- King CA, et al. Health Aff. https://bit.ly/47zF090.
Few residential facilities are available to treat teens for substance use, and those that do are expensive, a recent study found.
Overdoses of drugs, particularly opioids, have been increasing among teens. Residential facilities are one option for youths who don’t respond to outpatient treatment and those with comorbid mental health disorders.
The authors of this study sought to determine how accessible residential treatment is for children under age 18 with opioid use disorder and cost of treatment. To do so, they conducted a “secret shopper” study in which researchers posed as an aunt or uncle of an uninsured 16-year-old who recently had a nonfatal fentanyl overdose.
They used the Substance Abuse and Mental Health Services Administration’s treatment locator and Google ads to find residential facilities in every state and Washington, D.C., that treated adolescents. Researchers then called each facility and asked about bed availability, cost and accepted payment methods.
The authors identified 354 facilities that indicated they accepted adolescents, 27 of which had incorrect phone numbers or did not answer. They could not identify any facilities in 10 states and Washington, D.C.
Of the 327 facilities reached, 160 said they provided residential treatment for patients younger than 18. About 41% were for profit, and 59% were nonprofit.
In addition, 57% accepted Medicaid (20% of for-profits and 83% of nonprofits). However, 23 states had no facilities that accepted Medicaid.
Fifty-four percent of facilities had a bed available immediately, including 77% of for-profit and 39% of nonprofit facilities. The mean wait time was higher for nonprofit than for-profit facilities (31 vs. 19 days). Waitlists also were more common among facilities that accepted Medicaid than those that did not (57% vs. 19%).
For those paying out of pocket, the mean cost per day was nearly three times higher for for-profit facilities than nonprofits ($1,211 vs. $395). About half of facilities required full or partial payment upfront, which averaged $28,731.
“This study shows that affordable, timely and effective treatment is severely lacking for the most vulnerable kids in our population,” lead author Caroline King, M.D., Ph.D., said in a news release.
