ArticleThe Journal of adolescent health : official publication of the Society for Adolescent Medicine2020
Young Adults Have Worse Outcomes Than Older Adults: Secondary Analysis of a Medication Trial for Opioid Use Disorder.
Article in The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Novel Insights into Addiction Management: A Meta-Analysis on Intervention for Relapse Prevention.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use, Update 2018-2023: Current Status, Best Practices, and Opportunities for Advancing the Science.Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53Pooled it
- The comparative effectiveness of Core versus Core+Enhanced implementation strategies in a randomized controlled trial to improve substance use treatment receipt among justice-involved youth.BMC health services research · 2022Trial
- Extended-release naltrexone for youth with opioid use disorder.Journal of substance abuse treatment · 2021Trial
- Examination of Correlates of OUD Outcomes in Young Adults: Secondary Analysis From the XBOT Trial.The American journal on addictions · 2021Trial
- Opioid Misuse and Asthma and Allergic Diseases in College Students: The Role of Race and Ethnicity.AJPM focus · 2026Article
- The association between state cannabis legalization and non-fatal opioid poisonings among adults with employer-sponsored insurance in the United States.Preventive medicine reports · 2026Article
- Machine learning-based computational validation of the Addictions Neuroclinical Assessment framework in relation to hazardous drinking.Journal of psychiatry & neuroscience : JPN · 2026Article
- The Development of a Patient-Centered Digital Health Care Technology for Young Adults in Opioid Use Disorder Treatment: Qualitative Study.JMIR formative research · 2025Article
- "It's more than just the act of not using. It's a feeling of finally completing something.": Person-centered definitions of successful treatment outcomes from patients and staff at a methadone treatment program in Baltimore City.Journal of substance use and addiction treatment · 2025Article
- Assessing inequities in buprenorphine treatment across the care cascade.Drug and alcohol dependence · 2025Observational
- Impact Of Relationship Quality and Recovery Attitudes on Medication for Opioid Use Disorder Among Young Adults.Journal of drug issues · 2025Article
- Product and trial design considerations on the path towards a vaccine to combat opioid overdose.NPJ vaccines · 2025Review
- Understanding the needs of postpartum emerging adults with substance use disorders to improve recovery supports.Frontiers in public health · 2025Article
- Adverse Events at 1 Month Following Medication Initiation for Opioid Use Disorder Among Adolescents and Young Adults.Substance use & addiction journal · 2025Article
- Lessons learned from concerned significant others: a qualitative analysis on involvement in services for young adult opioid use disorder.Frontiers in public health · 2025Article
- Medications for Opioid Use Disorder Among Transition Age Youth Compared to Adults 26 or Older in Rural Settings.JAACAP open · 2024Article
- Engagement, initiation, and retention in medication treatment for opioid use disorder among young adults: A narrative review of challenges and opportunities.Journal of substance use and addiction treatment · 2024Review
- Medications for Opioid Use Disorder for Youth: Patient, Caregiver, and Clinician Perspectives.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2024Article
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Abstract
purposeYoung adults are disproportionately affected by the current opioid crisis. Although medications for opioid use disorder are broadly effective, with reductions in morbidity and mortality, the particular effectiveness of medications for opioid use disorder among young adults is less well understood.
methodsThis secondary analysis compared young adults (aged 18-25 years) with older adults (aged ≥26 years) in a large comparative effectiveness trial ("XBOT") that randomized subjects to extended-release naltrexone or sublingual buprenorphine-naloxone for 6 months. Opioid relapse was defined by opioid use over four consecutive weeks or seven consecutive days, using urine testing and self-report.
resultsAmong subjects in the intention-to-treat sample (n = 570, all randomized participants), a main effect of age group was found, with higher relapse rates among young adults (70.3%) compared with older adults (58.2%), with an odds ratio of 1.72 (95% confidence interval = 1.08-2.70), p = .02. In the per-protocol sample (n = 474, only participants who started medication), relapse rates were higher among young adults (66.3%) compared with older adults (50.8%), with an odds ratio of 1.91 (95% confidence interval = 1.19-3.06). Among the intention-to-treat sample, survival analysis revealed a significant time-by-age group interaction (p = .01) with more relapse over time in young adults. No significant interactions between age and medication group were detected.
conclusionsYoung adults have increased rates of relapse compared with older adults, perhaps because of vulnerabilities that increase their risk for treatment dropout and medication nonadherence, regardless of medication assignment. These results suggest that specialized, developmentally informed interventions may be needed to improve retention and successful treatment of opioid use disorder among young adults.
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