Understanding and Supporting Adolescents with an Opioid Use Disorder 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.
  • 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.

The Role of Medications in the Treatment of Adolescents and Young Adults with Opioid Use Disorder (Banta-Green C & Cooley L, 2018), a report written by ADAI, reviews the current research about treatment medications and young adults along with important real world insights from expert prescribers and substance use treatment providers.

Treatment of Opioid Use Disorders in Youth, 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.

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 (Bagley et al, Ann Emerg Med 2020; 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.