In years past, an adolescent patient presenting to primary care with symptoms of opioid use disorder (OUD) would have been a highly rare event in most communities. With OUD and fatal overdoses rising among adolescents and young adults (termed youth) over the past 15 years, this scenario has unfortunately become more common. Fatal drug overdoses increased 3.5-fold for youth aged 15 to 24 years from 1999 to 2014.1 Amidst this epidemic, relatively little is known about how primary care clinicians treat youth with OUD. Of particular interest is whether youth receive medication-assisted treatments (MATs), which have been shown to improve quality of life and reduce overdose risk.2