Narrowing the Substance Use Care Gap for Teens

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For Employers
5 min read


It’s difficult to be a teenager. Many of the things adults are able to do are restricted to those over 18; many of the things that are still open to children exclude adolescents. For much of this brief but critically important stage of life, adolescents feel trapped between societal boundaries. Those difficulties often extend to other circumstances, such as drug and alcohol use.

Millions of U.S. teens have a substance use problem that leaves them, and often their families, crying out for personalized, high-quality, effective treatment. However, few programs are qualified to treat adolescents for alcohol, nicotine, and opioid use – and even fewer offer medication assisted treatment (MAT). This means teens who need treatment the most, often can’t get access to evidence-based, MAT-supported care. Is there a way to fix this dangerous gap in care?

Access to care

It’s estimated that 5.1 million young adults in the United States have a substance use disorder (SUD). But their chances of getting treatment are bleak, with 9 out of 10 of those not receiving any treatment.

Multi-addiction is also a greater problem among adolescents than adults, with detailed research from the 2021 National Survey on Drug Use and Health (NSDUH) finding that multi-addiction is present in 18% of adolescents aged 12 – 17 compared to 15% of adults.

Compounding the challenge of access to care are findings from the National Institute on Drug Abuse, which highlight that only 1 in 4 residential addiction treatment facilities caring for U.S. adolescents under 18 offers buprenorphine, a medication used to treat opioid use disorder, and only 1 in 8 offers buprenorphine for ongoing treatment.

Because adolescents are at a particularly vulnerable time in their development, their still-maturing brains can be more easily damaged by substances; therefore, it’s even more important that they have access to prompt, effective, and specialized SUD treatment.

Minding the gap

Early intervention is the key to successful treatment. For those adolescents who do not get treatment, their problems are unlikely to simply go away. Recent findings from a nationally representative, ongoing study looked at SUD use that started in adolescence and continued into adulthood. Researchers found that more than 60 percent of adolescents with the most severe SUD symptoms carried two or more SUD symptoms into adulthood. And the more symptoms that were reported, the more likely the person was to continue to have problems with substance use into adulthood.

In closing the care gap, it’s also important to realize that substance use by adolescents is rarely an isolated problem. Findings from the 2021 NSDUH Report revealed that: 

  • Among adolescents aged 12 to 17, 6.3 million had either an SUD or an MDE in the past year
  • Almost a million adolescents had a major depressive episode (MDE) in the same year they experienced a substance use problem (co-occurring disorder)
  • Those with a past-year MDE were more likely to have used some substances in the past year or past month compared with their counterparts who did not have a past-year MDE
  • Only 40 percent of those who had at least one MDE received any mental health treatment, and treatment that addresses both of those problems is even more rare. 

One study looking at factors associated with co-occurring disorders and access to treatment, found that less than 1 percent of affected youth received treatment for both SUD and mental health problems in a given year. Both problems are complex and interconnected, so the less treatment someone gets for either can worsen both.

Real-life impact

The impacts of lack of access to effective SUD and mental health treatment for adolescents and dependents extends to other family members. Findings from the 2023 Pelago Annual State of Substance Use Management Trend Report discovered that 1 in 3 workers have reported dealing with a family member’s substance use, and 46 percent reported personal or family member difficulties stemming from drug or alcohol use. And the estimated amount that SUDs can cost employer sponsored health insurance is an astonishing $35 billion a year.

In a study that combined measures of parental confidence with workplace productivity, 53 percent of working parents reported they had missed at least one day of work a month because of a child’s mental health issues. While that number does not mention the number of parents who are also dealing with SUDs, research indicates these disorders have significant overlap. According to research from Hoffman et al., estimated rates of co-occurring mental health disorders among adolescents with substance use disorders range from 60-75%.

Closing the gap 

Pelago is working to close the SUD care gap for teens by being the first online substance use platform to offer multi-substance adolescent support. Teens 15 through 17 can receive treatment for alcohol and tobacco use, and those 16 and over have access to opioid use disorder (OUD) treatment. Those treated for OUD are eligible for MAT for the most effective substance use care.

Access to MAT is so important because this level of care is rarely available to those under 18. A 2018 retrospective cohort study of opioid-dependent youth found that less than 5 percent were able to obtain MAT in their treatment program. (MAT for those under 18 who use nicotine or alcohol is not FDA approved.) Teenagers can be entered into treatment through a parent or guardian’s insurance if Pelago is supported by that particular program, or they can be entered independently, depending on their situation.

Unlike other adolescent SUD treatment programs, the Pelago program also addresses mental health issues that often accompany SUDs. Anyone who enters the program will also be screened for depression and anxiety, and based on that assessment, be referred to care if and when appropriate.

While being a teenager is always rough, getting help for a teen with SUD shouldn’t have to be a difficult experience. With its new virtual treatment platform designed specifically for adolescents, Pelago makes getting treatment easier, more accessible, and more effective. When that treatment is successful, teens can then start dealing with other tough issues…like school, clothes, and dating.

To learn more about how your workplace benefits or health plan team can best support employees and members, including adolescents, contact a solutions expert today.

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