National research published recently in JAMA Network Open reveals mixed progress in addressing opioid use disorder among adolescents and young adults, despite recommendations from major medical organizations that doctors offer addiction medications to this population.
Analysis of Medicaid and insurance claims covering roughly 230,000 young people ages 13 to 25 diagnosed with opioid use disorder between 2016 and 2023 found that about half initiated treatment by seeing a clinician, with approximately one-third attending at least two appointments in the first month. Among those engaged in care, roughly one in six received medication for the condition. However, continuation rates proved substantially lower: just one in 32 young people remained on medication for six months. The improvement in treatment initiation contrasts sharply with concerning retention trends, prompting researchers and clinicians to focus on understanding and addressing barriers to sustained care.
Several structural and regulatory obstacles complicate medication access for minors. Federal law requires minors to undergo two documented failed recovery attempts without medication before becoming eligible for methadone, and many specialized clinics decline to treat patients under 18. Buprenorphine, which physicians can more readily prescribe, remains uncommon in residential adolescent treatment facilities. Experts noted that turning 18 dramatically expands treatment options available to young people, highlighting the disparity in care across age groups.
Experts identified multiple factors contributing to poor retention, including limited research on long-term medication effects in young populations, family apprehension about extended treatment commitments, and racial disparities in care continuity. Clinicians emphasized that creating welcoming, nonjudgmental clinical environments proves essential for engagement. Primary care physicians and pediatricians with established relationships with patients and families represent a critical resource, yet many lack comfort prescribing these medications. Recent evidence suggests growing interest among generalist physicians in understanding and treating opioid use disorder, which researchers view as an encouraging sign for expanding capacity to serve young people facing addiction challenges.
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