95 percent of teens with nicotine use disorder and Medicaid coverage get no counseling or pharmaceutical treatment
WEDNESDAY, Sept. 25, 2019 (HealthDay News) — Use of evidence-based treatment for nicotine use disorder (NUD) is extremely limited among adolescents and young adults with Medicaid coverage, according to a research letter published online Sept. 23 in JAMA Pediatrics.
Nicholas Chadi, M.D., from Boston Children’s Hospital, and colleagues used the Truven MarketScan Medicaid database to identify 81,144 individuals aged 10 to 22 years with at least six months of continuous enrollment who received a diagnosis of NUD between Jan. 1, 2014, and June 30, 2015. Claims data were used to determine receipt of counseling or pharmacy treatment (nicotine replacement therapy, varenicline, and sustained-release bupropion) within six months of NUD diagnosis.
The researchers found that only 4.1 percent of youth with follow-up data received counseling for NUD, 1.3 percent received pharmacotherapy, and 0.1 percent received both counseling and pharmacotherapy at six months. Among those receiving NUD treatment, older age, white race, asthma, depression, anxiety, attention-deficit/hyperactivity disorder, and co-occurring alcohol or marijuana use disorder were associated with receipt of pharmacotherapy. The most commonly prescribed medication was bupropion (46 percent), followed by nicotine replacement therapy (31.2 percent) and varenicline (22.7 percent).
“Such low treatment rates during a developmental period when adolescents and young adults are at increased risk of developing lifelong nicotine addiction likely represent a missed opportunity to address NUDs in this population,” the authors write.
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