According to a new study, young opioid addicts who took extended treatment with buprenorphine and naloxone (Suboxone) were less likely to continue using these drugs than those who underwent short term detox and counselling. Relapse rates were more than twice as high in youths treated with short term detox and counselling after four and eight weeks of treatment than in those who took extended treatment in a randomized trial, researchers at the University of Pennsylvania reported in the Nov. 5 issue of the Journal of the American Medical Association.

The study involved 152 patients 15 to 21 year old who had been using opioids regularly for a mean of 1.5 years. Patients in the buprenorphine-naloxone subgroup got the drug for nine weeks, and then the program was followed by counselling including one individual and one group session weekly for 12 weeks. The other subgroup received a lower dose of the drug and was tapered off after two weeks. They got weekly individual and group counselling.

Compared with the detox group, the extended-therapy group had lower rates of opioid-positive urine test results at 4 and 8 weeks, lead author Dr. George E. Woody, from the University of Pennsylvania, Philadelphia, and colleagues report in the study. By week 12, the differences were less significant: positive urine tests were found in 51% of control patients and 43% of the extended-medication group.

By the end of the study, young patients who continued to take Suboxone were less likely to use opioids, cocaine and marijuana, to inject drugs, or drop out of treatment than those who received short-term detoxification and counseling.

Suboxone treatment combines buprenorphine, a drug used for moderate to severe pain, with naloxone hydrochloride, a drug that prevents or reverses the effects of opioids.

In an accompanying editorial, David Fiellin, M.D., of Yale University, agreed that the extended-medication approach gave better results than detox plus counseling.

“The implication is that adolescent opioid-dependent patients, like their adult counterparts, will likely need long-term, rather than short-term, opioid agonist treatment,” Dr. Fiellin wrote.

Dr. Fiellin also noted that there has been an increase in the use of prescription painkillers and other opioids among teens and young adults.

Previous studies have shown that more teens say it is easier for them to acquire prescription drugs than it is to buy alcohol. The 2007 National Survey on Drug Use and Health: National Findings, resealed by the Department of Health and Human Services has shown that more American teens who try drugs for the first time continue to use these drugs. Overall, from 2002 to 2007, the report found a decrease in the rates of adolescent substance abuse for almost every type of illegal drug, including marijuana, cocaine, LSD, Ecstasy as well as prescription drugs. The reports point to the association between substance abuse and mental health. 24.3 million Americans aged 18 or older experienced serious psychological distress.

Dr. Nora Volkow, director of the National Institute on Drug Abuse, say the findings “highlight the need for longer-term studies to determine whether sustained treatment can improve outcomes.”