Professional societies recommend that adolescents with opioid use disorder (OUD) receive medication for opioid use disorder (MOUD). This cross-sectional study examined the association between adolescent specialty treatment episodes for OUD with planned MOUD use compared to adults over time.

We used data on first episodes of specialty treatment for OUD (n = 671,183) from the Treatment Episode Data Set – Admissions, a national database of publicly funded treatment programs in the US Admissions occurred between 1/2017–12/2022. The primary exposure was being adolescent (15–17 years). The main outcome was planned MOUD use, defined as having MOUD in a treatment plan.

Adolescent specialty treatment episodes for OUD were significantly less likely to have planned MOUD use than adults (aOR 0.05, 95% CI, 0.02–0.09). Linear combination tests of the interaction between age group and year confirmed that adolescent episodes were significantly less likely to have planned MOUD use than adults across all years. In 2021 and 2022 this disparity narrowed slightly. In 2021, adolescent episodes had 10% of the adjusted odds of planned MOUD use compared to adults in 2017 (95% CI, 0.07–0.15). In 2022, adolescent episodes had 9% of the adjusted odds of planned MOUD use compared to adults in 2017 (95% CI, 0.06–0.11).

Adolescents entering specialty treatment for OUD had significantly lower odds of planned MOUD use than adults. The relatively smaller difference between adolescents and adults in recent years suggests a potential trend toward greater MOUD access, though future research is needed to understand access barriers.