Only 1 in 6 Youth With Opioid Addiction Receive Medication

A large national study, published in JAMA Network Open in October, shows how often young people with opioid addiction fall out of treatment. Most never make it through the full process.

Researchers followed 229847 Medicaid enrolled adolescents and young adults ages 13 to 25 who received an opioid use disorder diagnosis between 2016 and 2023. They tracked four stages of care: treatment initiation engagement medication and six month retention. The numbers dropped sharply at every stage.

The Study Shows Steep Drop Off

About half of the young people in the study started some form of treatment within 14 days of diagnosis. Only 32.9 percent engaged in care. Researchers defined engagement as at least two additional treatment visits within 34 days of starting treatment.

Medication marked another major break in the process. Among those who engaged in treatment 46.3 percent received medication for opioid use disorder.

The overall number looks much smaller when you follow the full group with just 15.2 percent of all young people in the study receiving buprenorphine, methadone or extended release naltrexone.

Age created an even wider gap with adolescents younger than 18 received medication only 6.6 percent of the time compared with 51.2 percent among those ages 18 and older.

Retention showed the biggest problem. Only 3.1 percent of the entire group stayed on medication for at least 180 days. Roughly 1 in 32 young people with opioid use disorder.

Black youths were half as likely as White youths to receive medication and the youngest adolescents also had the weakest results at every stage.

Fentanyl has driven much of that increase. Untreated opioid use disorder during adolescence and young adulthood can shape health outcomes for decades.

Medical Detox Can Create a Better Starting Point

The study’s treatment cascade mirrors what happens in real life. Medical detox often serves as an early clinical step for people with opioid dependence. It manages withdrawal and helps stabilize the patient so medication and therapy can follow.

A young person who enters medical detox and leaves with a buprenorphine prescription plus a follow up appointment has a clearer path into ongoing care.

Someone who leaves detox without a medication plan faces a much higher chance of dropping out.

Detox alone doesn’t treat opioid use disorder. The study makes that point indirectly but clearly. Among young people who received behavioral health services without medication progression through the treatment process largely stopped. Medication often determines whether treatment continues.

How Medication Assisted Treatment Works

Medication assisted treatment combines FDA approved medications with counseling. The three medications include buprenorphine methadone and extended release naltrexone.

Buprenorphine appeared most often in the study followed by methadone and then naltrexone.

Retention varied by medication. Among young people who started treatment 26.2 percent of those taking methadone remained on it for at least 180 days. The figure fell to 19.2 percent for buprenorphine and 5.8 percent for extended release naltrexone.

Methadone use remained rare among adolescents younger than 18. Long standing federal restrictions contribute to that gap.

Researchers also found that retention declined in more recent years. They say the trend needs more study. Changes in clinician behavior insurance barriers and care patterns during the fentanyl era could all play a role.

What Families Can Do

A parent or guardian dealing with a teenager or young adult who has opioid use disorder shouldn’t read this study as proof that treatment fails. The findings point to a different problem: treatment can be difficult to enter and even easier to leave.

Ask direct questions when you contact a program. Does it offer medication? What happens after detox? Who schedules the follow up appointment? When does that appointment happen?

Young people have a better chance of staying in care when each transition has someone responsible for it.

Finding Detox and Treatment Programs

Detox.com lists medically supervised detox programs that manage opioid withdrawal and connect patients with medication assisted treatment. Asking whether a program treats adolescents and prescribes medication on site can quickly narrow your options.

Call 800-996-6135Sponsored to find detox centers and medication assisted treatment programs in your area.