A scoping review of interventions for engaging adolescents and young adults in opioid use disorder treatment across the care cascade.

Abstract

Background: 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.Objectives: 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.Methods: 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.Results: 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.Conclusions: 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.