Published March 13, 2017 Reuters
Just a small fraction of adolescents with opioid addiction will receive medications that can help them quit, new research shows.
These medications, usually methadone or suboxone, are prescribed to reduce craving for opiates and ease withdrawal symptoms, and studies show they help opiate users to abstain. In 2016, the American Academy of Pediatrics advised doctors to consider medication-assisted treatment, specifically suboxone, for adolescents with “severe opioid use disorders.”
To get a “baseline” sense of medication-assisted treatment in adolescents with opiate or heroin addiction, Kenneth Feder of Johns Hopkins School of Public Health in Baltimore and his colleagues looked at data on 139,092 patients receiving treatment at publicly funded programs in the United States in 2013.
While 26 percent of adult heroin addicts received medication-assisted treatment, that was true for just 2 percent of adolescents.
Among patients addicted to opiates, 12 percent of adults received medication, compared to less than 1 percent of adolescents, the researchers reported in the Journal of Adolescent Health.
“There’s more that needs to be done across the board to facilitate access to these treatments when they’re medically necessary,” Feder told Reuters Health by phone. “The best validated treatment for somebody struggling with an opiate addiction is treatment that includes some sort of medication assistance.”
Patients seeking medication-assisted treatment face a number of obstacles. Methadone is only offered at specific substance abuse treatment centers, and these centers need a waiver to treat anyone under 18. Also, Medicaid rules state that adolescents with opiate addiction must have failed treatment twice in order to be prescribed methadone. Doctors can prescribe suboxone, the other main drug for this purpose, to patients 16 and older, but only if they have a waiver.
“These treatments may not be covered by a state’s Medicaid program,” Feder added. “And if they are medically necessary, we think they should be covered by a state’s Medicaid program.”
The difference in medication-assisted treatment rates between adolescents and adults is “really striking and very concerning,” Dr. Lisa Marsch of Geisel School of Medicine at Dartmouth in Lebanon, New Hampshire, told Reuters Health by phone. Marsch has studied medication-assisted treatment but did not participate in the new study.
Medication-assisted treatment is clearly more effective for adults and adolescents, Marsch said, and by not extending the treatment to more patients, “we are doing a real disservice based on the science and the data.”
About a half-million US adolescents use prescription opiates every year, and just under 10 percent will become addicted, Marsch added. “We want a chance to stop this problem early.”