Many teens who overdose on opioids do not get effective follow-up

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Nonfatal opioid overdoses offer a critical window for intervention in young people who have never received a diagnosis of opioid use disorder (OUD). An NIH-funded analysis of more than 4 million Medicaid records suggests most teens enrolled in the Medicaid program who have been treated for an overdose do not receive evidence-based follow-up treatments and have high rates of recurrent overdoses.

Scientists identified more than 3,600 youth aged 13-22 who experienced nonfatal overdoses and remained continually enrolled in Medicaid for at least 30 days after the overdose. They found that less than one-third of these young people received any timely addiction treatment after overdose, and only 1 in 54 received the OUD medications buprenorphine, naltrexone, or methadone. The Medicaid claims from 16 states were filed between 2009 and 2015. Youths who experienced a heroin overdose were significantly less likely than those who overdosed on other opioids to receive any treatment.

The researchers cite recommendations by the American Academy of Pediatrics Committee on Substance Use and Prevention to improve access to medication assisted treatment for adolescents and young adults with OUD. They also cite several probable obstacles to treatment, including a lack of pediatricians familiar with treating opioid overdose and addiction, a dearth of treatment facilities that accept youth and offer pharmacotherapy, and multiple hurdles faced in finding treatment centers that accept Medicaid. Findings suggest that interventions are urgently needed to link youths to treatment after overdose.

The research was published in JAMA Pediatrics, and was funded by grants from NIDA, the NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the California Behavioral Health Center of Excellence. Researchers are based at the Johns Hopkins School of Medicine in Baltimore, the University of California at Los Angeles, the Children’s Hospital Association in Lenexa, Kansas, as well as the Boston University School of Medicine and the Boston Medical Center.