When a young person is arrested for drug possession, are they merely experimenting with the forbidden, or are they addicted? It's a crucial question. Experimentation is relatively harmless, although it can have serious legal consequences. Addiction, however, requires treatment.
When it comes to the opioid epidemic, it's far more likely that addiction is the issue. A common scenario is for the person to become addicted to a legally prescribed pain medication like OxyContin or Vicodin. Once the prescription ends, the addicted person may turn to the streets to obtain the needed drug -- or a substitute like heroin.
There are effective drugs that can treat opioid cravings: buprenorphine and naltrexone. They're often covered by insurance and are approved for young people by the American Academy of Pediatrics. The trouble is, a new study found they're not being prescribed for youth, even when they're insured.
The study found that only 27 percent of insured patients diagnosed with opioid addiction were given either of the two drugs. Researchers looked into the medical records of around 21,000 patients between 13 and 25 who were covered by a major insurer during 2001-2014, a period when opioid addiction was skyrocketing.
One of the study's main authors noted that, in his own practice, he often sees young people who have been to multiple addiction treatment programs without being offered one of the two drugs, which treat cravings so that the underlying addiction issues can be addressed.
Cost, prescribing barriers and bias could be at play
The cost of the drugs under insurance varies, but overall the cost of buprenorphine, a daily medication, is about $100 per month. Naltrexone, a monthly shot, costs about $1,000. Beyond cost, however, there may be unfamiliarity among some doctors. Naltrexone should only be given to people who are completely free from opioids, and buprenorphine requires some special training and a DEA prescription waiver.
Interestingly, the study also found that the rate at which the drugs were prescribed were lower among young women, Hispanics and African-Americans than among young white men. This could indicate either that there is some difference in access to care, or perhaps doctor bias.
What's clear is that parents and those who care for opioid addicts need to know that these drugs are available and effective so they can be utilized to support and sustain recovery.