The Case for Continued Buprenorphine Utilization in High-Risk Adolescent Patients with Opioid Use Disorder
We describe a case of a 17 year old male with Opioid Use Disorder (OUD) and comorbid mental health diagnoses including Generalized Anxiety Disorder and Oppositional Defiant Disorder. He has a history of multiple incarcerations. He was initiated on buprenorphine sublingual (SL) form almost a year ago and then subsequently relapsed to opioid use several times. Abrupt cessation of medication assisted treatment (MAT) occurred during an incarceration followed by immediate relapse upon release from jail three months later. The patient was then restarted on buprenorphine-naloxone sublingual form with plan to administer subcutaneous depot form of buprenorphine (also known as Sublocade). The SQ buprenorphine was never initiated due to denial of the injectable based off age criteria.
Our case presents the barriers to medication assisted treatment in a high risk population of adolescents and young adults who are at risk of treatment dropout. Continued MAT could be lifesaving in this high risk group.