Amid the roar of the opioid crisis, little is heard about the lack of drug treatment for young people.
Now, a new analysis of federal survey data brings attention to a serious issue within a larger problem that is getting worse.
That issue is how few children and youths who abuse drugs, including opioids, get the help they need.
“Only a small percentage of youth who report pain reliever (including opioid) abuse or dependence receive addiction treatment, and youth of color are significantly less likely to receive treatment than their white peers,” according to an analysis of the National Survey on Drug Use and Health. “This gap between white youth and youth of color age 21 and under has persisted almost every year since 2002, when opioid prescription deaths began to rise.”
Consider these general facts about the raging crisis from the Centers for Disease Control and Prevention:
· More than 700,000 people, about the population of Washington, died of a drug overdose from 1999 to 2017.
· An opioid was linked to about two-thirds of the 70,200 drug overdose deaths in 2017.
· The number of overdose deaths involving opioids was six times as great in 2017 as in 1999.
· 130 Americans die every day, on average, of an opioid overdose.
Not only are relatively few young people within this emergency receiving treatment, but the percentage is falling, with youths of color faring “persistently lower than their white counterparts,” according to the analysis by Child Trends, a Bethesda-based research organization that focuses on children and youths.
The picture it paints is bleak and going south.
“As of 2016, 16.1 percent of white youth who abused pain relievers received treatment, compared to 16.7 percent in 2002,” the report’s authors, Andra Wilkinson and Hannah Winslow, said. “Just 9.5 percent of youth of color who abused pain relievers received treatment in 2016 — a 4.3 percentage point drop from 2002 (when 13.8 percent received treatment).”
There is one noticeable problem with the data: The small sample size of African American, Hispanic, Native American, Hawaiian/Pacific Islander, Asian and multiracial youths required them to be lumped together for statistical purposes. Child Trends acknowledged this is “regrettable since each group’s experiences in attempting to access treatment are different.”
Sen. Joe Manchin III (D-W.Va.) has taken a strong interest in the issue because his state has been hit harder than most by the opioid crisis. “With treatment penetration rates ranging between 10 and 16 percent, it’s clear that access to substance abuse treatment is a major problem for all of our children,” he told the Federal Insider. “Often, these children or their parents recognize that they need help, but they are turned away because there simply aren’t enough facilities, beds, or mental health providers in their community.”
So, what needs to be done?
Manchin is pushing legislation, the LifeBOAT (Budgeting for Opioid Addiction Treatment) Act, that he said “would impose a 1-cent fee on every milligram of opioid produced, with the funding directly going to substance abuse treatment. This steady funding stream would provide another $2 billion a year.”
The report recommends increasing the availability of youth addiction treatment programs. Recent history, unfortunately, doesn’t offer much hope.
“The number of substance abuse treatment facilities did not change from 2007 to 2017, and fewer than one-third of facilities offer programming for youth,” Child Trends said. “Additionally, only 10 percent of facilities offer medication-assisted therapy, which is considered best practice for treating opioid addiction.”
Furthermore, greater access to treatment may not close the gap between white youths and those of color. “Youth of color may be less likely to seek treatment than their white peers. Youth of color are less likely to be insured, screened for substance abuse, and referred to treatment by clinical providers,” Child Trends reported.
Compounding the problem is the nation’s oppressive racial history.
“In the black community, substance abuse has historically been addressed through the criminal justice system, rather than via treatment provision,” Wilkinson and Winslow wrote, “which could discourage black youth from seeking treatment.”
In response to the study, the Centers for Medicare and Medicaid Services said it introduced a program last year aimed at “improving the quality of care for children covered by Medicaid and CHIP [Children’s Health Insurance Program], especially those with or at-risk for developing significant health needs.” Also, 21 states have demonstration projects “to help increase access to treatment for opioid use disorder and other substance use disorders,” including treatment for adolescents.
Among other efforts, the Indian Health Service said it and “tribal programs currently operate 12 Youth Regional Treatment Centers across the U.S. that provide culturally appropriate residential treatment for American Indian and Alaska Native youth suffering from substance abuse issues.”
Regrettably, the data, the responses from agencies and past practice generate no optimism.
Consider this pessimistic passage from Child Trends regarding the effect of increased spending on Medicaid and increased health insurance coverage for young people through the 2010 Affordable Care Act: “During the period from 2002 to 2016, some positive steps were taken; overall, though, these do not seem to be associated with either increases in the percentage of youth receiving addiction treatment or with closing the gap between white youth and youth of color.”
More creative and aggressive action is mandatory.