Adolescent and Young Adult Access to Opioid Use Disorder Care.

Abstract

Adolescents and young adults (AYAs) with opioid use disorder (OUD) have low rates of treatment engagement and retention. Their care-seeking experiences remain underexamined, and understanding these experiences is critical for improving engagement for this vulnerable population. We examined how AYAs navigate support for OUD, access medications for OUD (MOUD), and explored barriers and facilitators to care. We conducted semistructured interviews with English-speaking AYAs (ages 15-25 years) who had accessed care for OUD. Participants were recruited through purposive and respondent-driven sampling and clinical referral. Interviews were conducted in-person or by phone, audio-recorded, and transcribed. Rapid qualitative analysis strategies were employed to expedite translation of findings to practice. From interviews with 20 AYAs, we identified 4 main themes: "chasing care," "needs first," "relationships matter," and "real talk and real options." "Chasing care" conveys the difficulty participants faced to establish viable care connections and the reliance on adults or a crisis moment to successfully access care. Treatment success was reported to be improved when programs addressed basic needs (housing, transportation, employment). Both "relationships matter" and "real talk" emphasized that authentic and informed engagement with AYAs was crucial for treatment retention. The AYAs we spoke with wanted appropriate and accessible care for their OUD. They wished they had learned about fentanyl and associated risks earlier. They also wished they had had learned about MOUD much earlier in their care engagement process. They valued providers who were nonjudgmental regarding multiple aspects of their identity and their substance use.