Drug-related overdose deaths among teens more than doubled between 2019 and 2020, despite adolescent drug use becoming less common.
Teen overdoses have reached a crisis point, a new study published in the New England Journal of Medicine found, with an average of 22 adolescents dying from drug overdoses every week in 2022. Fentanyl is among the leading drivers of increased teen overdose deaths.
Fentanyl is now involved in at least 75% of adolescent overdose deaths, according to researchers’ analysis of CDC data.
Fentanyl-related deaths sharply increased among the general population in 2013, but the impact on teens was delayed until 2019. The deferred impact may be because the drug was originally found in powder forms but has increasingly been used in counterfeit pills designed to resemble drugs more likely to be used by adolescents, like oxycodone and benzodiazepines.
Certain states, mainly in the western United States, were associated with a mortality rate nearly twice as high as the national average. Arizona, Colorado and Washington State were among the areas of highest concern.
“To stem the rising tide of adolescent overdose deaths, we believe clinicians, parents, educators and policymakers must act quickly,” the study’s authors said.
Study authors recommend making low-barrier and evidence-based addiction treatment available to adolescents as well as taking steps to reduce stigma surrounding treatment. One recently-sealed deal is seeking to do just that.
Digital substance use disorder (SUD) treatment provider Boulder Care partnered with UnitedHealth to extend its care to eligible Washington state adolescents, aged 14 to 17, covered by Medicaid.
“There have been a dearth of addiction medicine providers who will treat this population, and closures have further narrowed that gap as the need is rising,” Stephanie Strong, Boulder’s CEO, told Addiction Treatment Business. “Under this new partnership, we’ll be able to invest in what we hope will be a world-class program for serving vulnerable people.”
The program will launch in Q2 2024, but has already experienced “explosive” demand. It will begin at the community level, treating a few hundred teens, but Boulder hopes to scale the offering to several thousand in Washington state and other U.S. states.
The wrap-around care offered through the program is made possible by its value-based payment model.
“It is not sufficient to only have prescribers on a fee-for-service rate schedule in order to care for this population or SUD in general,” Rose Bromka, Boulder’s chief operating officer, told ATB. “It really requires more holistic care.”
Boulder is partnering with local infrastructure, including schools and community clinics, to minimize the impact on students like the lost class time.
The company will tailor its approaches to a younger cohort of patients, hiring younger peer recovery specialists and specialized case managers. Teen patients will have access to all of Boulder’s services, including access to buprenorphine and other medications for addiction treatment (MAT).
“Medication is still the gold standard [for youths with opioid use disorder (OUD)], but there’s a lot of stigma about prescribing it for younger adults,” Strong said. “We work with families about some of those stigmas and ultimately get to what’s absolutely the best thing for an individual that we’re treating.”
Boulder’s fully-digital approach also helps diminish stigma and impact on teens’ day-to-day lives, Strong said.
“One great benefit of telemedicine is being able to reach places where there’s just a dearth of treatment providers,” Strong said. “At Boulder, that means almost 40% of our patients live in a rural community. We know that the ability to reach people privately without stigma is another major benefit of telehealth and for our population, like teens who are in school and in potentially unstable family situations.”
Stigma and misinformation around SUD are more prevalent among teens than among adults, Strong said. She advocates for increased prevention education and overdose awareness.
“New treatment modalities tailored for younger adults just are not changing fast enough,” Strong said. “Modern providers who are able to take on this care will hopefully close those gaps. In the long term, we hope that addiction medicine will be taught in more medical schools that more pediatric primary care providers will start taking on patients with addiction and complex behavioral health conditions. But we can’t wait for that to happen, knowing it may be a decade or longer.”