Trends and age-related disparities in opioid use disorder treatment admissions for adolescents and young adults

• Type of Material: Article
• Authors: Justine Welsh, Emory University; Michael L Dennis, Chestnut Health Systems; Rodney Funk, Chestnut Health Systems; Maggie J Mataczynski, Emory University; Mark D Godley, Chestnut Health Systems
• Language: English
• Date: 2021-12-06
• Publisher: PERGAMON-ELSEVIER SCIENCE LTD
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jsat.2021.108584
• Title of Journal or Parent Work: JOURNAL OF SUBSTANCE ABUSE TREATMENT
• Volume: 132
• Start Page: 108584
• End Page: 108584
• Grant/Funding Information: This work was supported by the National Institute on Drug Abuse [grant numbers R21 DA046738, R01 DA011323]. This funding source had no role in design and conduct of the study; collection, management, analysis, interpretation of data; preparation, review, approval of the manuscript; and in the decision to submit this manuscript for publication.
• Keywords: Psychology, Clinical; YOUTH; Life Sciences & Biomedicine; Science & Technology; Substance Abuse; Young adult; Opioid use disorder; Treatment admission; TREATMENT FACILITIES; Medications for opioid use disorder; Psychology; DEPENDENT ADOLESCENTS; Social Sciences; Adolescent; SERIES

Abstract

Background: Treatment of opioid use disorder (OUD) in adolescents and young adults is imperative to reduce the risk of overdose and other opioid-related harms. Limited information has been published about national trends in health disparities including utilization, access to medication for opioid use disorder (MOUD), and treatment retention of adolescents and young adults with OUD. Methods: This secondary data analysis tested for trends and age-related disparities in national OUD treatment admissions, as well as length of stay (defined as continuous enrollment in some form of treatment at a program) and planned use of MOUD for adolescents (age 12–17) and young adults (age 18–24) using the Treatment Episode Data Set from 2008 to 2017. The study also used data from the National Survey on Drug Use and Health to identify population prevalence of OUD and presentation to OUD treatment in adolescents and young adults compared to older adults (age 25+). Results: OUD treatment admissions significantly decreased over the decade by 63% (z = 2.61, p < .01) for adolescents and 13% (z = 2.25, p < .01) for young adults. The rate of planned MOUD at intake increased from 1.1% to 3.0% for adolescents but did not achieve significance. MOUD was more commonly recommended in young adults across the time period (13.5 to 21.8%, z = 2.24, p < .01). Treatment length of stay did not change significantly for adolescents, but did increase for young adults from 2008 to 2017 in the 91+ (19.9–23.9%, z = 2.22, p < .01) and 181+ days (9.7–12.5%, z = 2.26, p < .01) categories. Relative to older adults, the percent of people with OUD presenting for OUD treatment is significantly lower for adolescents (44.6% vs. 3.6%, OR = 0.05, p < .05) and young adults (44.6% vs. 22.2%, OR = 0.36, p < .05). Among those who initiated treatment, lower rates occurred of planned MOUD for adolescents (93% vs. 2%, OR = 0.002, p < .05) and young adults (93% vs. 56%, OR = 0.10, p < .05). Conclusions: A significant unmet need exists for OUD treatment and recommendation of MOUD in adolescents and young adults with OUD. These trends are concerning given increasing rates of opioid-related emergency room admissions and deaths during the same time period. Federal and state funders should examine adolescent and young adult's services separately from older adults (25+) to reduce age-related access disparities and ensure adequate MOUD treatment capacity.