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Primary care pediatricians feel less prepared to manage adolescents’ opioid use disorder (OUD) compared with other substances, according to a research letter published online in JAMA Pediatrics.

Scott E. Hadland, M.D., from Mass General for Children in Boston, and colleagues used data from 474 primary care pediatricians participating in the 2021 American Academy of Pediatrics Periodic Survey to assess their preparedness to provide adolescent OUD care.

The researchers found that most agreed or strongly agreed that it is their responsibility to identify substance use disorders (93.9 percent) and refer patients to treatment (97.4 percent). However, fewer participants agreed or strongly agreed that it is their responsibility to treat substance use disorders (20.3 percent) or prescribe medications for addiction treatment (12.4 percent).

Fewer respondents felt prepared or very prepared to counsel adolescents on opioid use (48.3 percent), compared with alcohol (87.1 percent), cannabis (81.7 percent), and electronic cigarette use (80.1 percent). Compared with other substances, pediatricians were less likely to provide counseling (63.0 percent) and more likely to refer patients off-site for care (71.8 percent) for opioid use compared to alcohol (87.7 and 51.7 percent, respectively), cannabis (88.9 and 45.4 percent, respectively), and e-cigarette use (91.6 and 26.5 percent, respectively). Less than one-quarter of respondents (23.7 percent) reported ever diagnosing an adolescent with OUD, and only 5.5 percent had ever prescribed OUD medication.

“With the growing problem of OUD, training on OUD management in primary care is needed,” the authors write.

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