“My son died last week from an opioid related overdose,” said the voice on the phone. The call came from my cousin who said his son, a smart, capable young adult had just lost his life to opioids. Shortly afterward, I heard of another young adult relative who had also died of an overdose. I wanted to write about this then but didn’t know what to say. What can you say to a parent who stands at the graveside of an adult child who has died from a preventable health issue? Not to diminish the pain these young adults try to alleviate with drugs, but the real victims are parents, siblings, and children who have to live with this senseless loss.
If you are reading this as a parent and thinking – “I’m glad I am not dealing with this problem,” consider yourself lucky. Substance abuse is an equal opportunity health problem with disregard for whether the young adult has come from a good home or not. I need to move this subject out of the shadows of stigma and shame. These shadows ignore the problem and diminish opportunities for loving support from other parents who are affected. One of our challenges as millennial parents is that we have invested so heavily in the success of our children that we can’t bear to admit that they are struggling or having serious problems. We are a community of parents. Every young adult in trouble is our young adult, and we need to stand together as parents.
Nearly three million Americans have opioid use disorder, the result of both prescription drug usage and heroin. There has been a 200% increase in the rate of deaths from drug overdose between 2002 and 2017. On an average day, 130 people die of an opioid overdose. Drug overdose is the leading cause of accidental death in the United States. The largest group affected by overdose are those between the ages of 25-34, followed by those in the age group of 35-44. These are millennials. By the way, opioid overdose deaths are four times greater in Caucasians than Blacks and Hispanics. Opioids come in four forms:
- Natural opioids like morphine and codeine;
- Semi-synthetic such as oxycodone, hydrocodone, hydromorphone, and oxymorphone:
- Synthetic opioids such as tramadol and fentanyl and,
- Heroin, an illicit opioid synthesized from morphine. There is more than one way to get hooked on opioids.
Whether intentionally or not, the pharmaceutical industry and physicians have significantly contributed to the problem of synthetic opioid (pain killers) addiction.
I had personal experience in this regard. Three years ago, when most of the statistics reported above come from, I had back surgery. When I came out of the anesthesia, I was asked about my pain level. I said about a “two,” and they gave me Tylenol. I kept waiting for the pain to hit, and it never did. I continued on Tylenol until I left the next day. As I was going, the nurse gave me an electronically signed prescription for ninety oxycodone. What if I had taken these thinking the doctor wanted me too and became addicted? How many people question prescriptions and doctor’s orders? I did raise my concern with the doctor, and they have since changed their protocols related to prescribing opioid pain killers.
First, some bad news. Only 1 in 10 people with substance abuse use disorders receive treatment. We have to do better. Second, the rate of relapse from treatment when provided is up to sixty percent after one year. Now some good news. More attention is being given to preventing opioid overprescribing and providing funds for treatment at both the federal and state levels. But we have to do better. The emerging literature on treatment appears to support Medication-assisted Treatment (MAT) along with counseling and other requirements (e.g., family involvement) and services (e.g., sober housing). Medications such as buprenorphine, methadone, and naltrexone, along with behavioral interventions, show the greatest promise. Optum (United Behavioral Health Group) recently conducted a webinar demonstrating the superior results of their studies comparing MAT and counseling with other forms of treatment. Medications can reduce cravings; they do not address the stress people are experiencing, depression, anxiety, and other co-morbid conditions. This is why a multidimensional approach is necessary.
What can parents do if they find their son or daughter is addicted? First, confront them in love and not with judgment and shame. Substance abuse is a disease and not a moral failure or a sign the parents have failed. Second, offer options such as having an independent assessment if you or your young adult are not sure there is a problem. If they resist this, ask them to see a family therapist with you where you can discuss your concerns as a family. Fourth, encourage the young adult to seek counseling on their own and offer some resources. Go to psychologytoday.com/ therapists, punch in their zip code, and encourage them to pick out a therapist they think will be helpful. Finally, if they are addicted, and you can get them into some treatment program that uses a combination of medications, counseling, and related services, DO IT! If they relapse, offer them an opportunity to go to a different or relapse focused program. For more help, consider contacting the national helpline for substance abuse at 1-800-662-HELP (4357).