Access to addiction meds for young people has improved — but retention hasn’t — SkimNews
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- Scott Hadland's JAMA Network Open study of ~230,000 Medicaid-enrolled youth ages 13-25 diagnosed with opioid use disorder from 2016-2023 found just 1 in 32 of those engaged in care stayed on medication for six months — a rate that may have actually decreased even as initiation rose.
- The study found that while roughly half of diagnosed youth initiated treatment and about a third had two or more appointments in the first month, only 1 in 6 of those engaged in care received any addiction medication.
- Federal law requires minors to have two documented 'failed' recovery attempts without medication before they can start methadone, and across the entire eight-year study period fewer than 10 minors received it — a number so low researchers suppressed the exact figure for privacy.
- Buprenorphine is easier for doctors to prescribe than methadone, but recent research cited in the article shows few residential treatment facilities for adolescents actually offer it.
- Black youth and other racially minoritized groups had worse attrition through every stage of care than their white peers in the study, mirroring structural barriers that also plague adult addiction treatment.
- Overdose deaths among young people skyrocketed starting around 2019, with poisonings including overdose becoming the third-leading cause of death for those 19 and under, per the article.
Why it matters: For adolescents with opioid use disorder, the gap between starting medication and staying on it separates evidence-based care from continued overdose risk — now the third-leading cause of death for those 19 and under. Narrowing it depends on whether more pediatricians prescribe buprenorphine in settings patients will actually return to.
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