Sarah Bagley: We've all heard a lot about the increase in opioid related overdose deaths in the 

United States, but you may be wondering, "How do those relate to 

adolescence?" Well, there's some good news and some bad news. Some of the 

good news is that prescription opioid use among adolescents continues to 

decrease, and we know that from the National Survey on Drug Use and Health 

and the Monitoring the Future study, both studies that are conducted among 

youth every year.

However, there was a study that came out in 2016 that looked at opioid related 

poisonings in youth during the time period where we've seen opioid deaths rise 

in adults. In that study there was a 176% increase in opioid related admissions 

for poisonings in 15 to 19-year-olds. There was also a data brief released by the 

National Center on Health Statistics in the middle of August, 2017 that showed a 

significant increase in overdose deaths from opioids among teenagers in the last 

couple of years.

Then you may wonder, "Well, what's going on with young adults?" We know 

that young adults use substances at higher rates than other age groups and that 

holds true for opioids as well. From 2002 to 2013 there was a 108% increase in 

past year heroin use in 18 to 25-year-olds. However, we also know that opioid 

related overdose deaths are lower in emerging adults or young adults compared 

to older age groups, driving home the point that intervening early with this 

group is really important so that we try to prevent those deaths later on in life.

Teens and young adults use opioids for a lot of the same reasons that they may 

decide to try other substances. It might be because it's sensation seeking and 

they like they high that they get when they try a pill. It might be because they're 

feeling depressed or hopeless and taking taking the opioid relieves that feeling 

that they have. It may also be because they're bored and it's what their friends 

are doing and so that that's why they decide to do it.

It can be difficult to engage an adolescent or a young adult in treatment. That 

might even mean it can be difficult for them to remember to come in. There are 

a couple of things that we do in our program that we think increases the 

likelihood that our patients will show up for their appointments and for their 

care. So one of the things that we do is we do a lot of reminder calls. We'll do 

multiple reminder calls. We also will tell our patients that if they're having 

trouble with transportation, we'll help subsidize that. So we might give them a 

public pass for public transportation, or try to help pay some of their parking 

fees as well. In addition, for patients who might not have access to food, we'll 

try to make sure that they have access to snacks or other meals when they 

come to the visit. For some patients who may be trying to visit family, who are 

far away, we may even pay for a bus ticket.

All of these things we feel like are important to demonstrate to our patients that 

their engagement with us is important and that we also recognize that they are 

more than just their disease and have other things going on in their lives, and 
really showing them that we recognize that unless we're addressing those, it's 

going to be hard for them to show up.