Opioid Epidemic and Our Children

Katherine Herczeg, MSN, APRN
Bitterroot Physicians Clinic South
3334 DVN Lane
Darby, MT 59829

Opioid Epidemic and Our Children
Extensive studies have been performed on adult patients with a history of drug use and misuse. These studies have led to the development of screening tools and treatment guidelines for such patients to aid the healthcare provider in avoiding negative outcomes. The issue is many drug abusing adults first experimented and had signs of addiction between the ages of 12-21 years old. In this article I will be addressing specifically the legal opioids, which consist of the prescription pain relievers oxycodone, hydrocodone, codeine, morphine, fentanyl and others. The general public may know the other common names of these drugs as Vicodin, Percocet, Norco etc. Abuse of prescription opioids has more than doubled and prescription opioid abuse was second only to marijuana for 2.2 million adolescent first-time users of an illicit drug in 2009 (Bass, 2016). It has been shown that if drug use can be avoided in youth, the incidence of addiction can be greatly reduced in the adult population.

Why the significant rise in adolescent drug use? To understand that it's important for all of us to know that the adolescent brain is uniquely sensitive to the effects of nicotine, alcohol, and other drugs. Research has shown that 90% or more of addicted adults began drug use between the ages of 12 and 21 years (Brennan, 2015). Contributing to the problem are healthcare providers who may be dispensing more opioids than are needed and contributing to the nonmedical use of opioids. This prescribing practice may be for things such as sports injuries and at the parental request to treat their child's pain with medications other than over the counter options. A major concern with this practice is that compared with other drugs of abuse among adolescents, the speed of initiation to addiction among opioids is both common and accelerated. Several additional factors that are likely to have contributed to the severity of the current prescription drug abuse problem includes drastic increases in the number of prescriptions written and dispensed, greater social acceptability for using medications for different purposes, and aggressive marketing by pharmaceutical companies. There is a major misconception by children as well as adults that because the medication is "prescribed" it must be "safe". Medication misuse is taking a medication in a way that is not intended, such as: 1.)Taking someone else's prescription, even if it is for a legitimate medical purpose like relieving pain. 2.) Taking an opioid medication in a way other than prescribed-for instance, taking more than your prescribed dose or taking it more often, or crushing pills into powder to snort or inject the drug. 3.) Taking the opioid prescription to get high. 4.) Mixing them with alcohol or certain other drugs.

A study performed in 2009 cited the following reasons a child may try an opioid: to relax or relieve tension, to feel good or get high, to experiment, to relieve physical pain and to have a good time with friends. Adolescents are vulnerable to experimentation with opioids due to their sensation-seeking nature and risk-taking behaviors. Opioids attach to receptors in the brain reducing the perception of pain and can produce a sense of well-being and/or extreme euphoria. However, opiates can also cause, sleepiness, confusion, nausea (feeling sick to the stomach), constipation and slowed or stopped breathing.

Due to the rising epidemic amongst adolescents, parents ask, "how are they gaining access to these drugs?" The most common way children get access to these medications is through their parents' prescription pain medications, or they get some from friends at school who have access to their parents' medication. Perhaps a friend or family member innocently offered one of their own pills to alleviate that headache or stomachache. Another example would be the teen who had wisdom teeth removed and didn't take all of the prescription. The bottle was saved and later accessed by the teen. If family members have taken any opioid medications in the past, I highly recommend they make sure they have properly disposed of any remaining pills so that children and teens cannot access them. If they are currently taking these medications, they should keep them in a locked cabinet.

According to the Centers for Disease Control (CDC) in 2014, there were more than 460,000 adolescents who were current nonmedical users of pain relievers, and 168,000 had an addiction to prescription pain relievers. In 2015, 276,000 adolescents were current nonmedical users of pain relievers, with 122,000 having an addiction to prescription pain relievers. Drug overdose death rates have increased more than 250% since 2001, with much of the increase attributed to opioids. Many of the pediatric overdose related deaths from opioids were accidental. Again, the drugs can cause slowing of breathing to the point the adolescent goes to sleep and does not wake up.

So how do we as parents, guardians, teachers, healthcare providers recognize and prevent such tragedy to our youth? Frighteningly for both parents and the healthcare provider, opioid use disorder can present as a fatal event in the absence of dependence, family knowledge of a problem, or even with first use. Stress and exposure to drug use among family or friends are thought to generally increase addiction risk. Many psychiatric disorders including depression and anxiety can increase risk of addiction and drug experimentation. Behavioral tendencies such as excitement seeking, extreme extroversion, and impulsivity generally increase the risk for adolescents to addiction. Signs that your youth may have addiction issues include symptoms such as: slurred or slowed speech, dilated pupils, flushing of the face or neck extreme drowsiness, drooping eyelids, school work has declined and their grades are dropping, loss of interest in hobbies, loss of interest in the way they look and their overall appearance, secretive and guarded behavior and money/household items are missing.

I urge you to educate and arm yourselves against this growing epidemic that is unnecessarily claiming the lives of our children. Don't think that it couldn't happen to you. This problem transcends all socioeconomic classes, ages, genders, religions and professions. If you suspect that your child has an addiction with opiates, I urge you to contact your local health provider, hospital, or addiction specialist for their recommendations. Addiction is curable with appropriate treatment.

Questions and or comments regarding this week's health column please contact, Katherine Herczeg, MSN, APRN at Bitterroot Physicians Clinic South, a service of Marcus Daly Memorial Hospital, 3334 DVN Lane, Darby, MT 59829, a service of Marcus Daly Memorial Hospital. Working together to build a healthier community!


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