October 08, 2019
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Most youth with nicotine use disorder are not treated

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Nearly all Medicaid-insured adolescents and young adults with diagnosed nicotine use disorder, or NUD, do not receive counseling or pharmacologic treatment for their condition, according to research published in JAMA Pediatrics.

“We have treatments that are proven to work for older people and are very likely to work for young people as well. Not using these treatments is a missed opportunity,” Nicholas Chadi, MD, MPH, a pediatrician at Boston Children’s Hospital, said in a news release.

Chadi and colleagues assessed information collected from a national Medicaid database to detect patients aged 10 to 22 years diagnosed with NUD. Patients who were enrolled in Medicaid for at least 6 months and diagnosed between Jan. 1, 2014, and June 30, 2015, from 11 states were included.

The researchers identified nearly 3.5 million patients, 3.8% of whom had NUD. Of these patients, 81,144 were youths.

Infographic about treatment of nicotine use disorder among teens and young adults 

Few adolescents and young adults received counseling for NUD (4.1%), and just 1.3% received nicotine replacement therapy or other pharmacologic therapies. Only 0.1% (n = 110) received both counseling and medications to treat NUD.

According to Chadi and colleagues, patients were more likely to be treated with medications if they were older, white, had a second diagnosis of asthma, depression, anxiety, ADHD and co-occurring alcohol or marijuana use disorder. When medications were given, most patients received bupropion (46%), nicotine replacement therapy (31.2%) or varenicline (22.7%).

“As providers, we have a tremendous opportunity here to intervene and help prevent future generations of people dealing with the long-term health consequences of nicotine use disorder,” Scott Hadland, MD, MPH, MS, a pediatrician and addiction specialist at Boston Medical Center’s Grayken Center for Addiction, said in the release. “We have tools that we know are effective in helping curb nicotine addiction, and we need to get these tools into the appropriate hands.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.