COVID-19 Access to Addiction Treatment in Pandemic-Affected Youth

The study’s findings, carried out by researchers at Johns Hopkins Children’s Center and elsewhere, were published in the journal


New research shows that young people in their 20s are hardest hit by the economic disruption of the pandemic, says Rachel Alinsky, MD, MPH, Youth Center’s addiction and adolescent medicine specialist children, and an assistant professor of pediatrics at Johns Hopkins University. of Medicine.


Over the past two decades, while addiction treatment rates among older adults have increased, Alinsky said, treatment rates have decreased in younger age groups. Meanwhile, she adds, a study by the Centers for Disease Control and Prevention found that overdose rates among teens and young adults rose to 49 percent in 2019 and 2020 — the early stages of a pandemic. COVID-19 pandemic.

In an effort to understand how the COVID-19 pandemic affects access to addiction treatment for adolescents and young adults, investigators focused on prescription requirements for buprenorphine (commonly known as buprenorphine). is Suboxone or Zubsolv), a medication prescribed to treat opioid use disorder (OUD).

Among those being treated for OUD, buprenorphine is considered the standard of care. The Johns Hopkins Children’s Center experts note that adolescents and young adults with OUD are less likely to be prescribed buprenorphine than older adults with OUD – in part due to the stigma surrounding OUDs and treatments, and the lack of treatment facilities for these younger age groups .

Gathering information from a database of outpatient prescribing requirements in the United States, managed by a company specializing in health information technology (IQVIA), the researchers identified changes in Changes in prescription drug use among 12- to 29-year-olds during the early stages of the COVID-19 pandemic. A total of 413,152 of these teens and young adults purchased at least one Buprenorphine prescription between January 2018 and August 2020. Monthly prescriptions during this time frame ranged from 90,932 to 120,740.

The team found that monthly buprenorphine prescription rates increased by 8.3% among 12- to 17-year-olds, but it decreased by 7.5% among 18- to 24-year-olds and 5.1% among those aged 12 to 17. people aged 25 to 29. Also analyze data based on health insurance. , the team found that most of the drop in prescriptions for young people was due to a sharp drop in prescriptions with commercial insurance or cash.

Prescriptions bought through commercial insurance fell 19.9% ​​among 18- to 24-year-olds and 11.8% among 25-to-29s. Cash prescribing fell 18.7% among 18-year-olds. to 24 years of age and 19.9% ​​of those aged 25 to 29 years.

By contrast, the number of prescriptions covered by Medicaid, a federally and state aid program for people with limited incomes, did not change significantly.

“These findings highlight Medicaid as a safety net program that allows these young people to continue their life-saving drug treatment, even in this time of financial crisis,” Alinsky said.

Economic disruptions due to COVID-19, such as job losses, are likely to lead to a reduction in treatment among those with commercial insurance, as well as a decrease in the number of people receiving treatment for the first time, she added. . Pandemic job losses could leave many people without private employee-funded health insurance, unable to pay their private insurance premiums, or unable to pay for medications. . Young adults in their 20s are considered the age group hardest hit by these COVID-19 economic disruptions.

The US government has introduced a number of helpful policies – such as restrictions on relaxing telemedicine – that make it easier to prescribe addiction treatments, the researchers say. However, “government changes are not enough,” Alinsky said. According to her, new research shows that such efforts have disproportionately failed among young people, because they are more vulnerable to job loss and the economic impact on their ability to maintain insurance. trade and continued treatment.

Alinsky cautioned that the study did not include data on buprenorphine dispensed through opioid treatment programs, but that the overall number of people under 18 participating in these programs is very small. The researchers also did not have data to determine whether a young adult was a primary enrollee or a dependent in a commercial insurance plan, or whether buprenorphine was prescribed directly by a provider or through an examination. remote healing.

It’s Important to Protect Teens from Addiction

The researchers say their study highlights the importance of protecting this vulnerable population, especially during a national emergency or pandemic. Alinsky says the healthcare community needs to do all it can “to educate young people about their options if they lose insurance or have trouble paying for their drugs.” She also encourages teens and young adults to seek help with addiction and to make sure they have naloxone on hand to reverse the effects of an overdose.

“Anyone who uses opioids or is worried about a family member who is using stimulants can buy naloxone from a pharmacy,” says Alinsky.

In terms of next steps, Alinsky and her research team plan to study the potential effects of Medicaid policies on access to treatment for adolescents and young adults.

Those looking for help can make an appointment at the Adolescent/Family Early Intervention and Recovery Support Center for Addiction Management at the Johns Hopkins Children’s Center. A behavioral health service locator is available on the US Substance Abuse and Mental Health Services Administration website.

Along with Alinsky, the study authors from Johns Hopkins were Laura Prichett, Hsien-Yen Chang, G. Caleb Alexander and senior author Brendan Saloner. Bradley Stein from RAND Corporation also contributed to the research.

Source: Newswise

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