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Adolescent Treatment for Addiction is Scarce and Cost Prohibitive, According to New NIDA-Supported Study

According to a 2022 survey, over 2 million adolescents aged 12 to 17 in the United States have a substance use disorder (SUD), yet very few receive substance use treatment. 1Given the significant increases in overdose deaths over the past decade, access to evidence-based treatment is crucial, especially among adolescents who have a heightened vulnerability to developing a SUD due to their developing brains.

“The ability to access timely, evidence-based treatment for addiction can be a matter of life or death, and the current system too often fails young people,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA). “We need to make access to timely, affordable, and evidence-based care the norm across treatment settings.”

A recent study reveals that access to residential treatment for adolescents with SUDs is limited and costly. From October through December 2022, researchers at the Oregon Health & Science University (OHSU) conducted a “secret shopper” study to understand the experiences of families seeking treatment for adolescents with SUD, more specifically, opioid use disorder (OUD). The study also aimed to discern the accessibility, availability, treatment practices, and costs. Inquiries about treatment practices included the availability of buprenorphine, the only medication for addiction treatment (MAT) approved by the Food and Drug Administration (FDA) for adolescents.   

Of the 354 residential treatment facilities that were contacted and indicated providing adolescent services, according to online databases, 160 confirmed that they actually provide treatment to patients under the age of 18. Of those, only about half (54%) of the facilities had a bed available for same-day admittance; 39% had no beds available or offered a waitlist. Among the facilities that offered a waitlist, the average wait time was 28 days.  

There were also significant differences in accepted payment types and costs. Of the 160 facilities, 126 (79%) accepted cash payment, which average about $878 per day. In addition, daily costs among for-profit facilities were about $816 more expensive than nonprofits. About nearly half of the facilities (48%) required up-front payment before admission, making the average cost of a monthly stay over $26,000. 

Nearly 57% of the facilities accepted Medicaid: 83% were nonprofit treatment facilities, and 20% were for-profits. Only 7 states reported accepting Medicaid, had bed availability right away, and offered buprenorphine.  

This study was published in Health Affairs and supported by NIDA and the National Center for Advancing Translational Sciences (NCATS). The results build on previous research and underscores the scarcity and significant costs of treatment.

Key Findings:

  • Out of 354 facilities that advertised providing adolescent treatment, less than half (45%) actually provided residential treatment to individuals under the age of 18. 

  • 54% of the residential addiction treatment facilities for adolescents had same-day bed availability

  • Among the facilities that offered a waitlist for a bed, the average wait time was 28 days.  

  • The average cost per treatment was $878 making the average cost of a month’s stay over $26,000.

  • Only 7 states reported accepting Medicaid, had bed availability right away, and offered buprenorphine.  


  1. Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication No. PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.

  2. C King, et al. Adolescent Residential Addiction Treatment In The US: Uneven Access, Wait Lists, And High Costs. Health Affairs. DOI: 10.1377/hlthaff.2023.00777 (2024).


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