A study published by Oregon Health & Science University in January found that access to residential addiction treatment for teens in the United States is scarce and expensive.
In Washington, opioid-related deaths among teens aged 14 to 18 surged from 3.6 to 10.6 per 100,000 between 2016 and 2022, according to the state health department.
Olivia Rae Wright, an addiction specialist for PeaceHealth in Vancouver, co-authored the study along with 10 researchers from OHSU, Yale University and Boston University. Using the Substance Abuse and Mental Health Services Administration treatment locator, they identified 160 addiction treatment centers in the country that serve youths 17 and younger — of those, only 12 were in Washington.
“You’ve got parents that are just desperate for a place for their kid to go because they’ve already tried everything in the outpatient setting,” Wright said. “The only thing left is residential, and the places that are still open are just incredibly expensive.”
From Oct. 24 through Dec. 20, 2022, four authors — Caroline King, Natashia Smith, Dana Button and Patrick C.M. Brown — conducted a “secret shopper” study, by role-playing as the aunt or uncle of a 16-year-old who had experienced a recent nonfatal overdose.
The four authors called treatment facilities and used a script involving the fictitious teen, whom they said was uninsured but qualified for Medicaid and had an opioid use disorder caused by chronic use of opioids that resulted in distress or impairment over time.
The callers also elicited information on bed availability, accepted payment methods and the cost of treatment per day. In addition, they asked if treatment centers offered buprenorphine, also known by its brand name, Suboxone. It is the only medication approved by the U.S. Food and Drug Administration to treat adolescents with opioid use disorder.
Of the 160 facilities, only 54.4 percent had a bed immediately available. The mean wait time for a bed was 28.4 days.
Additionally, nearly half of the facilities (47.5 percent) required some up-front payment. The mean reported up-front cost was $28,731 for the first month.
Out of the 160 identified treatment facilities, 41.3 percent were for-profit, and 58.8 percent were nonprofit. The study found that only 19.7 percent of for-profit facilities accept Medicaid, compared with 83 percent of nonprofits.
Washington was one of the seven states that had a facility that accepted Medicaid, had a bed open the same day and offered Suboxone.
“These pills are killing many people quickly, but they also kill people slowly as they become more and more dependent,” Wright said during a 2022 roundtable discussion about the dangers of fentanyl.
Wright believes two groups of adolescents are at the biggest risk of opioid overdose: the ones who unknowingly experiment with drugs containing fentanyl and those who use opioids and may slowly develop opioid use disorder.
Part of the solution is educating parents and kids about Narcan and implementing addiction treatment into primary care, Wright said.
“There’s almost nowhere in the state of Washington for kids who already have opioid use disorders. It’s a desert,” she said.
