161 - Ready, Willing, but Able? Provider Perspectives on What's Needed to Provide Medication to treat Opiate Use Disorder for Adolescents & Young Adults

Publication Number: 1151.161

Renata Sanders, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Natalie LaBossier, Children's Hospital Of Philadelphia, Philadelphia, PA, United States; Bevin Gwiazdowski, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Marne Castillo, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Samara Jinks-Chang, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Nadia Dowshen, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Ashley D. Thompson, Childrens Hospital of Philadelphia, Upper Darby, PA, United States; Dominique Absalom, Childrens Hospital of Philadelphia, Philidelphia, PA, United States; Errol L. Fields, Johns Hopkins Medicine, Hyattsville, MD, United States; Christopher Hammond, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Oluwaseun Falade-Nwulia, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Background: Despite an overall trajectory of increasing opioid related overdose among adolescents and young adults (AYA) in the US, less than a quarter receive medications for opioid use disorder (MOUD). Integrating MOUD into pediatric and primary care may improve access.

Objective: To assess acceptability and feasibility of MOUD provision in primary care spaces serving AYAs.

Design/Methods: Participants completed a 30-minute quantitative survey and 45-60 minute key informant interview regarding perceptions and current practices related to prescribing MOUD for adolescents with opioid use disorder (OUD). Quantitative data were summarized using descriptive statistics. Inductive and deductive coding was used to analyze the data. Grouped and categorized codes were then analyzed to identify emergent themes.

Results: Twenty-three providers participated. Mean age was 38.4 (SD 10.7), n=12 (54%) were female, and most self-identified as White (n=11, (50%)) or Black (n=7, (32%%)). Most providers were pediatrics/adolescent medicine specialists (n=14 (60%)) or primary care clinicians (n=6 (26%)) and (n=17 (77%)) reported regularly screening for substance use. A quarter (n=6 (26%)) prescribed buprenorphine in the last 12 months. Less than half (43.5%) felt confident treating AYAs with an OUD and 34.8% felt confident in their ability to support AYAs in abstaining from further use. Most providers (n=14 (60.9%)) expressed willingness to prescribe buprenorphine and a desire for additional training to increase capacity for MOUD prescribing (69.6%). The majority (n=19 (82.6%)) believed OUD treatment should be part of routine AYA care and viewed provision of MOUD as professionally fulfilling (n=15 65.2%). Structural and operational barriers such as clinic workflows, payer complexities and limited institutional support were identified as barriers to routine OUD care and MOUD prescribing in AYA care settings.

Conclusion(s): These data suggests that providers who care for AYAs in pediatric and primary care settings are motivated to provide MOUD to AYAs with OUD. To address this need, more resources will need to focus on training and addressing structural barriers to MOUD prescribing in AYA primary care.