Adolescents and Treatment for Opioid Use Disorder

"In the present study, fewer than one in ten adolescents with past-year OUD reported receiving MOUD, and fewer than one-tenth of adolescent opioid-related treatment admissions included MOUD in the treatment plan versus more than a third of adult admissions. Compared with data from prior years,16 these figures suggest that MOUD inclusion in adolescent opioid-related treatment admissions has increased yet remains limited. Specific federal X-waiver restrictions regarding prescribing buprenorphine for MOUD were eliminated in late 2022 and early 2023,32 and at this time, buprenorphine can be prescribed in a variety of medical and treatment settings. Nonetheless, the NSDUH data used in the present study indicated that adolescent MOUD receipt was comparably low in 2022 and 2023, potentially reflecting persistent MOUD stigma and concerns of family; service providers; and the legal, social, and medical systems with which adolescents interact.5,44,45 Buprenorphine has been approved by the Food and Drug Administration for people ages sixteen and older and has been prescribed off label for younger adolescents.46 With continued research and initiatives to identify and manualize specific best practices for MOUD in adolescents, professional organizations and expert groups can develop and disseminate clear guidelines for providers and facilities to adopt. The study’s analysis of OUD treatment facilities in N-SUMHSS was not able to determine how many facilities offer MOUD to adolescent clients, yet data from OTPs (specialized certified and accredited clinics that dispense methadone and other MOUD) in N-SUMHSS indicate that approximately one in ten OTPs nationwide provided adolescent-tailored programming.

"Adolescent-tailored programs (as opposed to treatment programs that accept adolescents but do not provide adolescent-tailored services) are potentially better prepared to meet adolescents’ specific developmental and psychosocial needs; the American Society for Addiction Medicine’s proposed framework for adolescents and youth specifies that adolescents should receive services in adolescent-specific groups, rather than alongside adults.47 Results of the present study indicate that fewer than one in four of all OUD treatment facilities participating in N-SUMHSS offered a group or program tailored for adolescents, which is lower than estimates from prior years (ranging from 32 percent in 2003 to less than 29 percent in 2010 for substance use treatment facilities overall).44"