Teens, older adults not getting medications to treat opioid abuse

Insurance a factor in access to drug treatments, a new study said.

Adolescents and older adults abusing opioids could benefit from medications to treat addiction – but they aren’t getting the needed treatments, according to a new study.

Researchers cited evidence of the effectiveness of the medications methadone, buprenorphine or naltrexone. But estimates indicate low access to those drugs for young people, pregnant women, rural residents, adults in the criminal legal system, and racial and ethnic minorities.

“Medication for OUD (opioid use disorder) is associated with reductions in opioid use and disorder, longer treatment retention, and substantially reduced opioid-related mortality,” the study said. “Despite the strong evidence base, access to MOUD is limited by low facility and clinician uptake and persistent stigma surrounding OUD and medication.”

The investigation is the first to estimate past-year medication for opioid use disorder (MOUD).

Researchers used data from the National Survey on Drug Use and Health, maintained by the Substance Abuse and Mental Health Services Administration of the federal Department of Health and Human Services.

In a sample of more than 2.2 million people with treatment need, 27.8% reported past-year MOUD. Those using MOUD included no adolescents ages 12 to 17 and only 13.2% of adults age 50 or older.

Researchers noted buprenorphine is the only medication approved to treat OUD in adolescents.

“Gaps in access could be worsened by specialty facilities with adolescent treatment programs being less likely to provide MOUD than facilities serving adults,” the study said. “Our findings support calls for additional MOUD engagement and retention strategies tailored for youths.”

For older adults, misconceptions about substance abuse in older age and lower screening and assessment rates may contribute to lower treatment rates.

“Insurance was the main enabling resource associated with treatment status,” with 35.2% of people with public insurance receiving MOUD, compared to 21% of people with private insurance and 16.8% of those with no public or private insurance.

Medicaid was an important characteristic among those receiving MOUD.

“However, our study shows that substantial gaps remain even among publicly insured people, which composed more than half of our sample,” the study said.

Those needing MOUD reported contacts with the health care and criminal legal systems, but most did not receive the treatment, “highlighting systemic gaps and continued missed opportunity increase MOUD uptake.”

The study “Use of Medication for Opioid Use Disorder Among U.S. Adolescents and Adults With Need for Opioid Treatment, 2019,” was published March 23 in published in JAMA Network Open.