Based on the premise that addiction care requires collaboration between municipalities and regions, the Maria clinics have been highlighted as good examples of how addiction care in Sweden can work. Despite this, there is a lack of updated knowledge about how staff understand and give meaning to substance-using youth and the treatment system. By adopting Carol Bacchi's critical approach "problematizations", this study examines how youth with substance use problems, as well as interprofessional treatment collaboration around them are constructed. Twenty semi-structured interviews with staff in Maria clinics and municipal social services, have been analyzed using post-structural interview analysis. Three main subject positions were identified: self-medicating, disturbing and law-breaking youth whose characteristics made them fit better or worse with the current supply of interventions in the treatment system. In discussing the key aspects of professional collaboration, the participants concentrated on leadership, healthcare and shortcomings in psychiatry. The staff tended to create a reality through a medical discourse where the complexity of youth substance use is reduced to an isolated individual problem, that should primarily be identified and treated through medical interventions. This can be limiting regarding the staff's understanding of substance-using youths’ situations and how interprofessional collaboration can support them.