TUESDAY, Oct. 6, 2026 (HealthDay News) -- Most youths with opioid use disorder (OUD) do not engage in care or receive medications for OUD (MOUD), according to a study published online Oct. 2 in JAMA Network Open.
Scott E. Hadland, M.D., M.P.H., from Mass General Brigham for Children in Boston, and colleagues examined progression through the OUD cascade of care (COC) among Medicaid-enrolled youths. The cohort study involved participants with OUD aged 13 to 25 years.
The researchers found that 50.7 percent of the 229,847 youths with OUD enrolled in Medicaid initiated treatment within 14 days of diagnosis, and 32.9 percent engaged in care. Overall, 46.3 percent of the 75,614 youths who engaged in treatment received MOUD, representing 15.2 percent of all youths with OUD. Only 6.6 percent of adolescents younger than 18 years who engaged in treatment received MOUD compared with 51.2 percent of young adults aged 18 years and older. The most initiated medication was buprenorphine, followed by methadone and extended-release naltrexone (68.5, 25.5, and 6.0 percent, respectively). Only 3.1 percent of youths continued medication for 180 days or longer. Among youths receiving MOUD, retention was highest for methadone, followed by buprenorphine and extended-release naltrexone (26.2, 19.2, and 5.8 percent, respectively). There was variation in the median time receiving MOUD by medication: 59, 45, and 31 days for methadone, buprenorphine, and extended-release naltrexone, respectively. Consistently lower progression through the COC was seen for younger adolescents aged 13 to 15 years and racially minoritized youths.
"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," Hadland said in a statement. "Our findings suggest large gaps in care that are keeping this population vulnerable to premature death and poor health outcomes."
One author disclosed ties to the pharmaceutical industry.
