Among Medicaid enrollees ages 10 to 24 with opioid use disorder (OUD), 61% had one or more co-occurring non-substance-related mental health disorders, according to recent research. This includes 38% who had anxiety-related disorders, 27% who had depressive disorders, and 18% who had post-traumatic stress disorder (PTSD).

Further research to understand OUD access to care for enrollees in this age range could improve how OUD is diagnosed, how care is linked, and treatment usage, the researchers concluded.

Retrospective inpatient and outpatient MarketScan Medicaid database claims from January 2020 to December 2023 were used for the analysis. Data include individual-level, deidentified claims from Medicaid programs in select states. The analysis focused on beneficiaries aged 10 to 24 years.

The analysis included data for 4.2 million Medicaid-enrolled youth and young adults. Within this group, 0.27% (11,436 young people) had a new OUD diagnosis; 0.09% (3,993 young people) had a new, non-fatal opioid-involved overdose event; and 0.04% (1,894 young people) had an OUD diagnosis and a new, non-fatal opioid overdose event.

Across the entire 4.2 million young people included in the analysis, 5% had a substance use disorder (SUD) diagnosis. The most common SUDs were cannabis use disorder (4%), stimulant use disorder (1%), and alcohol use disorder (1%). About 30% had a non-substance-related mental health diagnosis. The most common diagnoses were anxiety (17%), depression (11%), and PTSD (5%).

Among the young people with OUD, 67% had one or more co-occurring SUDs, and 61% had one or more co-occurring non-substance-related mental health diagnoses. The most common co-occurring SUDs were: cannabis use disorder (43%), stimulant use disorder (31%), and alcohol use disorder (22%). The most common co-occurring mental health diagnoses were: anxiety (38%), depressive disorders (27%), and PTSD (18%).

Among the subgroup who had a non-fatal opioid-involved overdose, 46% had one or more co-occurring SUDs, and 57% had one or more non-substance-related co-occurring mental health diagnoses. The most common co-occurring SUDs among this group included cannabis use disorder (28%), stimulant use disorder (19%), and alcohol use disorder (15%). The most common co-occurring mental health diagnoses included anxiety-related disorders (35%), depressive disorders (30%), and PTSD (14%).

These findings were presented in Opioid Use Disorder and Nonfatal Opioid-Involved Overdose Among Medicaid-Enrolled US Youth, 2020-2023, by Yijie Chen, Ph.D.; Andrew Terranella, M.D., MPH; Nisha Nataraj, MS, Ph.D.; Laura M. Mercer Kollar, Ph.D.; and Christopher R. Harper, Ph.D. The goal was to determine the incidence of newly diagnosed OUD among youth in clinical settings.

The full text of Opioid Use Disorder and Nonfatal Opioid-Involved Overdose Among Medicaid-Enrolled US Youth, 2020-2023 was published on October 27, 2025, by JAMA Pediatrics. A free abstract is available (accessed November 5, 2025).

For more information, contact: U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, Georgia 30329; 800-232-4636; Email: CDCInfo@cdc.gov; Website: https://www.cdc.gov/