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Treatments Used in U.S. Adolescent Residential Addiction Facilities

Among U.S. adolescent residential addiction treatment facilities listed in the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Locator, only 1 in 4 offered buprenorphine and 1 in 8 offered buprenorphine for ongoing treatment, a study shows. “By comparison, nearly two-thirds of adult residential facilities offer buprenorphine,” the authors write. “The average parent would need to call 9 facilities on the SAMHSA Treatment Locator list to find one that offered buprenorphine and 29 to find one for an adolescent younger than 16 years.”

Buprenorphine is the only agent approved by FDA for use in adolescents aged 16 years or older with opioid use disorder. In addition to the SAMHSA Treatment Locator, the researchers identified facilities using the SpyFu website to identify additional facilities offering services online. Seeking residential treatment for a 16-year-old with a recent nonfatal fentanyl overdose, the investigators contacted facilities by telephone while posing as the aunt or uncle and asked specific questions about buprenorphine and general questions about other treatments.

The results showed the following: “Of 160 facilities, 39 (24.4%) offered buprenorphine, including through partnership with outside clinicians, which varied by US region (18.0% in the West to 40.0% in the Northeast). Twelve facilities (7.5%) offered buprenorphine initiation but discontinued before discharge, 17 (10.6%) initiated buprenorphine and offered ongoing treatment, and 3 (1.9%) offered buprenorphine for ongoing treatment only. Twelve facilities (7.5%) offered buprenorphine to adolescents younger than 16 years. Four facilities (2.5%) offered long-acting injectable buprenorphine.

“Among the 121 facilities that did not offer buprenorphine or were unsure, 57 (47.1%) indicated that adolescents who were prescribed buprenorphine by their own clinician could continue receiving it, at least temporarily, although some facilities indicated they would discontinue it before discharge, and 27 (22.3%) required adolescents to not be receiving buprenorphine at admission. Sixty-three facilities (39.4%) indicated that adolescents could undergo on-site withdrawal. Of those facilities, 18 (28.6%) offered buprenorphine and some did not offer any medication adjuncts.…”

Source: JAMA