Opioid treatment options for teens still limited despite deep loss – NBC4 Washington

In her son Stafford’s empty room, Liz Nibley knelt and prayed, “God, please keep Stafford alive.”

The Bethesda resident didn’t pray for a cure for her young son, just that he was still alive.

“We love you. Give it another chance. We never, ever want to lose you,” her prayer continued.

That night came years into Nibley’s struggle to get her son off drugs. Stafford fled a drug treatment program. Liz said it wasn’t the first time she’d done it. It would be days before his mother saw him again.

Stafford was in high school when he started using drugs. It started with marijuana and escalated to heroin and finally fentanyl.

Nibley showed News4 video clips of her son playing a lead role in Our Lady of Good Counsel High School’s production of Les Misérables during his freshman year.

NBC Washington

“Listen to that voice,” she said as she looked at how happy she was on stage. “Look how beautiful her eyes are.”

It wasn’t long after that performance that Nibley, her husband and their other children learned that Stafford needed help getting off drugs.

“It is very, very hard. There is no guide and sometimes you really feel like you are navigating this journey alone,” Nibley said.

What families face when seeking care for their children

Families can face a long road to treatment when a young person uses fentanyl, said Dr. Marc Fishman, a Maryland psychiatrist who specializes in addiction treatment. He didn’t treat Stafford, but he treats teenagers in what he knows is a difficult environment to find care.

“It shouldn’t be that hard,” he said.

“When I see the parents, they’re up to their ears in alligators. They’re exhausted… They don’t know where to turn. They don’t know what to do,” he said.

Fishman just opened Maryland’s first inpatient drug treatment center specifically for teenagers, the first. There aren’t many more north of Virginia, and none in DC

A young person who struggles with drug use may need treatment repeatedly, he said.

“Sometimes people get lucky and get it the first time or the second time, but a lot of people screw up and don’t know and only get (to treatment) after a near-fatal overdose, which is too late,” he said.

Stafford’s family found him in 42 drug treatment programs

Stafford did not participate in just one or two drug treatment programs. His family found him 42 programs.

Number 42 rolled out of the mother tongue as if finding her son those programs wasn’t a remarkable feat of persistence.

Even now, he has the list of all 42 programs on his phone. Scrolling through the list, he said the programs were conducted across the country. Some were better than others, some were awful, and a few worked for Stafford for a while. Few of the programs had coordinated home care.

Together, the 42 drug treatment programs cost hundreds of thousands of dollars, even with insurance.

When Stafford started all the programs, her mother said so many goodbyes, she recalled.

“I just always looked forward to the future. I always had hope for the future,” he said.

But after 42 programs and nearly 10 years of struggle, addiction overtook Stafford just days before his 25th birthday.

Police found him dead in a Baltimore motel.

“The police said there was so much fentanyl. There was so much fentanyl,” Nibley said.

The role that pediatricians can play in the treatment of addictions

Stafford isn’t the only one who started using drugs as a teenager. Fishman, the psychiatrist, pointed to research suggesting that 90 to 95 percent of adults with substance use disorders began using drugs before age 18.

He said primary care doctors should know how to treat young people.

“We need to do a better job of pushing these treatments into primary care, because that’s where the kids are already,” Fishman insisted.

For teenagers, it’s most likely a pediatrician. But in most cases, a child’s pediatrician does not have experience in treating drug use. The American Academy of Pediatrics has a hotline that offers advice for pediatricians, but there are no formal clinical guidelines for treating opioid use.

Research published in the Journal of the American Medical Association in late February shows that nearly a quarter of American pediatricians surveyed had diagnosed a teen with an opioid use disorder, but only 5.5% of they had prescribed drugs that can save their lives by negating the effect of opioids. .

Buprenorphine is the medication used to treat many patients struggling with opioid use. It is often prescribed under the brand names Suboxone, Subutex, or Zubsolv, among others. According to the Center for Addiction and Mental Health, it is a “long-acting opioid medication that is used to replace short-acting opioids that someone may be addicted to, such as heroin, oxycodone, or fentanyl. When taken at the right dose, buprenorphine prevents withdrawal symptoms and reduces drug cravings without making the person feel high or drowsy. This reduces the harms associated with opioid abuse and offers give people addicted to opioids the chance to stabilize their lives.”

The FDA has only approved buprenorphine for patients 16 and older, but addiction specialists told the I-Team it can be used safely “off-label” for younger patients.

How Virginia Law Affects Teens Seeking Life-Saving Drug Treatment

In Virginia, however, it is illegal to prescribe buprenorphine to anyone under the age of 16.

Dr. Zeina Saliba, chief of addiction and recovery services at Inova, said she believes Virginia’s law hurts children who need treatment the most.

“If there’s a young person below that age, for whom the standard of care or the recommendation would be, ‘Let’s get a life-saving drug,’ that’s not easy to do in this state,” he said

Saliba said she hears from frustrated and overwhelmed parents and medical colleagues who are trying to convince them to make sure children don’t go without treatment for using fentanyl.

“A dream state would be that no matter where you go in the healthcare industry, we’ll help you get to the right place,” he said. “(…) We are not here now”.

Saliba said not all children need detox or inpatient treatment. Sometimes outpatient therapy and medication may be enough. Finding someone who can help with direct care is crucial.

“One of the most important things will be to meet with a professional who can identify the different domains, evaluate to be able to give you a strong recommendation,” he said.

An average of 22 people between the ages of 14 and 18 died in the US every week in 2022 from drug overdoses caused by fentanyl in counterfeit pills, according to new research from UCLA Health. That’s the equivalent of losing a classroom of teenagers every week.

If you need help for a youth struggling with fentanyl use in the DC area, there are many resources available. Go here for information on how to find help.

Reported by Ted Oberg, produced by Rick Yarborough, shot and edited by Steve Jones