‘It’s really critical that we save lives’

For Sam, finding addiction treatment in a medical office jammed with puzzles, toys and picture books has not been as odd as he thought it would be.

He mom, Julie, accompanied him to the appointment. She said she was grateful the family found a doctor who understands teens and substance use.

Before he started visiting Tri-River, Sam had seven months of residential and outpatient treatment without being offered buprenorphine to help control cravings and prevent relapse. When Sam’s cravings for opioids returned, a counselor suggested Julie call Medina.

“Oh my gosh, I would have been having Sam here, like, two or three years ago,” Julie said.

Some parents and pediatricians worry about starting a teenager on buprenorphine, which can produce side effects including long-term dependence. Pediatricians weigh the possible side effects against the threat of a fentanyl overdose.

“In this era, where young people are dying at truly unprecedented rates of opioid overdose, it’s really critical that we save lives,” said Hadland. “And we know that buprenorphine is a medication that saves lives.”

In the exam room, Sam was about to get his first shot of Sublocade, an injection form of buprenorphine that lasts 30 days. He switched to the shots because he didn’t like the taste of Suboxone, oral strips of buprenorphine that dissolve under the tongue. He was spitting them out before he got a full dose.

The injection is painful, and takes 20-30 seconds. A nurse coached him to breathe deeply. When it was over, staffers joked that even adults usually swear when they get the shot. Sam said he didn’t know that was allowed.

His biggest question: “Do you think I can snowboard tonight?” Sam asked the doctor.

“I totally think you can snowboard tonight,” Medina answered.

Sam was going with a new buddy. Making new friends and cutting ties with his former social circle of teens who use drugs has been one of the hardest things, Sam said, since he entered rehab 15 months ago.

“Surrounding yourself with the right people is definitely a big thing you want to focus on,” Sam said. “That would be my biggest piece of advice.”

This article is from a partnership that includes WBUR, NPR and KFF Health News.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – an independent source of health policy research, polling and journalism.