Targeting recovery capital for adolescents through treatment for opioid use disorder: a pilot expansion of the Youth Opioid Recovery Support intervention

Background Youth Opioid Recovery Support (YORS) is a multi-component behavioral treatment approach for youth with opioid use disorder (OUD) with known efficacy on adherence to injectable medications for OUD (MOUD) in young adults. YORS has not been tested in adolescents or youth on sublingual buprenorphine, the most common medication choice among youth. Indicators of recovery capital (RC) are also underexplored outcomes, as previous research has focused on MOUD adherence and opioid use metrics. Methods Adolescents ( N = 11) aged 13–17 seeking treatment for OUD were recruited from inpatient or outpatient addiction treatment, and designated family members were recruited as treatment significant others (TSOs, N = 10), for a 16-week uncontrolled feasibility pilot trial that adapted YORS for adolescents. The primary outcome was self-reported days of MOUD adherence, and secondary outcomes included opioid abstinence, days of opioid use, feasibility and acceptability of the intervention, and change in RC indicators. Seven adolescents and five TSOs were retained to complete measures for acceptability and recovery capital variables. Results Participants reported MOUD adherence for 70.3% of days in the intervention and opioid use for 4.8% of days with available data. All YORS components were implemented successfully, with variable uptake, and participants averaged high ratings of satisfaction. Pre/post-intervention preliminary signals of RC were examined and showed positive change over time in the subset of retained participants. Conclusions Our findings suggest that YORS is an appropriate treatment approach for adolescents with OUD and their families, with promising preliminary results that should be further explored in randomized studies with larger samples.