Young People Are Underserved By Medication-Assisted Treatment

By Kelly Burch 06/21/17

The younger the patient, the less likely they are to receive medications like Suboxone or Vivitrol to treat their opioid addiction.

Professional physician consulting concerned teenage patient at clinic

Young people who are addicted to opioids are unlikely to receive medication-assisted treatment, without which they often go on to battle addiction long-term. 

According to a study recently published in the journal JAMA Pediatrics, only one in four young people ages 13 to 25 diagnosed with opioid addiction received medication-assisted treatment using buprenorphine or naltrexone (commonly known by their brand names Suboxone and Vivitrol). 

The younger a patient is, the less likely he or she will receive medication. Just one in ten 16- and 17-year olds received medication, according to the study. 

The researchers say that without proper treatment, many young people will continue to abuse opioids as adults. One-third of adults in treatment for opioid use disorder began using opioids before age 18, and two-thirds started before they were 25.

“We need to be delivering effective medications earlier in the life course,” Dr. Scott Hadland, a pediatrician and addiction specialist at Boston Medical Center, and lead author of the study, told The Boston Globe

Alarmingly, there were also racial and gender differences in who got treated with addiction meds. If you're female, Black, or Hispanic, you were less likely to have access to the medications. Dr. Hadland chalks it up to "provider bias." 

Medication-assisted treatment is considered the best practice for treating opioid addiction. Last year, the Surgeon General’s Report on Alcohol, Drugs and Health called for an end to the stigma around medication-assisted treatment.

“Abundant scientific data show that long-term use of maintenance medications successfully reduces substance use, risk of relapse and overdose, associated criminal behavior, and transmission of infectious disease, as well as helps patients return to a healthy, functional life,” the report said.  

However, the biases toward addiction and medication-assisted therapies still affect care for patients. “The single biggest problem is that clinicians have historically been hesitant to treat addiction,” Hadland said. “A lot of clinicians say they don’t want to take care of 'those patients.'”

Lucien Gonzalez, a member of the American Academy of Pediatrics Committee on Substance Use and Prevention, said that he was not surprised by the study. “Unfortunately, it highlights again that we’re underdoing it… Particularly with emerging adults, that 18-to-25 range, they’re not getting it. They really do need it.”

Gonzalez said that pediatricians should be comfortable providing medications to treat addiction in a primary care setting. Pediatricians can’t give methadone, but they can prescribe buprenorphine or naltrexone. Gonzalez suggested that stigma may play a role in preventing pediatricians and primary care providers from doing so.

“The worry level is a little strange to me. Especially since a lot of practices don’t have trouble giving oxycodone,” he said. 

However, it remains true that few pediatricians have been trained in addiction medicine, and few have the federal waiver that is required to prescribe buprenorphine. The high co-payments for the drug also prevent some sound people from accessing it. 

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.