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Heroin Addiction and Related Clinical Problems: 2021, 23, N4 (pages: 51 - 58)

An Assertive Outreach Intervention for Treatment of Opioid Use Disorder in Young Adults

Wenzel K., Fishman M., Wildberger J., Vo H., and Burgower R.

Summary: Background: Opioid use disorder (OUD) is a major public health crisis, disproportionately affecting youth. The Youth Opioid Recovery Support (YORS), a multi-component assertive outreach intervention, has demonstrated improved outcomes for young adults with OUD compared to usual care. In this paper we present descriptive data and qualitative lessons learned in implementing this intervention. Methods: Participants (N = 21) were young adults (18-26) with OUD enrolled during an inpatient treatment episode who intended to pursue outpatient treatment with extended release naltrexone. Retrospective chart abstractions were performed on participants enrolled in a pilot version of the YORS intervention lasting 24 weeks to identify clinically significant themes and trajectory descriptions. Results: Participants received assertive outreach communication from the study team an average of 40.2 days (SD=17.7), primarily via phone calls or text messages. Participant's treatment significant others were contacted an average of 26.8 days (SD=16.0). Participants engaged in an average of 2.5 (SD=1.2) family sessions throughout the study. Home-delivered medication was administered primarily at private residences (34%) and recovery housing (29%). Conclusions: Three main themes were identified as imperative to the intervention. First, the treatment team must be persistently assertive, particularly throughout the course of illness and ambivalence toward treatment. Flexibility is essential in meeting the patient where they are in order to promote patient-centered care. Lastly, involving family members and treatment significant others are crucial in improving treatment adherence.