Addressing Stigma in Medication Treatment of Adolescents With Opioid Use Disorder

Abstract

: In September 2016, the American Academic of Pediatrics released a policy statement that adolescents with opioid use disorder should be offered pharmacotherapy with buprenorphine/naloxone, methadone, or naltrexone. In our clinical practice, however, we have encountered the perception among patients, families, and clinicians alike that medications should be used as a last resort. That we should wait until things get worse is a discarded approach. As addiction specialists, it is imperative that we prevent and identify risky use and use disorders, then intervene early and offer timely, evidence-based treatment. We suggest that adolescents deserve special attention and that specific efforts should be made to reduce the stigma associated with treating adolescents with opioid use disorder with medications to optimize those efforts.

Association of Treatment With Medications for Opioid Use Disorder With Mortality After Hospitalization for Injection Drug Use–Associated Infective Endocarditis

“…We excluded those younger than 18 years because they are less likely to be treated with MOUD. 22 , 23 …”

Personal and Socioeconomic Determinants in Medication-assisted Treatment of Opioid Use Disorder in Adolescents and Young Adults

“…Youth seeking a sober support network often express feeling unwelcome at 12 step programs or not being "sponsored" until they are "sober" (meaning no MAT or other medications). 65,66 Without peer support, the risk of relapse or mortality significantly increases. 65…”

Using nominal group technique to identify barriers, facilitators, and preferences among patients seeking treatment for opioid use disorder: A needs assessment for decision making support

“…Negative feelings about medications combined with low motivation for treatment reduce medication uptake (Ridge, Gossop et al 2008). Moreover, medications, especially with methadone, are often stigmatizing for many patients (Pinto, Maskrey et al 2010, Gryczynski, Jaffe et al 2013, Yarborough, Stumbo et al 2016, Bagley, Hadland et al 2017) and many counseling and abstinence-based programs disparage medications, especially OAT, as inconsistent with recovery, a notion which may be perpetuated by peers, family, and clinicians (Olsen and Sharfstein 2014), despite contrary evidence (Substance Abuse and Mental Health Services Administration 2018). Patients may view pharmacotherapy as ineffective: only a third of people who inject drugs believe that medications were superior to detox for treating their addiction (Luty 2004).…”