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ON THE JOB

At this Boston Medical addiction clinic, many of the clients are teens

Dr. Sarah Bagley works with young people whose lives have been derailed by addiction, at Boston Medical Center's CATALYST Clinic.
Aram Boghosian for The Boston Globe
Dr. Sarah Bagley works with young people whose lives have been derailed by addiction, at Boston Medical Center's CATALYST Clinic.

It’s called being “dope sick” — when someone’s tired of getting high and no longer wants to spend the day searching for drugs. Addiction medicine physician Sarah Bagley sees kids who already have reached that stage. Some of them started using opioids or heroin as young as 10 or 11 years old. By the time they’re at the CATALYST Clinic at Boston Medical Center, a program designed to treat young people struggling with substance use, their lives have started to unravel. The name stands for Center for Addiction Treatment for Adolescents/Young adults who use Substances.

Bagley, 37, also is trained in pediatrics. At the hospital, she leads a team of physicians, nurses, and social workers who help adolescents — and parents — who are at the breaking point. “Addiction is a public health crisis, with one in six young adults dealing with addiction, the highest rate for any age group across the country,” she says.

Bagley says the reality of a child addicted to drugs hits home when a teen talks about shooting up — but still sleeps with a teddy bear. The Globe spoke with her about adolescents and addiction.

“It’s a standard intake question: How did you feel when you took your first sip of alcohol or tried a drug? A lot of teens will say, ‘I really didn’t like the taste of alcohol, but I loved the way it made me feel.’ If they have a strong positive response that first time, they seek that sensation and feeling again. We are human beings — we do things that make us feel good.

“Teens might have a lot of ambivalence about giving up drinking or drugging, but at the CATALYST Clinic, our job is to help them realize that it’s the substance use that’s creating havoc in their lives. They’re missing milestones in their life because of addiction, whether it’s the prom or just going to a football game. And by the time they come to us, they are using to avoid withdrawal symptoms. With opioids, for example, withdrawal can feel miserable, like having the worst flu ever.

“And while there is a stereotype of a [drug user] being from a broken family, the reality is that substance use can happen from seemingly innocent situations, like a prescription for a high school sports injury or wisdom tooth extraction. Many teens begin their opioid use because they take a pill from a friend or family member.

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“I became interested in teen addiction when I started to notice that adult addicts would say that they started using when they were teens. Addiction is a pediatric illness, and it’s important to intervene early. Recovery is hard work. It’s an enormous task to ask a kid with developing adolescent brain to stop hanging around with a group of friends and [to] change their behavior. It’s unfair to ask someone to get sober if it doesn’t improve their lives, so our clinic offers wrap-around care that includes treating the issues that go beyond addiction, like getting back to school, improving family relationships, even finding transportation. We offer the best treatment we can, but at the end of the day, teens need to have the intrinsic motivation to change.

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“Some days I’ll leave the clinic and wonder what I could have done better to help someone. I have to remind myself that I am not my patient. I’ve had to learn my own limitations and grapple with how hard it can be to meet patients where they are.”

Cindy Atoji Keene can be reached at cindy@cindyatoji.com.