Adolescents and Treatment for Opioid Use Disorder

"The results of this study indicate that fewer than one in three adolescents with past-year OUD in the general US population reported receiving any type of substance use treatment in the most recently available federal surveys (2022–23), and adolescents’ receipt of MOUD was even more limited. Moreover, the availability of OUD treatment facilities with groups or programs specifically tailored for adolescents varied considerably by region and by program type, with generally lower availability in the southeast US and for OTP, inpatient, and residential programs. Overall, results highlight opportunities to strengthen adolescent OUD screening and treatment engagement efforts; promote evidence-based treatment options, including MOUD, for adolescents; and tackle geographic disparities in access to adolescent-tailored OUD treatment.

"With respect to screening and engaging adolescents in treatment, schools represent a critical entry point.20,41 School health or counseling centers represented the second most frequently reported setting of substance use treatment for adolescents with past-year OUD, supporting the relevance of integrated care within school settings (for example, school-based telebehavioral health and school-based health centers), as well as service referral procedures connecting families, schools, community agencies, and medical and treatment providers. School counselors often face high caseloads, varied job responsibilities, and limited specialized behavioral health training and clinical supervision,42 yet research suggests that school-based substance use treatment may help reduce disparities in adolescents’ treatment access and engagement and potentially even abate the “school-to-prison-pipeline.”41 More than one in four adolescent opioid-related treatment admissions in this study were referrals from the courts and criminal-legal system, and prior analyses have identified juvenile justice system as the largest referral source for adolescents admitted to treatment for any type of substance use.3 This underscores the relevance of coordination between juvenile justice and treatment providers to ensure that evidence-based screening, referral, and treatment practices are employed, especially considering the limited published guidance on best practices in juvenile justice–involved treatment and minimal research documenting MOUD for adolescents in the criminal and legal system.43"