A novel approach to treating adolescents with opioid use disorder in pediatric primary care

Medication treatment for opioid use disorder is effective, and recommended for adolescents, though very few adolescents with opioid use disorder ever receive medications. Reasons include lack of trained medication prescribers for this age group and difficulty in identifying adolescents with substance use disorders. This manuscript examines a novel implementation model of identifying and providing treatment for substance use disorders, including opioid use disorder, in a pediatric primary care practice.

Patients presenting to a selected primary care pediatrics practice for any reason between March 9, 2017 and July 24, 2017 that were identified by screening, self-report or other clinical information to have a substance use problem were referred to an integrated clinical social worker for treatment. We recorded the number of patients that were referred, number of visits completed and SUD and mental health diagnoses.

In the first 4 months of this program, 683 patients aged 12-22 completed a health maintenance appointment; 20 were referred for substance use disorder treatment and 13 completed at least one substance use disorder treatment visit with the integrated clinical social worker. The mean number of visits completed was 5.3. Three patients with opioid use disorders were identified and 2 were induced on buprenorphine.

Our model for treatment of substance use disorders, including opioid use disorders, was feasible and acceptable in a pediatric primary care practice. Broadly implemented, such a model could substantially increase access to substance use disorder treatment for adolescents and young adults.