Most Youth With Opioid Disorders Do Not Receive Medications For Addiction

MedicalResearch.com Interview with:

Scott Hadland, MD, MPH, MS Youth Addiction Specialist Assistant Professor of Pediatrics Boston University School of Medicine

Dr. Hadland

Scott Hadland, MD, MPH, MS
Youth Addiction Specialist
Assistant Professor of Pediatrics
Boston University School of Medicine
Director, Urban Health and Advocacy Track, Boston Children’s Hospital and Boston Medical Center
Associate Program Director, Boston Combined Residency Program in Pediatrics, Boston Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Almost no data have been available on this topic to date.  A recent study showed that teens in subspecialty treatment for opioid addiction were significantly less likely than adults to receive a medication.  Our study was the first to comprehensively look across the health care system, including looking at adolescents and young adults diagnosed with opioid use disorder in outpatient clinics, emergency departments, and inpatient hospitals.

We had three important findings.  First, looking at a large sample of 9.7 million adolescents and young adults between the age of 13 and 25 years, we found that the number of youth diagnosed with opioid use disorder increased six-fold from 2001 to 2014.  This is perhaps not surprising given the national opioid crisis we know to be occurring.

Second, we found that only a minority of youth (1 in 4) received buprenorphine or naltrexone, the two medications available for opioid addiction that can be prescribed in usual medical settings.  These two medications are evidence-based and their use is recommended by the American Academy of Pediatrics.  Utilizing them is critical to ensure that we offer effective treatment early in the life course of addiction, which can help prevent the long-term harms of addiction.

Third, we found significant differences in who received medications.  Whereas approximately 1 in 3 young adults in our study received a medication, only 1 in 10 of the 16- and 17-year-olds we studied received one, and among adolescents under 15 years of age, 1 in 67 received a medication.  Females were less likely than males to receive medications, as were black youth and Hispanic youth relative to white youth.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: Use of medications should be very carefully discussed between patients, family members, and physicians.  Medications have been shown to treat withdrawal and cravings, and reduce relapse, and are an extremely effective component of treatment for opioid use disorder.

Offering medications early in the life course of addiction – particularly to patients with severe addiction – is critical to prevent downstream harm from addiction.  We need to ensure that pediatricians, and other providers who care for youth, feel comfortable addressing addiction just as they do other pediatric problems, because as our data show, addiction is a pediatric onset condition.  This isn’t just my personal belief: this approach is supported by the American Academy of Pediatrics.

However, as we work to expand treatment for young people with opioid use disorder, we need to ensure that we do so in a way that is equitable, and that does not exacerbate the sex or race and ethnicity differences that we observed.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Our next study will be looking at youth with public health insurance and their access to medication treatment for opioid use disorder. My worry is that in some states, public health insurance has traditionally offered poor coverage for addiction treatment services.  It is possible that the treatment gap we observed in this study would be even further exacerbated in some states’ public health insurance programs due to poor coverage of services.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Saloner B, Feder KA, Krawczyk N. Closing the Medication-Assisted Treatment Gap for Youth With Opioid Use Disorder. JAMA Pediatr. Published online June 19, 2017. doi:10.1001/jamapediatrics.2017.1269

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

 

 

 

 

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

 

 

 

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.