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Changes in psychological well‐being among heroin‐dependent adolescents during psychologically supported opiate substitution treatment
Author(s) -
Smyth Bobby P.,
Ducray Kevin,
Cullen Walter
Publication year - 2018
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12318
Subject(s) - heroin , anxiety , buprenorphine , psychiatry , methadone , clinical psychology , mental health , polysubstance dependence , opiate substitution treatment , motivational interviewing , psychological well being , psychology , antidepressant , repeated measures design , medicine , opiate , substance abuse , psychological intervention , drug , opioid , statistics , receptor , mathematics
Aim Heroin‐dependent adolescents demonstrate high rates of comorbid psychological problems. Among heroin‐dependent adults, opiate substitution treatment ( OST ) programmes appear to reduce mental health problems. We sought to examine the impact of OST on psychological well‐being in adolescents, as this is unknown. Methods We conducted a prospective study examining psychological well‐being in heroin dependent adolescents, aged 18 years or younger, engaged in outpatient psychologically supported OST . Patients were treated with either methadone or buprenorphine. This was complimented with individual key working, counselling (motivational interviewing and cognitive behavioral therapy) and group work focusing on life skills. The B eck Y outh I nventory was used to measure psychological well‐being at treatment entry and repeated after 4 months of treatment. Results Among 55 consecutive treatment episodes, we examined the 32 episodes where the patient persisted with the OST programme. Polysubstance use was the norm at treatment entry. At follow‐up, the median doses of methadone and buprenorphine were 50 mgs and 8 mgs, respectively. Only three patients were treated with antidepressant medication. There was significant improvement in the mean depression (65.0 to 57.9, P = 0.001), anxiety (61.7 to 57.0, P = 0.006) and anger (57.8 to 54.6, P = 0.009) subscale scores. The self‐concept and disruptive behaviour subscale scores did not improve significantly. Conclusion In this relatively short‐term follow‐up, psychosocially assisted OST appears to be associated with improved psychological well‐being in heroin‐dependent adolescents, especially in the area of depressive and anxiety symptoms.