Miller Sarah J, Harrison Sayward E, Harrod Steven B, Hills Kimberly J, Litwin Alain
Department of Psychology, University of South Carolina, Columbia, SC, USA.
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Am J Drug Alcohol Abuse. 2025;51(3):290-307. doi: 10.1080/00952990.2024.2443938. Epub 2025 Feb 10.
A high number of adolescents and young adults engage in opioid misuse and/or meet criteria for opioid use disorder (OUD). Youth also experience worse treatment outcomes when compared to adult counterparts. This scoping review aimed to identify and summarize existing interventions designed to increase engagement of youth across the OUD care cascade, as well as describe clinical and research implications. Peer-reviewed literature was searched using PubMed, PsycInfo, and Web of Science. Studies were eligible if they presented outcomes of an intervention focused on engaging adolescents and young adults (ages 12-25 years) in the OUD care cascade and were published in English. Nine articles met inclusion criteria that described interventions for adolescents and young adults across engagement, initiation, and retention in the OUD care cascade. Several strategies were used in interventions, including behavioral health and integrated health services, contingency management, meaningful family involvement, assertive outreach, and provider trainings/consultation. Only one intervention has been tested with a randomized control trial. Due to small sample sizes and lack of control groups, findings from existing intervention studies do not indicate which strategies are most effective. Further research is urgently needed to develop and evaluate effective interventions for youth with OUD. Providers working with youth should implement services to meet youth's individual needs. Providers should consider utilizing integrated services and referrals to behavioral health, involving family in treatment, and use of contingency management and assertive outreach. Continuing education for providers on OUD treatment and developmental concerns is also crucially needed.
大量青少年和青年存在阿片类药物滥用问题和/或符合阿片类药物使用障碍（OUD）的标准。与成年患者相比，青少年患者的治疗效果也更差。本综述旨在识别和总结现有的干预措施，以提高青少年在OUD照护流程中的参与度，并描述其临床和研究意义。通过PubMed、PsycInfo和Web of Science检索同行评审文献。如果研究呈现了旨在促使青少年和青年（12至25岁）参与OUD照护流程的干预措施的结果且以英文发表，则该研究符合纳入标准。九篇文章符合纳入标准，描述了针对青少年和青年在OUD照护流程中的参与、启动和留存的干预措施。干预措施中使用了多种策略，包括行为健康和综合健康服务、应急管理、有意义的家庭参与、主动 outreach（此处原文可能有误，推测为“外展服务”）以及提供者培训/咨询。只有一项干预措施经过了随机对照试验的测试。由于样本量小且缺乏对照组，现有干预研究的结果并未表明哪些策略最有效。迫切需要进一步开展研究，以开发和评估针对患有OUD的青少年的有效干预措施。为青少年提供服务的提供者应实施满足青少年个体需求的服务。提供者应考虑利用综合服务并转介至行为健康服务、让家庭参与治疗以及使用应急管理和主动外展服务。还亟需为提供者提供关于OUD治疗和发育问题的继续教育。
