Adolescent heroin use: a review of the descriptive and treatment literature

The prevalence of heroin use is rising among young people. We reviewed descriptive and treatment studies of heroin-using youth. Medline and Psychinfo were searched with the following kewords: heroin or opiate; and adolescent or young or juvenile. Nine articles describing treatment and five articles describing clinical characteristics of youth with heroin use were reviewed. Descriptive studies of heroin-using youth demonstrate substantial polysubstance use and psychiatric comorbidity. The largest treatment study found that, of four different treatment modalities, methadone maintenance had the highest retention rate. For youth who stayed in treatment for at least 6 months, therapeutic communities or drug-free treatment resulted in better outcomes compared with methadone maintenance. No controlled treatment trials were found. Length of time in treatment, regardless of modality, was the best predictor of outcome. The rise of heroin use among adolescents and young adults calls for descriptive studies as well as controlled treatment studies.