Medication Treatment and Health Care Use Among Adolescents With Opioid Use Disorder in Ohio

Abstract

PurposeThe opioid epidemic impacts both adolescents and adults, and overdose deaths continue to rise. Two medication treatments (buprenorphine and naltrexone) are effective for treating opioid use disorder (OUD) in office-based settings but are seldom prescribed to adolescents. The present study describes medication treatment for OUD and other care received by adolescents with OUD in a state at the center of the opioid epidemic. MethodsThis retrospective cohort study included adolescents (aged 12–18 years) enrolled in Ohio Medicaid with an index OUD diagnosis (August 1, 2012, to May 31, 2016). Analyses describe the proportion of adolescents who received medication for OUD, health care (general medical outpatient, behavioral health, hospitalization, and emergency department), and other medications (attention deficit/hyperactivity disorder, antidepressants, antipsychotics, benzodiazepines, and opioid analgesics) within 3 months after OUD diagnosis. The results are compared by age group (12–15 and 16–18 years). ResultsAmong 626,508 adolescents enrolled in Medicaid, 2,097 met inclusion criteria. Overall, 4.6% received medication for OUD, whereas 9.8% received an opioid analgesic, within 3 months after OUD diagnosis. The proportion of older adolescents receiving medication for OUD was significantly higher than younger adolescents (5.9% vs. 1.2%; p < .001), whereas a higher proportion of younger adolescents received attention deficit/hyperactivity disorder medications, antidepressants, and antipsychotics. Low proportions of adolescents in both age groups received benzodiazepines (2.4% and 3.6%). During the 3 months after OUD diagnosis, 48.5% of adolescents had general medical outpatient visits, and 29% received outpatient behavioral health services. ConclusionsAlthough a large proportion of adolescents with OUD have subsequent visits in outpatient settings, few receive medications to treat OUD.