Polysubstance Use and Heroin Relapse Among Adolescents Following Residential Treatment

Abstract

This study examined posttreatment patterns of polysubstance use and heroin relapse in a sample of 43 adolescents (ages 14–20) entering short-term residential treatment for primary heroin use. At 12-month follow-up, youths that achieved heroin abstinence (N = 19) were significantly less likely than youths that relapsed to heroin (N = 24) to endorse polysubstance use and cannabis, cocaine, or benzodiazepine use. Furthermore, heroin-abstinent youths significantly reduced their cannabis and cocaine use across the study period while youths that relapsed made initial reductions before returning to their pretreatment levels of use for these drugs. Clinical implications for heroin-using youths and areas for future research are discussed.

KEYWORDS:

• adolescent
• heroin
• opioid
• polysubstance use
• relapse

Acknowledgments

The authors would like to thank and acknowledge Jasmina Burdzovic Andreas, PhD, for providing statistical consultation.

Notes

Notes. Mean (SD) is presented for all continuous variables; percentages are shown for categorical variables.

*p < .05.

Notes. ^a Use of three or more substances in the past 90 days. ^bChi-square statistic not calculated.

*p < .05. **p < .01.

We used a last observation carried forward (LOCF) approach to impute the missing follow-up data for these 17 cases and then reran all major analyses. There was no difference in our pattern of findings using this approach. The best practices for managing missing data (multiple imputation and maximum likelihood methods) require the use of multiple variables that are correlated with the missing variable(s), and we felt that such approaches were beyond the scope of this article.

The proportion of days of heroin use was adjusted for time spent confined (e.g., placed in residential facility, detention, or hospitalized) during the past 90 days. The formula used was the following: days of heroin use/(90 days – number of days confined).