Examining Treatment Length of Stay and Medication Assisted Treatment Among Emerging Adults with Opioid Use Disorder

Background: Increases in opioid use disorder (OUD) and overdose among emerging adults aged 18 to 29 is a serious public health problem. Furthermore, emerging adults with OUD have the lowest rate of treatment engagement and retention compared to any other age group. Research on increasing treatment retention among emerging adults is sparse, especially among individuals with OUD in outpatient settings. In this study, we examined associations with length of stay in outpatient treatment among emerging adults with OUD and the effect of medication assisted treatment (MAT) on treatment retention among specific age groups of emerging adults with OUD.

Method: Data is from the 2019 Treatment Episode Data Set Discharges (TEDS-D), including all emerging adults with OUD seeking substance use treatment in outpatient settings (N = 83,986). Measures in TEDS-D included receipt of MAT, co-occurring mental health or substance use disorders, a dichotomous indicator of prior treatment episodes, and length of stay (number of days in treatment). Demographic measures included gender, age, race/ethnicity, education, and marital status. A negative binomial regression examined associations with days in treatment among the variables described above.

Results: Results showed that length of stay was lower among individuals between 21-24 years old (IRR = .87, p < .01) and 25-29 years old (IRR = .85, p < .01), compared to individuals between ages 18-20. Results also showed that those who did not receive MAT had a shorter length of stay (IRR = .68, p < .01). Individuals who did not have a co-occurring mental health or substance use disorder also had a longer length of stay (IRR = 1.08, p < .01), and individuals with a history of prior treatment had a longer length of stay (IRR = 1.21, p < .01). Among demographic measures, individuals who were Black/African American had a lower length of stay (IRR = .96, p < .01) compared to White non-Hispanic individuals. Women had a longer length of stay than men (IRR = 1.01, p < .01). Individuals with a college or high school degree or GED had a longer length of stay than individuals with no high school degree or GED (IRR = 1.02, p < .01). Follow up analyses showed that the association between receiving MAT and treatment retention was stronger for emerging adults between ages 25-29, and less strong among emerging adults ages 18-21. Marital status was not significant in this model.

Conclusions and Implications: This study underscores how MAT can influence length of stay for OUD treatment among emerging adults of different ages. Although older emerging adults may show shorter length of stay, they show longer stays in outpatient treatment when they receive MAT. Social workers in research and policy may benefit from this work by addressing the availability and use of MAT in a client’s treatment plan, where applicable, to increase the likelihood of retention among emerging adults aged 25 to 29. Future research should continue efforts to address the effects of opioids on emerging adults through examining within-group differences for additional outcomes including treatment effectiveness.