + 1.3 years (range 11-16). Females (60%) and Aboriginals (25%) were over-represented compared to adult clientele presenting to the Centre. These 61 subjects had a total of 113 episodes of treatment – 30 with methadone, 56 with buprenorphine, and 27 with symptomatic (non-opioid) medication. Subjects treated with methadone had significantly longer retention in treatment than subjects treated with buprenorphine (288 days vs. 101 days, p<0.01), attended on more days in the first month (t=4.2, p<0.001), were more likely to drop out without consultation with staff (χ2=9.9, df=2, p<0.01). Compared to subjects receiving buprenorphine or methadone, those whose first treatment episode was with methadone were less likely to return for a subsequent episode of treatment (Chi square 6.06, df 2, p=0.048).

These findings are consistent with an earlier report that young patients treated with buprenorphine tend to have recurrent, short episodes of treatment. While this was not a randomized trial, the results suggest that methadone treatment was more effective at retaining adolescent patients and reducing premature discharge and subsequent return to treatment.

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