Statewide trends in access to medications for opioid use disorder (moud) among adolescents with opioid use disorders in Indiana

Purpose: Opioid use disorder (OUD) and related harms have risen among adolescents, yet access to medications for OUD (MOUD) remains limited, particularly among Medicaid-enrolled youth. This study examines trends in OUD diagnosis and MOUD receipt among Indiana Medicaid adolescents and differences by race, ethnicity, and age. Design: Outcomes were initial OUD diagnosis, MOUD receipt conditional on diagnosis, and MOUD initiation delay, examined at beneficiary and population levels. Analyses were stratified by demographics, with linear regression assessing predictors. Results: Of 420,361 Medicaid adolescents, 871 (0.2 %) had an OUD diagnosis and 73 (8.4 %) among them received MOUD. Diagnosis rates increased 67 % between 2019 and 2023, with higher rates among males and White adolescents. Black and Hispanic adolescents were less likely than White peers to be diagnosed (-11 % and -7 %, respectively); among those diagnosed, Black youth were far less likely to receive MOUD (-89 %), while Hispanic youth had the highest treatment rate (15.8 %). Delays in MOUD initiation was longest for Black adolescents (781 days), followed by White (665 days) and Hispanic (588 days) youth. Younger teens (12-14) were less likely to be diagnosed (-20 %) and treated (-56 %) than older peers. Conclusions: MOUD access among Indiana Medicaid adolescents remains low, with persistent racial and ethnic differences in diagnosis and treatment rates. Targeted policies are needed to expand equitable access, particularly for Black and younger adolescents.