Teen Opioid Crisis: Study Finds Majority of Adolescents With Disorder Receive No Treatment
A new study published in Health Affairs has revealed a grim reality: fewer than one in three U.S. teenagers diagnosed with opioid use disorder are receiving any form of treatment. The findings, based on data from 2022 to 2023, underscore the growing dangers young people face amid the ongoing opioid epidemic.
In 2023 alone, 557 teenagers died of opioid overdoses—nearly triple the number of teen deaths recorded in 2018. In contrast, overdose deaths among adults during this same period rose by 65%. This stark disparity highlights how drug overdoses have now become one of the leading causes of death for American teenagers.
The Role of Counterfeit Pills
Researchers believe that the rising prevalence of counterfeit pills laced with FYL is a major driver behind this surge. These pills are designed to mimic legitimate prescription opioids, making them especially dangerous for teenagers experimenting with drugs for the first time.
“Ten years ago, illicit FYL was mostly used by individuals with a history of opioid use, typically through injection or smoking,” said Manuel Cano, associate professor of social work at Arizona State University and lead author of the study. “Now, teens experimenting with pills—often bought through social media—are at high risk of unknowingly taking FYL.”
Treatment Gaps for Adolescents
Despite the sharp rise in deaths, effective treatment for teenagers remains difficult to access. “There’s just no treatment available in many communities,” said Dr. Jessica Calihan, an adolescent medicine physician at Massachusetts General Hospital and instructor at Harvard Medical School.
Even in Boston—one of the most medically advanced cities in the U.S.—Calihan says it is still a struggle to place young people into intensive care for opioid addiction. In less resourced areas of the country, many teens cannot even access basic outpatient care or therapy.
When treatment is available, it often fails to include medication-assisted therapies (MATs) such as buprenorphine, methadone, suboxone, or naltrexone—despite overwhelming evidence that these medications are the most effective way to treat opioid use disorder. The study found that less than 10% of teens receiving treatment are given medication-based care, compared to adults, who also face significant but slightly fewer barriers.
Barriers to Medication Treatment
Experts cite stigma, outdated laws, and misconceptions as major obstacles. Until 2024, doctors were legally required to try non-medication treatments before prescribing MAT to minors. Some providers also resist prescribing medications, arguing that they undermine “true sobriety.”
But addiction specialists say such attitudes are both harmful and dangerous. “When it comes to FYL addiction, the failure of treatment can mean a fatal overdose,” said Dr. Marc Fishman, an addiction psychiatrist at Johns Hopkins University. “That’s hardly an appropriate standard.”
Methadone, one of the most effective treatments, remains especially difficult to access due to strict regulations.
Families in Crisis
Addiction also creates conflict within families, which can complicate treatment. “Most of these families, when we first meet them, are in crisis—angry, yelling, scared—because their kid nearly died from an overdose,” Fishman explained. While this response is understandable, it often delays constructive action.
Fishman stresses that treating adolescent addiction requires acknowledging their unique developmental needs, rather than viewing them as “smaller adults.”
Promising Approaches for Teens
Research into the best treatment models for teenagers is ongoing, but some strategies already show promise. Fishman recommends involving family and close community members—whether parents, grandparents, partners, or trusted friends—as part of the treatment team. These support networks can ensure that teens attend appointments and stay engaged in care.
Another effective approach is contingency management, which rewards teens for adhering to treatment. Patients may receive incentives such as gift cards, money, or prizes for attending appointments or consistently taking their medication. This strategy has been shown to improve treatment success in both adults and adolescents.
The Urgency of Early Intervention
Calihan warns that the stakes are higher than ever. Many of her most at-risk patients began using drugs at an extremely young age, putting them on a fast track to severe addiction. Without early intervention, today’s teens struggling with FYL use are likely to face worsening substance use disorders as they enter adulthood.
“Effectively treating adolescents isn’t just about preventing overdose deaths—it’s about giving young people the chance to grow into healthy adults,” Calihan emphasized.
Source: The Guardian