How these Oregon high schools aim to help teens recover from drug addiction

Driving the news: The first such school in Multnomah County — Rivercrest Academy — opened last month in NE Portland.

• The idea began in the 1980s and has spread to 20 states.
• This year, the Oregon Legislature approved state funding for a total of nine nonresidential public recovery high schools by 2029.

Why it matters: Research has found that among students with substance use disorder — medically defined as uncontrollable use despite harm — recovery high schools can significantly decrease drug use and increase school attendance compared to other high schools.

By the numbers: Researchers at the joint Oregon Health & Science University-Portland State University School of Public Health estimate that 5.4% to 11.6% of Oregonians between the ages of 12 and 17 have substance use disorder.

• That's between about 16,500 and 35,400 young people. Oregon ranks third highest nationally for youth with substance use disorder, according to Mental Health America, an advocacy group.

Context: The OHSU-PSU report also found treatment options for teenagers fall far short of need.

• "Hardly any of them are getting treatment in a specialty facility," which can be a critical step depending on the level of addiction, Elizabeth Needham Waddell, a report author, told Axios,

How it works: Recovery high schools are not treatment facilities.

• Rivercrest — like dozens of similar schools in other states — follows local curriculum and graduation requirements and includes daily group support sessions and one-on-one sobriety coaching during the regular school day.
• The school's primary focus is to "provide education for students who meet the criteria for substance use disorder" and who "want to abstain" from drugs and alcohol, principal Todd Nicholson told Axios.

Of note: Schools also randomly test students for drug use but, unlike some, Rivercrest does not require students to have a proven period of abstinence before enrolling.

• "We're not doing that because how would that be fair" when there are so few treatment facilities in Oregon focused on teen substance use, Nicholson asked.

What they're saying: "It's a lot more flexible and less stressful" than regular public high school, one Rivercrest sophomore told Axios in a phone interview. "Everyone there is going through something similar, so we can all relate and help each other."

• "It's a safe place for kids to be sober and meet other kids that are sober," a junior at Rivercrest said, in a separate call. "I like to go."

• Axios is not naming minor students or including full names of parents in order to protect the children's privacy.

Catch up quick: Oregon's first recovery high school — Harmony Academy in Lake Oswego — opened in 2019.

• Harmony is a state-chartered public school, so any student in Oregon can attend without approval or payment from their local district.
• Rivercrest is run by the Multnomah Education Service District and is available to students in Multnomah County — if their school district approves and covers the cost.

Limited spots frustrate families

Rivercrest sounded like "a dream come true" to Jeff, a parent who lives near the school and whose teen went to treatment for substance use at an out-of-state facility.

However, Portland Public Schools will pay for only 10 students to attend Rivercrest, and his child was being evaluated — PPS' Reconnection Services decides if the school is the right fit — along with four or five PPS students for two spots, Jeff told Axios.

• "I truly feel this recovery school could make an enormous positive impact" on the lives of teens who are trying to stop using drugs, including his child, Jeff wrote to PPS officials, according to emails he shared with Axios. "Please request more slots."

Zoom in: Rivercrest has 12 students enrolled — two from outside PPS — but capacity for up to 30 with current staff, according to Nicholson.

• Korinna Wolfe, senior director overseeing PPS' alternative schools program, said the district budgeted to cover 10 spots at Rivercrest this year — at a cost to the district of $38,300 each. Families do not pay.
• "I'm very excited that we're able to offer 10 spots. I wish we could offer a lot more," Wolfe told Axios.

Zoom out: PPS advises other students in need of a recovery high school to go to Harmony Academy — and the district pays for transportation for up to 16 students.

What they're saying: "We really liked it," Jeff, who first looked at Harmony, told Axios. But sending his struggling teen on an hourlong bus ride each morning "seemed insurmountable."

• "Why would PPS pay for someone in NE Portland to take a bus to Lake Oswego instead of requesting additional available spots for a recovery school in NE Portland?"

The other side: Wolfe told Axios that, counting both schools, PPS has gone from providing zero access to recovery high schools to facilitating 26 spots.

• She said PPS offers a "continuum of services" for students struggling with substance use, and recovery schools may not be the right match for everyone.

By the numbers: Harmony has about 30 students enrolled, including six from PPS and six from other Multnomah County school districts, all of whom would be eligible to attend Rivercrest.

• Nicholson said Rivercrest gets two to three calls a week from families asking about slots, but the service can be a hard sell to districts, and not just due to money.
• He said one school administrator told him, "We don't have kids like that in our district."

The intrigue: Jeff emailed PPS officials for weeks about his child, asking why the district wouldn't pay for more spots at Rivercrest.

• "If we are ever going to keep kids and people sober, recovery options have to be as easy to access as the drugs," he said.
• He said he has not received an answer, but when one PPS student left Rivercrest for another alternative high school recently, Jeff's teen received the spot.

What's next: By next fall, Rivercrest hopes to be funded directly from state educational coffers — eliminating the need for districts to pay for individual student slots there.

• That will depend on how quickly Oregon's Department of Education writes funding rules.

What we're watching: How quickly Rivercrest will grow, and when additional recovery high schools — one planned in Eugene hopes to open in 2025 — will come online.

Families detail difficulties finding treatment

Many teens who enroll in recovery high schools come from inpatient treatment. But because of Oregon's lack of services, finding care takes an extraordinary amount of time and energy.

Context: An investigation by The Lund Report this year found that the number of addiction inpatient treatment beds for teens had dropped as low as 13 in April 2022, and that Oregon's lack of behavioral health care for teens has been known for decades.

• Medication to treat opioid addiction is rarely offered to teens here.
• Oregon's first detox center specifically for teens opened in July.

State of play: Parents attending a weekly meeting of Collective Roots, a year-old local family recovery group that works closely with Rivercrest, told Axios about spending hours on the phone trying to find help for their children. Many waited weeks for treatment spots and had to go out of state to find care.

• Time in treatment depends on insurance, and even with coverage can cost thousands of dollars, they said.

What they're saying: "I was laughed off the phone," said one parent, Gretchen, describing searching for teen-focused treatment in Oregon.

• Crisis lines "literally refer you to places that are closed, that don't exist," Maya, another parent, told Axios.
• "You think [your child] will not be alive by the time treatment spots open," Anna, another parent, said.

Parents also told of using Narcan on their children after finding them unresponsive, and setting up round-the-clock watches for days at a time while waiting for help.

The big picture: Teens recovering from substance abuse and their parents tell Axios their drug and alcohol use is often connected to depression and anxiety — an experience backed by research.

Yes, but: Oregon is also among the worst at providing youth mental health care, according to a 2022 ranking by Mental Health America.

• "We could either go and see a mental health specialist, or we could go and see a drug and alcohol counselor," Brenda Martinek, who helped lay the groundwork for Rivercrest after her son, Taylor, died of a fentanyl overdose, told Axios.
• One would say, "We can't really deal with your mental health issues because you're using," and the other would say, "We can't really deal with your using because you have mental health issues," Martinek said. "It was awful and horrible."

The intrigue: Oregon is building on its COVID-19 experience to create, over the next two years, a virtual coordination center that can show health care providers in real time where behavioral treatment beds are open, including substance abuse treatment for teens.

• The system won't add any new resources, but it will help "visualize where our bottlenecks" and "unmet demand" are, Matthias Merkel, the OHSU professor overseeing the project, told Axios.

Separately, the advocacy organization Oregon Recovers recently launched a searchable network of various services for people recovering from substance abuse.

Reality check: It's still incomplete and only a starting point — a list "folks can start calling to see what's available," policy director Tony Morse told Axios.

The power of peers

The primary focus of the family recovery group working with Rivercrest is to offer teens dealing with substance use new friends their age — and a place to relearn how to have fun without drinking or getting high.

• "They're not going to stay sober if they're not having fun," Collective Roots founder Robin Bergeron told Axios.

How it works: Three evenings a week — more during summer vacation — a small group of teens gathers in a Portland church basement to play ping-pong or guitar, draw or just talk.

• Sometimes they're out — at laser tag or a corn maze — but always with adults trained as mentors for kids in recovery.

What they're saying: It's "very, very important" to have friends who are not using drugs, one 16-year-old at a meeting last week told Axios.

• "Because if I were to hang out with kids who do drugs I would be doing drugs, and if I weren't hanging out with anybody I'd kind of just be by myself alone and that would probably also lead to me doing drugs."

Reality check: Ending old friendships is very difficult, a 15-year-old participant said. "You make so many friends when you're using that you bond with and you still want to be friends with them."

• "But if they're still actively using, it's pretty much impossible for me to stay sober."

Context: Sometimes fun can be triggering if it's something they enjoyed before getting sober — like "exploring the city," one 16-year-old said.

• That used to mean "walking around … looking for half-smoked joints on the ground, looking for used foil" that might have drug residue.
• Now, it can mean going to a skate park with friends from this group, stopping for food and goofing off in the restaurant — silly but sober.

"Appreciating the world"

The teenagers in the group mentioned going to concerts together, hiking with parents, turning beautiful rocks into jewelry and just hanging out as ways they have fun without drinking or using drugs.

One 18-year-old — two months sober — described learning the pleasure of "appreciating the world."

• "Like embracing the realization that the world doesn't owe you anything, but it can give you a lot, and it does."