Addiction treatment declines among youths despite increase in ODs

Buprenorphine dispensing among youths decreased significantly from 2015 to 2020 despite a rise in opioid-related overdoses, according to a study published in Pediatrics.

The findings suggest that many youths in the United States with opioid use disorder (OUD) who could benefit from medication for OUD (MOUD) are not receiving it, Andrew Terranella, MD, MPH, a researcher in the CDC’s Division of Overdose Prevention, and colleagues said.

“Opioid-involved overdose deaths among youth are increasing, and many of these deaths could be prevented through treatment for opioid use disorders,” Terranella told Healio. “Buprenorphine is an effective treatment for OUD in adults and adolescents and it is recommended for youth with OUD by several professional societies. We know from past studies that buprenorphine is underutilized.”

The purpose of the study, Terranella said, was to better describe “dispensing of buprenorphine to youth at a national level and to understand how often it is prescribed, to how many youth, and which specialties are doing the prescribing.”

“Understanding these data can help policymakers and clinicians develop strategies to expand access to this potentially life-saving intervention,” Terranella said.

Using data from IQVIA's National Prescription Audit New to Brand and Total Patient Tracker, which contains prescriptions dispensed at approximately 49,000 retail pharmacies and represents 92% of all prescriptions in the U.S., Terranella and colleagues examined dispensing trends for youth aged 19 years or younger from 2015 to 2020, also examining sex, age and prescribing specialty.

The researchers ultimately found that only 336,000 total prescriptions were dispensed to 22,000 patients aged 19 years or younger over the 5-year period examined, far lower than the estimated 87,000 adolescents between 12 and 17 years and 227,000 young adults aged 18 to 25 years living with OUD.

The authors also learned that the rate of buprenorphine dispensed to youth decreased 25% over the study period, from 0.84 to 0.63 prescriptions per 1,000 youth per year. The proportion of youth dispensed buprenorphine also decreased from 7.6 to 4.2 persons per 100,000 population per year, a rate of 45%.

Terranella also noted that only 1% of the buprenorphine prescriptions were written by pediatricians.

“This demonstrates many missed chances to engage youth in treatment but also presents an opportunity to increase access by engaging pediatricians and helping them increase their comfort and ability to prescribe this medication,” Terranella said.

He said such medications can now be prescribed by any clinician.

“Medications for opioid use disorder are recommended in adolescents and young adults, and many who could benefit from MOUD are not receiving it,” Terranella said. “With the elimination of the buprenorphine waiver following passage of the omnibus funding bill in December, any clinician — including pediatricians — can now prescribe buprenorphine for OUD and pediatricians should consider prescribing in any patient with OUD.”