June 14, 2023 -Only 1 in 4 residential treatment centers for teens offers a recommended medicine for opioid addiction, according to a study that exposes an important gap in care.
Posing as an aunt or uncle seeking help for a fictitious 16-year-old who survived a fentanyl overdose, researchers called U.S. rehabs and asked if they offered the treatment medication buprenorphine.
Of 160 facilities with care for teens, just 39 provided buprenorphine, also known by the brand name Suboxone. One hundred said they didn’t and 21 said they didn’t know.
“As somebody who’s tried to promote the use of evidence-based treatments for addiction my whole career, it was jaw-dropping,” said Dr. Todd Korthuis of Oregon Health & Science University in Portland, a co-author of the study published Tuesday in the Journal of the American Medical Association.
Teen drug use in the United States is stable or declining. But the drug supply is tainted with fentanyl, driving fatal overdoses higher and making youthful experimentation potentially deadly.
Parents describe long, frustrating searches for help.
“It’s such an overwhelming situation for a parent to be in,” said Tracy Swartley of suburban Portland, Oregon, whose 19-year-old Eagle Scout son survived a fentanyl overdose and was able to start buprenorphine while in a residential treatment program. “You realize the choice you make is going to make a massive impact on the success of your child.”
Buprenorphine can be a “life-saving medication,” said Dr. Petros Levounis, an addiction psychiatrist and president of the American Psychiatric Association. Considered standard care, it is the only medication approved for teens 16 and older with opioid use disorder. It works by reducing cravings so a patient can begin the work of recovery.
Despite guidelines recommending medication and evidence it prevents overdose deaths, buprenorphine and other treatment drugs aren’t universally accepted. Some believe they replace one drug with another and that abstinence is the best recovery path. Other research suggests only two-thirds of rehab centers for adults offer medication.
The survey was done last year, before a new law eliminated the need for doctors to get a special waiver to prescribe it. That change may improve access, said Levounis, who was not involved in the research. Residential care is not the only alternative, he said, and parents should start by getting an evaluation from an addiction specialist.