Few young people with opioid use disorder receive medications approved by the Food and Drug Administration (FDA) to treat their addiction within three months of diagnosis, a new study finds.

The study, published in JAMA Pediatrics, found one in 21 teens under age 18 and one in four young adults ages 18 to 22 with opioid use disorder received methadone, buprenorphine or naltrexone within three months of their diagnosis, Reuters reports.

“This study shows that the great majority of youth are not receiving treatment recommended in evidence-based guidelines,” said study lead author Dr. Scott Hadland of the Grayken Center for Addiction at the Boston Medical Center. “That’s really concerning because the data suggest that when people do receive medication they are much more likely to remain in treatment.” He noted that staying in treatment can mean the difference between life and death.