The shortage of evidence-based treatment for young people with opioid use disorders comes clear in data released this week by Boston Medical Center's Grayken Center for Addiction.
A retrospective cohort study published in JAMA Pediatrics found that only one in four adolescents and young adults with an opioid use disorder receives one of the three approved medication treatments for the illness (methadone, buprenorphine or naltrexone) within three months of their diagnosis. The numbers are even lower for individuals under age 18, only about 5% of whom receive a medication treatment for opioid addiction.
“There are far too few pediatric providers who prescribe medications for addiction, and stigma is still playing a role in deterring many patients and families from using these evidence-based medications,” Grayken Center pediatrician and researcher Scott Hadland, MD, said in a news release.
The study examined health insurance claims in 2014 and 2015 for young people ages 13 to 22 who were enrolled in Medicaid. Sixty-nine percent of the youths who received treatment within three months of their diagnosis received only behavioral health services such as individual and group counseling.
The type of service received had a major bearing on how long young people remained engaged in treatment, according to the researchers. For those who received behavioral services only, the median duration of care was 67 days. By comparison, median time remaining in care for young people receiving methadone, buprenorphine or naltrexone was 324, 123 and 150 days, respectively.
“Our findings show that a serious gap exists in how we treat adolescents and young adults with opioid use disorder, and that this gap puts them at risk for discontinuing treatment early,” Hadland said.