Study reveals large gaps in care for youths with opioid use disorder
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One in 100 adolescents and young adults in the United States has an opioid use disorder (OUD) and, with the rise of fentanyl in the drug supply, overdoses in this age group have risen sharply since 2019.
A new study by investigators from Mass General Brigham asked whether Medicaid-enrolled people ages 13 to 25 with OUD receive evidence-based, reliable treatment.
Using eight years of national data from 229,847 adolescents and young adults, they found only half began treatment, one-third engaged in care, one-sixth received medication and one in 32 continued medication for 180 days or more.
Results are published in JAMA Network Open.
"Untreated opioid use disorder in young people has both immediate and lifelong consequences, and overdoses and poisonings have become a leading cause of death in this age group," said lead author Scott Hadland, M.D., M.P.H., chief of adolescent and young adult medicine at Mass General Brigham for Children. "Our findings suggest large gaps in care that are keeping this population vulnerable to premature death and poor health outcomes."
Using health insurance claims data, researchers found that within 14 days of diagnosis, 50.7% of adolescents and young adults with OUD initiated treatment and 32.9% engaged in care by attending two or more additional treatment sessions in the 34 days after initiating care. Of those who engaged in treatment, 46.3% began medication. The three most commonly prescribed medications were buprenorphine, methadone and extended-release naltrexone.
Only 3.1% of adolescents and young adults with OUD were still on a medication after 180 days, a time frame that has become a key quality-of-care measure given that longer treatment is associated with better outcomes. Additionally, younger adolescents and racially minoritized youths had consistently lower progression through the stages of care.
"Prior to our study, little was known about how youths progress through the stages of treatment for opioid use disorder," said Hadland. "What we found is essential to inform Medicaid plan design, service delivery and policies to improve quality and equity in youth opioid use disorder care."
Publication details
Opioid Use Disorder and Evidence-Based Care Among Medicaid-Enrolled Youths, JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2026.37263
Journal information: JAMA Network Open
Key medical concepts
Opioids and Opioid Use Disorder (OUD)BuprenorphineMethadone
Clinical categories
PsychiatryChildren's healthPediatricsPsychology & Mental health Provided by Mass General Brigham Who's behind this story?
Swati Mestri
Swati Mestri holds a bachelor's degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space. Full profile →
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Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →
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