Treatment of Adolescent Heroin Dependence: The End of an Era.
Smyth, B P; McCarney, G
In the 1990s, Ireland had the youngest population of heroin dependent patients in Europe.1 At that time problems where largely confined to Dublin, and within Dublin use was concentrated in specific areas of very significant deprivation.2,3 At the peak of the heroin epidemic in 1996, there were over 180 adolescents (under 18) presenting for addiction treatment in Dublin annually with a heroin use disorder.1 Given that addiction services had been developed with adults in mind, the National Drug Treatment Centre established the Young Persons Program (YPP) in 2000, in recognition of the very different needs of these young patients. The authors, both child & adolescent psychiatrists, arrived into the service a few years later.
The first National Drug Strategy (NDS), was launched in 2000 and this consolidated the move away from abstinence focused treatment which had begun in the 1990s and endorsed treatment approaches which were based on harm reduction principles. While opioid agonist treatments (OAT), such as methadone and buprenorphine, had become a central component of treatment for heroin dependent adults internationally, their use in adolescents was less established.
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