A study of more than 4 million Medicaid claims records during a recent seven-year period concludes that less than a third of the nearly 3,800 U.S. adolescents and young adults who experienced a nonfatal opioid overdose got timely (within 30 days) follow-up addiction treatment to curb or prevent future misuse and reduce the risk of a second overdose.
The analysis, led by researchers at Johns Hopkins Medicine, also found that only 1 in 54 -; less than 2% -; received standard-of-care counseling and medications recommended by the American Academy of Pediatrics (AAP) for treating opioid use disorder.
"If 1 in 54 young people with asthma or diabetes failed to receive standard therapies for emergency situations with their diseases, we wouldn't accept it," says Rachel Alinsky, M.D., M.P.H., a pediatrician and adolescent medicine fellow at the Johns Hopkins Children's Center and lead researcher of the study described recently in JAMA Pediatrics . "Yet, this is where we are now with the treatment our system is able to provide to youths who have survived an opioid overdose -; and we need to do better for them."
The U.S. Centers for Disease Control and Prevention (CDC) reports that in 2017, about 68% of the more than 70,200 drug overdose deaths in the United States involved one of the three types of opioids: illegal drugs such as heroin; prescription medications such as oxycodone (OxyContin), hydrocodone (Vicodin), morphine and methadone; and synthetic opioids such as Fentanyl. Of those deaths, just over 4,000 were among those ages 15 to 24. Additionally, the CDC says that the opioid mortality rate for people under age 20 has tripled since the year 2000.
Rates of nonfatal opioid overdoses for teens and young adults also have escalated, accounting for more than 7,000 hospitalizations and an estimated 28,000 emergency department visits just in 2015, the most recent year for which data are available.
Alinsky says the risk of a recurrent overdose for this group is extremely high. For example, she says, over 8% of the youths in the new study who survived a heroin overdose experienced another one within three months.
What makes these numbers so alarming is that a proven addiction intervention is available. According to the AAP, a combination of behavioral health counseling and pharmacotherapy -; using prescribed buprenorphine, methadone or naltrexone -; has been shown effective at reducing opioid use and keeping patients in care following an overdose.
It's been estimated that teens and young adults are only a tenth as likely as those over age 25 to get the recommended evidence-based treatment for opioid use disorder. In our study, we wanted to look more specifically at what happens to young patients after a nonfatal opioid overdose and compare that data to those for adults."
Rachel Alinsky, pediatrician and adolescent medicine fellow at the Johns Hopkins Children's Center Related Stories
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