I want to tell you this story about a patient named Sam growing up it was a
patient named Sam growing up it was a
patient named Sam growing up it was a pretty typical kid decent student good
pretty typical kid decent student good
pretty typical kid decent student good athlete popular when he got into high
athlete popular when he got into high
athlete popular when he got into high school he started hanging out with the
school he started hanging out with the
school he started hanging out with the older kids that were drinking and
older kids that were drinking and
older kids that were drinking and smoking pot and one day one of those
smoking pot and one day one of those
smoking pot and one day one of those kids brought in a bottle of pain pills
kids brought in a bottle of pain pills
kids brought in a bottle of pain pills and offered one to Sam nobody ever
and offered one to Sam nobody ever
and offered one to Sam nobody ever thinks that they’re going to get
thinks that they’re going to get
thinks that they’re going to get addicted just by experimenting but in
addicted just by experimenting but in
addicted just by experimenting but in the United States more than 150,000 kids
the United States more than 150,000 kids
the United States more than 150,000 kids under the age of 18 are addicted to
under the age of 18 are addicted to
under the age of 18 are addicted to opioids and Sam became one of them he
opioids and Sam became one of them he
opioids and Sam became one of them he started using pills everyday within a
started using pills everyday within a
started using pills everyday within a year or so he was injecting heroin and
year or so he was injecting heroin and
year or so he was injecting heroin and in the spring of 2017 he overdosed twice
in the spring of 2017 he overdosed twice
in the spring of 2017 he overdosed twice after the second rescue he was sent to a
after the second rescue he was sent to a
after the second rescue he was sent to a program where he was treated for his
program where he was treated for his
program where he was treated for his symptoms of withdrawal and after four
symptoms of withdrawal and after four
symptoms of withdrawal and after four days he was discharged with a
days he was discharged with a
days he was discharged with a prescription for sleeping pills and
prescription for sleeping pills and
prescription for sleeping pills and advice never to do drugs again
addictions a treatable condition there
addictions a treatable condition there are actually several effective
are actually several effective
are actually several effective treatments but sleeping pills aren’t one
treatments but sleeping pills aren’t one
treatments but sleeping pills aren’t one of them so it was really no surprise
of them so it was really no surprise
of them so it was really no surprise that within two days
that within two days
that within two days Sam relapsed and started using heroin
Sam relapsed and started using heroin
Sam relapsed and started using heroin again in the early 1900s when kids were
again in the early 1900s when kids were
again in the early 1900s when kids were diagnosed with diabetes they were
diagnosed with diabetes they were
diagnosed with diabetes they were admitted to the hospital and treated
admitted to the hospital and treated
admitted to the hospital and treated with a carbohydrate free diet when they
with a carbohydrate free diet when they
with a carbohydrate free diet when they got better they were sent back home and
got better they were sent back home and
got better they were sent back home and told never to eat sugar again most of
told never to eat sugar again most of
told never to eat sugar again most of them died within a couple of months but
them died within a couple of months but
them died within a couple of months but when we discovered insulin everything
when we discovered insulin everything
when we discovered insulin everything changed and now kids with diabetes are
changed and now kids with diabetes are
changed and now kids with diabetes are treated with diet and insulin and grow
treated with diet and insulin and grow
treated with diet and insulin and grow up to lead a healthy productive life but
up to lead a healthy productive life but
up to lead a healthy productive life but this changed hasn’t happened with
this changed hasn’t happened with
this changed hasn’t happened with addiction since the 1970s we’ve known
addiction since the 1970s we’ve known
addiction since the 1970s we’ve known that methadone reduces drug use overdose
that methadone reduces drug use overdose
that methadone reduces drug use overdose and death but we restrict it you can
and death but we restrict it you can
and death but we restrict it you can only get it from
only get it from
only get it from highly regulated programs that exist
highly regulated programs that exist
highly regulated programs that exist outside of mainstream medical facilities
outside of mainstream medical facilities
outside of mainstream medical facilities in the 1990s a newer drug was introduced
in the 1990s a newer drug was introduced
in the 1990s a newer drug was introduced it works like methadone but it’s safer
it works like methadone but it’s safer
it works like methadone but it’s safer and in 2000 Congress passed the drug
and in 2000 Congress passed the drug
and in 2000 Congress passed the drug abuse treatment Act which allows any
abuse treatment Act which allows any
abuse treatment Act which allows any doctor who gets eight hours of training
doctor who gets eight hours of training
doctor who gets eight hours of training to prescribe this medication from any
to prescribe this medication from any
to prescribe this medication from any general medical facility so in 2017 17
general medical facility so in 2017 17
general medical facility so in 2017 17 years later Sam’s story should be
years later Sam’s story should be
years later Sam’s story should be outrageous but actually it’s pretty
outrageous but actually it’s pretty
outrageous but actually it’s pretty common if we think of all of the kids
common if we think of all of the kids
common if we think of all of the kids who have opioid addiction as an iceberg
who have opioid addiction as an iceberg
who have opioid addiction as an iceberg then the biggest part the part that
then the biggest part the part that
then the biggest part the part that would be under water they never get any
would be under water they never get any
would be under water they never get any treatment at all and even among the tip
treatment at all and even among the tip
treatment at all and even among the tip of the iceberg that do get treatment
of the iceberg that do get treatment
of the iceberg that do get treatment it’s only the very tip of the tip that
it’s only the very tip of the tip that
it’s only the very tip of the tip that get appropriate treatment by which I
get appropriate treatment by which I
get appropriate treatment by which I mean one of the three indicated
mean one of the three indicated
mean one of the three indicated medications for treating addiction
medications for treating addiction
medications for treating addiction combined with professional counseling
combined with professional counseling
combined with professional counseling there are many reasons for this for one
there are many reasons for this for one
there are many reasons for this for one thing kids with addiction are often too
thing kids with addiction are often too
thing kids with addiction are often too ashamed or afraid to tell anybody about
ashamed or afraid to tell anybody about
ashamed or afraid to tell anybody about their problem one of the first patients
their problem one of the first patients
their problem one of the first patients I treated Dave it was a college freshman
I treated Dave it was a college freshman
I treated Dave it was a college freshman who became addicted to prescription pain
who became addicted to prescription pain
who became addicted to prescription pain medications he came to my program for
medications he came to my program for
medications he came to my program for treatment we started him on medications
treatment we started him on medications
treatment we started him on medications and he was working with a counselor he
and he was working with a counselor he
and he was working with a counselor he was doing really well but he wanted to
was doing really well but he wanted to
was doing really well but he wanted to keep his treatment a secret so he hid
keep his treatment a secret so he hid
keep his treatment a secret so he hid his pills and he lied about his
his pills and he lied about his
his pills and he lied about his appointments until we finally convinced
appointments until we finally convinced
appointments until we finally convinced him that he’d be better off if his
him that he’d be better off if his
him that he’d be better off if his parents knew and so he told them
parents knew and so he told them
parents knew and so he told them actually he brought them into one of our
actually he brought them into one of our
actually he brought them into one of our appointments and he told them right in
appointments and he told them right in
appointments and he told them right in front of me my heart was pounding when
front of me my heart was pounding when
front of me my heart was pounding when his father stood up and I’m sure Dave’s
his father stood up and I’m sure Dave’s
his father stood up and I’m sure Dave’s heart was pounding too and his dad said
heart was pounding too and his dad said
heart was pounding too and his dad said son I’m so proud of you your mom and I
son I’m so proud of you your mom and I
son I’m so proud of you your mom and I have known for a while that you were in
have known for a while that you were in
have known for a while that you were in trouble but we didn’t know exactly what
trouble but we didn’t know exactly what
trouble but we didn’t know exactly what was wrong now we see that you’ve figured
was wrong now we see that you’ve figured
was wrong now we see that you’ve figured out your own problem and where to
out your own problem and where to
out your own problem and where to help that moment made a really big
help that moment made a really big
help that moment made a really big impression on me as a young pediatrician
impression on me as a young pediatrician
impression on me as a young pediatrician and addiction medicine specialist and
and addiction medicine specialist and
and addiction medicine specialist and for the past 15 years I’ve been the
for the past 15 years I’ve been the
for the past 15 years I’ve been the director of an adolescent substance use
director of an adolescent substance use
director of an adolescent substance use disorders program where we treat kids
disorders program where we treat kids
disorders program where we treat kids like Dave every day but we can only get
like Dave every day but we can only get
like Dave every day but we can only get to the kids who can get to us which is a
to the kids who can get to us which is a
to the kids who can get to us which is a big problem because too few doctors
big problem because too few doctors
big problem because too few doctors treat addiction in the United States
treat addiction in the United States
treat addiction in the United States there are more than 750,000 practicing
there are more than 750,000 practicing
there are more than 750,000 practicing physicians every single one of us can
physicians every single one of us can
physicians every single one of us can prescribe addictive pain medications
prescribe addictive pain medications
prescribe addictive pain medications that really started the opioid crisis in
that really started the opioid crisis in
that really started the opioid crisis in the first place but only about 37,000 of
the first place but only about 37,000 of
the first place but only about 37,000 of us have taken the training to prescribe
us have taken the training to prescribe
us have taken the training to prescribe medications to treat addiction only half
medications to treat addiction only half
medications to treat addiction only half of us actually prescribed and only 1% of
of us actually prescribed and only 1% of
of us actually prescribed and only 1% of us are pediatricians
us are pediatricians
us are pediatricians a year or two ago the directors of a
a year or two ago the directors of a
a year or two ago the directors of a network of primary care pediatrics
network of primary care pediatrics
network of primary care pediatrics offices contacted me they wanted my help
offices contacted me they wanted my help
offices contacted me they wanted my help improving substance use care for
improving substance use care for
improving substance use care for adolescents within the network with some
adolescents within the network with some
adolescents within the network with some support from the BlueCross BlueShield
support from the BlueCross BlueShield
support from the BlueCross BlueShield foundation we selected one practice and
foundation we selected one practice and
foundation we selected one practice and we designed an experiment that had three
we designed an experiment that had three
we designed an experiment that had three parts first we put a licensed clinical
parts first we put a licensed clinical
parts first we put a licensed clinical social worker on staff then we trained
social worker on staff then we trained
social worker on staff then we trained the pediatricians to prescribe
the pediatricians to prescribe
the pediatricians to prescribe medications for addiction finally as a
medications for addiction finally as a
medications for addiction finally as a specialist I provided consultation and
specialist I provided consultation and
specialist I provided consultation and backup medical support well it just so
backup medical support well it just so
backup medical support well it just so happens that our guinea pigs were Sam’s
happens that our guinea pigs were Sam’s
happens that our guinea pigs were Sam’s doctors about two weeks after he
doctors about two weeks after he
doctors about two weeks after he relapsed he ran out of sleeping pills so
relapsed he ran out of sleeping pills so
relapsed he ran out of sleeping pills so he made an appointment to ask for a
he made an appointment to ask for a
he made an appointment to ask for a refill when he got to the office he was
refill when he got to the office he was
refill when he got to the office he was a little bit unkempt and smelly and he
a little bit unkempt and smelly and he
a little bit unkempt and smelly and he nodded off in the waiting room when a
nodded off in the waiting room when a
nodded off in the waiting room when a staff member woke him up to go see the
staff member woke him up to go see the
staff member woke him up to go see the doctor he was a little bit irritable so
doctor he was a little bit irritable so
doctor he was a little bit irritable so the staff weren’t certain that this
the staff weren’t certain that this
the staff weren’t certain that this experiment that was supposed to bring
experiment that was supposed to bring
experiment that was supposed to bring more kids like Sam into the office was
more kids like Sam into the office was
more kids like Sam into the office was such a great idea but he saw the doctor
such a great idea but he saw the doctor
such a great idea but he saw the doctor he started on medications started
he started on medications started
he started on medications started working with the counselor he stuck with
working with the counselor he stuck with
working with the counselor he stuck with it and he did really well in fact it was
it and he did really well in fact it was
it and he did really well in fact it was really pretty completely transformed and
really pretty completely transformed and
really pretty completely transformed and within a couple of weeks he even became
within a couple of weeks he even became
within a couple of weeks he even became the practices favorite patient he asked
the practices favorite patient he asked
the practices favorite patient he asked his doctors if they would help his
his doctors if they would help his
his doctors if they would help his girlfriend who also had an addiction and
girlfriend who also had an addiction and
girlfriend who also had an addiction and they immediately said yes and the staff
they immediately said yes and the staff
they immediately said yes and the staff reached out to enroll her as a new
reached out to enroll her as a new
reached out to enroll her as a new patient even though the office policy
patient even though the office policy
patient even though the office policy had been not to accept new patients over
had been not to accept new patients over
had been not to accept new patients over the age of 15 when that story got back
the age of 15 when that story got back
the age of 15 when that story got back to me I knew the experiment was a
to me I knew the experiment was a
to me I knew the experiment was a success I want to share some epilogues
success I want to share some epilogues
success I want to share some epilogues with you so Dave the kid who brought his
with you so Dave the kid who brought his
with you so Dave the kid who brought his parents with him to an appointment he
parents with him to an appointment he
parents with him to an appointment he ultimately graduated college and became
ultimately graduated college and became
ultimately graduated college and became a professional he got a job in a
a professional he got a job in a
a professional he got a job in a different City and he moved away the
different City and he moved away the
different City and he moved away the last time I saw him in the clinic he
last time I saw him in the clinic he
last time I saw him in the clinic he thanked me said he couldn’t imagine what
thanked me said he couldn’t imagine what
thanked me said he couldn’t imagine what would have happened had it not been for
would have happened had it not been for
would have happened had it not been for treatment Sam is doing really well it’s
treatment Sam is doing really well it’s
treatment Sam is doing really well it’s he’s been more than six months drug-free
he’s been more than six months drug-free
he’s been more than six months drug-free he looks great and he’s working
he looks great and he’s working
he looks great and he’s working full-time we never did catch up with his
full-time we never did catch up with his
full-time we never did catch up with his girlfriend she was underage and the
girlfriend she was underage and the
girlfriend she was underage and the Department of Child Welfare got involved
Department of Child Welfare got involved
Department of Child Welfare got involved she’s still on the bottom part of that
she’s still on the bottom part of that
she’s still on the bottom part of that iceberg under water but if she’s ever
iceberg under water but if she’s ever
iceberg under water but if she’s ever available we’re here waiting for her the
available we’re here waiting for her the
available we’re here waiting for her the practice is working hard to find kids
practice is working hard to find kids
practice is working hard to find kids who need treatment for opioid addiction
who need treatment for opioid addiction
who need treatment for opioid addiction they’ve hung posters in every room
they’ve hung posters in every room
they’ve hung posters in every room they’ve sent news letters home to
they’ve sent news letters home to
they’ve sent news letters home to parents and older patients they’ve even
parents and older patients they’ve even
parents and older patients they’ve even gone to the local schools to try and
gone to the local schools to try and
gone to the local schools to try and find kids who need help the social
find kids who need help the social
find kids who need help the social worker is counseling these kids and
worker is counseling these kids and
worker is counseling these kids and helping them get their lives back on
helping them get their lives back on
helping them get their lives back on track and when she’s not working with
track and when she’s not working with
track and when she’s not working with kids with opioid addiction she’s helping
kids with opioid addiction she’s helping
kids with opioid addiction she’s helping kids who are using alcohol and marijuana
kids who are using alcohol and marijuana
kids who are using alcohol and marijuana trying to prevent them from going down
trying to prevent them from going down
trying to prevent them from going down the path in the first place my
the path in the first place my
the path in the first place my colleagues and I are planning to open a
colleagues and I are planning to open a
colleagues and I are planning to open a second practice in a couple of months we
second practice in a couple of months we
second practice in a couple of months we have a waiting list of pediatricians
have a waiting list of pediatricians
have a waiting list of pediatricians that want to work with us we’re working
that want to work with us we’re working
that want to work with us we’re working hard to raise resources so we can spread
hard to raise resources so we can spread
hard to raise resources so we can spread the program as widely as possible I want
the program as widely as possible I want
the program as widely as possible I want to leave you secure in the knowledge
to leave you secure in the knowledge
to leave you secure in the knowledge that addiction is treatable if you
that addiction is treatable if you
that addiction is treatable if you happen to be a physician treat addiction
happen to be a physician treat addiction
happen to be a physician treat addiction outcomes from good addiction treatment
outcomes from good addiction treatment
outcomes from good addiction treatment or similar to or better than other
or similar to or better than other
or similar to or better than other chronic medical conditions so there’s
chronic medical conditions so there’s
chronic medical conditions so there’s really no reason not to and if you know
really no reason not to and if you know
really no reason not to and if you know somebody who’s struggling with opioid
somebody who’s struggling with opioid
somebody who’s struggling with opioid addiction help them find good treatment
addiction help them find good treatment
addiction help them find good treatment you could be saving a life thank you
you could be saving a life thank you
you could be saving a life thank you [Applause]
”
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