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 These medications, usually methadone or suboxone, are prescribed to
reduce craving for opiates and ease withdrawal symptoms, and studies
show they help opiate users to abstain. In 2016, the American
Academy of Pediatrics advised doctors to consider
medication-assisted treatment, specifically suboxone, for
adolescents with “severe opioid use disorders.”
To get a “baseline” sense of medication-assisted treatment in
adolescents with opiate or heroin addiction, Kenneth Feder of Johns
Hopkins School of Public Health in Baltimore and his colleagues
looked at data on 139,092 patients receiving treatment at publicly
funded programs in the United States in 2013.
While 26 percent of adult heroin addicts received
medication-assisted treatment, that was true for just 2 percent of
adolescents.
Among patients addicted to opiates, 12 percent of adults received
medication, compared to less than 1 percent of adolescents, the
researchers reported in the Journal of Adolescent Health.
“There’s more that needs to be done across the board to facilitate
access to these treatments when they’re medically necessary,” Feder
told Reuters Health by phone. “The best validated treatment for
somebody struggling with an opiate addiction is treatment that
includes some sort of medication assistance.”
Patients seeking medication-assisted treatment face a number of
obstacles. Methadone is only offered at specific substance abuse
treatment centers, and these centers need a waiver to treat anyone
under 18. Also, Medicaid rules state that adolescents with opiate
addiction must have failed treatment twice in order to be prescribed
methadone. Doctors can prescribe suboxone, the other main drug for
this purpose, to patients 16 and older, but only if they have a
waiver.
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“These treatments may not be covered by a state’s Medicaid program,”
Feder added. “And if they are medically necessary, we think they
should be covered by a state’s Medicaid program.”
The difference in medication-assisted treatment rates between
adolescents and adults is “really striking and very concerning,” Dr.
Lisa Marsch of Geisel School of Medicine at Dartmouth in Lebanon,
New Hampshire, told Reuters Health by phone. Marsch has studied
medication-assisted treatment but did not participate in the new
study.
Medication-assisted treatment is clearly more effective for adults
and adolescents, Marsch said, and by not extending the treatment to
more patients, “we are doing a real disservice based on the science
and the data.”
About a half-million US adolescents use prescription opiates every
year, and just under 10% will become addicted, Marsch added. “We
want a chance to stop this problem early.”
SOURCE: http://bit.ly/2lLuWYN Journal of Adolescent Health, online
March 1, 2017.
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