Only 1 in 4 adolescent treatment facilities offer buprenorphine for opioid use disorder

June 14, 2023
NIH-funded study indicates substantial need to expand access to evidence-based treatment among young people.

Only 1 in 4 residential addiction treatment facilities caring for U.S. adolescents under 18 years old offer buprenorphine, a medication used to treat opioid use disorder, according to a new study. Only 1 in 8 offer buprenorphine for ongoing treatment.

These findings highlight a significant gap in access to evidence-based addiction treatment among young people. Published in JAMA, this study was supported by the National Institute on Drug Abuse (NIDA) and the National Center for Advancing Translational Sciences (NCATS), both part of the National Institutes of Health, and led by researchers at Oregon Health & Science University (OHSU).

Residential treatment facilities are part of the continuum of care for adolescents with opioid use disorder. However, little is known about specific evidence-based treatment options offered to young people at these facilities, including medications for opioid use disorder. To address this gap, researchers at OHSU sought to determine how many adolescent treatment centers in the U.S. were offering buprenorphine to treat opioid use disorder.

Using the FindTreatment.gov database, which is maintained by the Substance Abuse and Mental Health Services Administration (SAMHSA), the researchers identified a list of 354 centers across the U.S. that offered treatment for “substance use,” in a “residential/24-hour residential” service setting, and for “children/adolescents” (defined as people aged 17 and younger) to include in the analysis.

Researchers called these facilities to inquire about treatment and services offered as potential users of these services for a 16-year-old with a recent non-fatal fentanyl overdose. Between October and December 2022, the study team called the facilities in a random order and confirmed that 160 (45%) of these facilities provided residential treatment to patients under the age of 18.

Of the 160 residential addiction treatment facilities found to provide treatment to young patients, the researchers found that 39 facilities (24%) said that they offered buprenorphine to patients aged 16 or older, including through partnership with outside prescribing clinicians, though specific parameters for offering buprenorphine varied by site. For instance, only 20 facilities (12.5%) said that they offered buprenorphine for ongoing treatment. 12 facilities (7.5%) said that they offered buprenorphine to adolescents under 16 years of age.

Among the other 121 facilities that did not offer buprenorphine to adolescents or weren’t sure, 57 (47%) indicated that adolescents prescribed buprenorphine by their own clinician could stay on it at least temporarily, although some stated they would discontinue it before discharge. And 27 (22%) required that adolescents were not taking buprenorphine in order to be admitted for residential treatment.

Based on these findings, the average person would need to call nine facilities on the SAMHSA list to find one that offered buprenorphine. To find one for an adolescent under 16, they would need to call 29 facilities.

NIH release