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Treating Adolescent Substance Use pp 77–90Cite as

Medications for Substance Use and Relapse Prevention

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Abstract

Adolescent substance use disorders (SUDs) are difficult to treat and associated with negative functional and health outcomes. Even with the use of evidence-based psychosocial interventions, many youth drop out of treatment or relapse within 6 months of treatment engagement. Medications for addiction treatment (MAT, formerly known as medication-assisted treatments), or the use of other adjunctive pharmacotherapy in conjunction with psychosocial interventions, have demonstrated effectiveness in improving adult SUD treatment outcomes. Only a few controlled pharmacotherapy trials have been completed in adolescents to date. Results have been mixed, with some medications showing promise and others showing no benefit over psychosocial treatment alone. Nicotine replacement therapy and bupropion for tobacco, N-acetylcysteine for cannabis, and buprenorphine-naloxone for opioid use disorders have shown early promise in improving youth SUD treatment outcomes when combined with psychosocial interventions. Providers may consider trialing addiction pharmacotherapies in youth who fail to improve with psychosocial treatments or who have additional negative prognostic factors.

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References

  1. Winters KC, Tanner-Smith EE, Bresani E, Meyers K. Current advances in the treatment of adolescent drug use. Adolesc Health Med Ther. 2014;5:199–210.

    Article  Google Scholar 

  2. Hammond CJ, Gray KM. Pharmacotherapy for substance use disorders in youths. J Child Adolesc Subst Abuse. 2016;25(4):292–316.

    Article  Google Scholar 

  3. Hammond CJ, Mayes LC, Potenza MN. Neurobiology of adolescent substance use and addictive behaviors: treatment implications. Adolesc Med State Art Rev. 2014;25(1):15–32.

    PubMed  PubMed Central  Google Scholar 

  4. O’Brien CP. Anticraving medications for relapse prevention: a possible new class of psychoactive medications. Am J Psychiatry. 2005;162(8):1423–31.

    Article  Google Scholar 

  5. Marsch LA, Bickel WK, Badger GJ, Stothart ME, Quesnel KJ, Stanger C, et al. Comparison of pharmacological treatments for opioid-dependent adolescents: a randomized controlled trial. Arch Gen Psychiatry. 2005;62(10):1157–64.

    Article  CAS  Google Scholar 

  6. Woody GE, Poole SA, Subramaniam G, Dugosh K, Bogenschutz M, Abbott P, et al. Extended vs short-term buprenorphine-naloxone for treatment of opioid-addicted youth: a randomized trial. JAMA. 2008;300(17):2003–11.

    Article  Google Scholar 

  7. Clark DB. Pharmacotherapy for adolescent alcohol use disorder. CNS Drugs. 2012;26(7):559–69.

    Article  CAS  Google Scholar 

  8. Subramaniam GA, Warden D, Minhajuddin A, Fishman MJ, Stitzer ML, Adinoff B, et al. Predictors of abstinence: National Institute of Drug Abuse multisite buprenorphine/naloxone treatment trial in opioid-dependent youth. J Am Acad Child Adolesc Psychiatry. 2011;50(11):1120–8.

    Article  Google Scholar 

  9. Vo HT, Robbins E, Westwood M, Lezama D, Fishman M. Relapse prevention medications in community treatment for young adults with opioid addiction. Subst Abus. 2016;37(3):392–7.

    Article  Google Scholar 

  10. Lowinson JH, Marion IL, Joseph H, Dole VP. Methadone maintenance. In: Lowinson JH, Ruiz P, Millman RB, editors. Substance abuse: a comprehensive textbook. 2nd ed. Baltimore: Williams and Wilkins; 1992.

    Google Scholar 

  11. Fishman MJ, Winstanley EL, Curran E, Garrett S, Subramaniam G. Treatment of opioid dependence in adolescents and young adults with extended release naltrexone: preliminary case-series and feasibility. Addiction. 2010;105(9):1669–76.

    Article  Google Scholar 

  12. Deas D, May MP, Randall C, Johnson N, Anton R. Naltrexone treatment of adolescent alcoholics: an open-label pilot study. J Child Adolesc Psychopharmacol. 2005;15(5):723–8.

    Article  Google Scholar 

  13. Miranda R, Ray L, Blanchard A, Reynolds EK, Monti PM, Chun T, et al. Effects of naltrexone on adolescent alcohol cue reactivity and sensitivity: an initial randomized trial. Addict Biol. 2014;19(5):941–54.

    Article  CAS  Google Scholar 

  14. Niederhofer H, Staffen W. Comparison of disulfiram and placebo in treatment of alcohol dependence of adolescents. Drug Alcohol Rev. 2003;22(3):295–7.

    Article  Google Scholar 

  15. Monti PM, Miranda R, Justus A, et al. Biobehavioral mechanisms of topiramate and drinking in adolescents: preliminary findings. Neuropharmacology. 2010;35:S164.

    Google Scholar 

  16. Dawes MA, Johnson BA, Ait-Daoud N, Ma JZ, Cornelius JR. A prospective, open-label trial of ondansetron in adolescents with alcohol dependence. Addict Behav. 2005;30:1077–85.

    Article  Google Scholar 

  17. Johnson BA, Roache JD, Javors MA, DiClemente CC, Cloninger CR, Prihoda TJ, Hensler J. Ondansetron for reduction of drinking among biologically predisposed alcoholic patients: a randomized controlled trial. JAMA. 2000;284(8):963–71.

    Article  CAS  Google Scholar 

  18. Kranzler HR, Van Kirk J. Efficacy of naltrexone and acamprosate for alcoholism treatment: a meta-analysis. Alcohol Clin Exp Res. 2001;25(9):1335–41.

    Article  CAS  Google Scholar 

  19. Witkiewitz K, Saville K, Hamreus K. Acamprosate for treatment of alcohol dependence: mechanisms, efficacy, and clinical utility. Ther Clin Risk Manag. 2012;8:45–53.

    Article  CAS  Google Scholar 

  20. Gray KM, Watson NL, Carpenter MJ, Larowe SD. N-acetylcysteine (NAC) in young marijuana users: an open-label pilot study. Am J Addict. 2010;19(2):187–9.

    Article  Google Scholar 

  21. Gray KM, Carpenter MJ, Baker NL, DeSantis SM, Kryway E, Hartwell KJ, et al. A double-blind randomized controlled trial of N-acetylcysteine in cannabis-dependent adolescents. Am J Psychiatry. 2012;169(8):805–12.

    Article  Google Scholar 

  22. Gray KM, Sonne SC, McClure EA, et al. A randomized placebo-controlled trial of N-acetylcysteine for cannabis use disorder in adults. Drug Alcohol Depend. 2017;177:249–57.

    Article  CAS  Google Scholar 

  23. Miranda R Jr, Treloar H, Blanchard A, Justus A, Monti PM, Chun T, et al. Topiramate and motivational enhancement therapy for cannabis use among youth: a randomized placebo-controlled pilot study. Addict Biol. 2017;22(3):779–90.

    Article  CAS  Google Scholar 

  24. Mason BJ, Crean R, Goodell V, Light JM, Quello S, Shadan F, et al. A proof-of-concept randomized controlled study of gabapentin: effects on cannabis use, withdrawal and executive function deficits in cannabis-dependent adults. Neuropsychopharmacology. 2012;37(7):1689–98.

    Article  CAS  Google Scholar 

  25. Hammond CJ. The role of pharmacotherapy in the treatment of adolescent substance use disorders. Child Adolesc Psychiatr Clin N Am. 2016;25(4):685–711.

    Article  Google Scholar 

  26. Moolchan ET, Robinson ML, Ernst M, Cadet JL, Pickworth WB, Heishman SJ, Schroeder JR. Safety and efficacy of the nicotine patch and gum for the treatment of adolescent tobacco addiction. Pediatrics. 2005;115:e407–14.

    Article  Google Scholar 

  27. Muramoto ML, Leischow SJ, Sherrill D, Matthews E, Strayer LJ. Randomized, double-blind, placebo controlled trial of 2 dosages of sustained-release bupropion for adolescent smoking cessation. Arch Pediatr Adolesc Med. 2007;161:1068–74.

    Article  Google Scholar 

  28. Gray KM, Carpenter MJ, Lewis AL, Klintworth EM, Upadhyaya HP. Varenicline versus bupropion XL for smoking cessation in older adolescents: a randomized, double-blind pilot trial. Nicotine Tob Res. 2012;14(2):234–9.

    Article  CAS  Google Scholar 

  29. FDA Drug Safety Communication: FDA revises description of mental health side effects of the stop-smoking medicines Chantix (varenicline) and Zyban (bupropion) to reflect clinical trial findings. 2016; available at https://www.fda.gov/Drugs/DrugSafety/ucm532221.htm. Accessed 31 Jan 2018.

  30. Curtin SC, Tejada-Vera B, Warner M. Drug overdose deaths among adolescents aged 15–19 in the United States: 1999–2015. NCHS data brief, no 282. Hyattsville, MD: National Center for Health Statistics. 2017. https://www.cdc.gov/nchs/products/databriefs/db282.htm. Accessed 31 Jan 2018.

  31. Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA Opioid overdose prevention toolkit. Rockville: Substance Abuse and Mental Health Services Administration (SAMHSA); 2014. Vol HHS Publ No. (SMA) 14–4742.

    Google Scholar 

Suggested Reading

  • Hammond CJ. The role of pharmacotherapy in the treatment of adolescent substance use disorders. Child Adolesc Psychiatr Clin N Am. 2016;25(4):685–711.

    Article  Google Scholar 

  • Hammond CJ, Gray KM. Pharmacotherapy for substance use disorders in youths. J Child Adolesc Subst Abuse. 2016;25(4):292–316.

    Article  Google Scholar 

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Source of Funding

AACAP and NIH research funding K12DA000357 (Hammond).

Author information

Authors and Affiliations

  1. Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Christopher J. Hammond & Pravesh Sharma

  2. Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Christopher J. Hammond

  3. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Christopher J. Hammond

Authors
  1. Christopher J. Hammond
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  2. Pravesh Sharma
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Correspondence to Christopher J. Hammond .

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Editors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA

    Justine W. Welsh

  2. Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA

    Scott E. Hadland

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Hammond, C.J., Sharma, P. (2019). Medications for Substance Use and Relapse Prevention. In: Welsh, J., Hadland, S. (eds) Treating Adolescent Substance Use. Springer, Cham. https://doi.org/10.1007/978-3-030-01893-1_7

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  • DOI: https://doi.org/10.1007/978-3-030-01893-1_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-01892-4

  • Online ISBN: 978-3-030-01893-1

  • eBook Packages: MedicineMedicine (R0)

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