Understanding and Supporting Adolescents with an Opioid Use Disorder

Understanding and Supporting Adolescents with an Opioid Use Disorder (pdf) is an eight page overview for providers working with adolescents and young adults with opioid use disorder, as well as loved ones of adolescents who use opioids. The purpose of this is brief is to provide an overview of the scope of the problem of opioid use disorder in adolescent and young adults, and identify treatment options and challenges.

Key points:

youth talking to provider
  • Opioid use disorder and overdose deaths have increased in young people in the US. Overdose risk in young people is heightened by the rise of illicit fentanyl in pills, powders, and other forms of drugs.
  • Medications for opioid use disorder (MOUD) are the standard of treatment for adolescents and young adults with opioid use disorder. Among these, buprenorphine is the only FDA-approved medication for people under 18, and it has the best evidence. Buprenorphine remains under-prescribed for adolescents and young adults. There are complex reasons for this including misconceptions about the use of buprenorphine in young people, and a lack of youth-serving providers who prescribe or dispense these medications
  • Compared to treatment that does not include medication, MOUD has better outcomes for adolescents including less drop out and less opioid use
  • Programs that serve adolescents and young adults should be adapted to their unique needs and stage of life. Programs should offer rapid access, have low barriers to entry and return, be available in settings where young people already seek care, and involve adolescents in program development.

Fact sheet: Medications for Opioid Use Disorder for Youth

This fact sheet from the WA Healthcare Authority  (2024) describes the current guidance on the use of medications for opioid use disorder in adolescents and young adults.

A Guide for Family and Friends to Support Youth Using Opioids

The Supporting the Health of Youth Who Use Fentanyl/Opioids guide addresses how and why to stay connected to youth, how medications can help, and common questions that come up while youth are on opioid use disorder treatment medications. Health and safety guidance along with practical resources for support are provided.

Adolescents and Opioid Use Disorder podcast

In this podcast, Adolescents with Opioid Use Disorder (Spotify), host Michelle Peavy (formerly UW ADAI) talks to Paul Barry, LICSW (formerly UW AIMS Center) about teens and opioid use disorder. Paul helps us take a look at what’s happening with adolescents who use opioids and what treatment options are available to help them. He also highlights the joy of working with youth, and together we wonder “What are we waiting for?” in terms of expanding effective and evidence-based treatment for adolescents with an opioid use disorder.

Treatment of Opioid Use Disorders in Youth

Treatment of Opioid Use Disorders in Youth (Vimeo video) provides an overview of treating opioid use disorder in adolescents. Dr. Marc Fishman discusses the use of the medications naltrexone and buprenorphine, as well as family engagement and behavioral approaches in this training sponsored by the UW’s Psychiatry and Addictions Case Conference series. Note this recorded before fentanyl predominated and before long-acting injectable forms of buprenorphine were widely used.

Dr. Fishman is board certified in addiction psychiatry and addiction medicine. He is a member of the Psychiatry faculty of the Johns Hopkins University School of Medicine, and Medical Director of Maryland Treatment Centers.

Characteristics and Receipt of Medication Treatment Among Young Adults Who Experience a Nonfatal Opioid-Related Overdose

This article by Bagley, et al, in Annals of Emergency Medicine (2000;75(1):29-38) describes characteristics of young adults, 18-25, who experience nonfatal overdose and explores the time to starting medications for OUD. This is one of the few research studies focused on real world medication for OUD access among young adults. They found that about one-third of people who had an overdose received treatment medications within a year and that the medication they received varied by age.

Implementation Supports for Health Care Providers Who Treat Adolescents

Implementation support can be key for health care providers to be willing to start and continue to provide medications for opioid use disorder to adolescents. Perspectives on Medication Treatment for Opioid Use Disorder in Adolescents: Results from a Provider Learning Series by Peavy KM et al in Substance Use & Misuse (2023;58(1):160-162) describes the content of an online learning series in Washington State and the level of support for treatment medications among different types of health care staff.

Medications for Opioid Use Disorder in Adolescents

This video series was held in 2021 and featured the following components presented by expert clinicians. The audience is health care and treatment providers:

The Role of Medications in the Treatment of Adolescents and Young Adults with Opioid Use Disorder

The Role of Medications in the Treatment of Adolescents and Young Adults with Opioid Use Disorder (pdf) is a detailed report by Banta-Green C & Cooley L published in 2018 that reviews research about treatment medications and young adults. Note that this report was written before the emergency of illicitly manufactured fentanyl and long-acting injectable formulations of buprenorphine. Qualitative data from three expert physician addiction medicine providers and researchers are provided alongside findings from interviews with local substance use disorder treatment professionals. These qualitative data provide important insights into what services and approaches appear to work best for youth with OUD.