Editor’s Word: Dr. Scott Hadland is a pediatrician and professional on adolescent substance use. He’s the chief of adolescent drugs at MassGeneral Hospital for Youngsters and Harvard Medical College. Observe him on Twitter, Instagram and LinkedIn. The views expressed listed here are his personal. Learn more opinion on CNN.
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Pediatricians like me aren’t used to our sufferers dying. Most youngsters and youths are wholesome and thrive, and though some would possibly experiment with medicine, teen overdoses are comparatively unusual. A rising menace, nevertheless, is forcing all of us – particularly mother and father – to grapple with a brand new actuality.
Just-released data from the US Facilities for Illness Management and Prevention present that in 2021 extra teenagers than ever earlier than died of overdoses, pushed by more and more potent and harmful medicine. Overdoses are actually the third leading cause of death in US youngsters below age 20, killing more than 1,100 teens annually – the equal of a college classroom each week.
Right here’s what mother and father have to learn about drug overdoses and the way to forestall them.
The brand new CDC knowledge paints a grim image of how teenagers are overdosing. Opioids trigger 9 out of 10 teen deaths, and fentanyl is the commonest opioid concerned. In lots of circumstances, teenagers are dying from counterfeit prescription pills that comprise fentanyl, an opioid 50 instances stronger than heroin.
These fake pills are made to look like real opioid painkillers resembling Percocet or OxyContin, anti-anxiety medicines like Xanax or different prescription tablets. However, as an alternative, these phony variations comprise fentanyl as a result of it’s sedating, eliciting an analogous impact to the true tablets they mimic.
Counterfeit tablets are in all places in America. The Drug Enforcement Administration lately introduced that its seizures of fake pills doubled from 2021 to 2022. When a teen buys a tablet from a pal or supplier, it’s now extra possible than not that will probably be a counterfeit and comprise a lethal amount of fentanyl. Counterfeit tablets now trigger at the least one out of every four teen overdose deaths, although that is possible an underestimate as a result of tablets discovered at dying scenes are hardly ever examined.
As a pediatrician, I’ve seen that teenagers flip to tablets for a variety of causes. Some strive tablets as a result of they’re experimenting. Nevertheless, regardless of an all-time excessive in overdose deaths, rates of drug use experimentation (together with opioids) amongst teenagers are at a historic low. Different teenagers search out tablets as a result of they’re combating mental health concerns – mostly depression, anxiety, or suicidality – and misusing sedating medicines briefly relieves their signs. Some teenagers have untreated bodily ache, main them to make use of opioids. And a few teenagers have an underlying opioid habit. Whatever the underlying cause for taking tablets, teenagers are sometimes unaware that what they’re buying is a counterfeit containing fentanyl.
Dad and mom are key to retaining teenagers secure. The brand new CDC knowledge tells us that teenagers most commonly overdose at home. Tragically, two-thirds of the time, their dad or mum or another person can also be house and the teenager dies alone in a distinct room (e.g., their bed room), with the potential bystander unaware that the teenager is even utilizing medicine. This may occasionally clarify why most teenagers who die of an overdose by no means obtain naloxone, a lifesaving overdose antidote.
So, what can mother and father do?
First, speak to your teen about fentanyl. Have an open dialogue, asking questions on whether or not they’ve heard about fentanyl and are conscious of faux tablets. Know that many drug sales happen through social media, and ask whether or not your teen has been approached on TikTok, Snapchat, or different platforms. Spend extra time listening than lecturing. Counsel them concerning the dangers of fentanyl however keep away from fear-mongering. Teenagers profit most after we empower them to make secure selections, and generally tune us out if we use scare tactics.
Second, be ready. Know the signs of an overdose. Teenagers who overdose initially seem groggy and pale, then rapidly lose consciousness and turn into limp. Their respiratory slows or stops, and their lips and fingernails flip blue.
Know how to respond to an overdose. Name 911 instantly and provides naloxone in case you have it. Naloxone is an easy-to-administer spray that rapidly reverses overdoses from fentanyl and different opioids. Like a fireplace extinguisher, naloxone is one thing to have on-hand, even if you happen to hope to by no means have to make use of it. Your well being care supplier can prescribe naloxone, and lots of native well being departments distribute it without spending a dime. More and more, schools have it on their premises, too.
Third, deal with any underlying threat components your teen has. A minimum of two out of every five teens who overdose have struggled with their psychological well being. Despair and anxiousness have turn into alarmingly common in the wake of Covid-19, reaching charges of 25% and 20%, respectively, amongst teenagers. To maintain teenagers from self-treating with illicit tablets which are prone to be counterfeit, mother and father ought to speak to their little one’s physician, who might help join them to counseling and, when wanted, prescribe treatment. Regardless of the hazard that illicit tablets pose, anti-depressant and anti-anxiety medicines prescribed by a physician and distributed at a pharmacy are secure and efficient for teenagers.
Dad and mom also needs to deal with any preexisting substance use. One-third of teens who die of an overdose have misused opioids earlier than, and one in seven has had a previous overdose that they survived. Many already misuse other drugs or alcohol. All of those are warning indicators that must be urgently addressed by a medical skilled.
For teenagers who’ve an opioid habit, evidence-based remedies can be found, together with safe-to-use medications that save lives. Though we intention to assist most teenagers cease utilizing opioids altogether, teenagers who do use must be recommended to by no means use them alone (so that somebody can intervene if an overdose happens), and to keep away from mixing opioids with different sedatives like alcohol or different medicines. In some areas, test strips can be found to assist teenagers perceive whether or not their medicine comprise fentanyl, which additionally generally contaminates other drugs like cocaine.
Sadly, I’ve met numerous households who’ve struggled to get wanted psychological well being and habit therapy for his or her teen. Locating high-quality care is troublesome, waitlists are widespread, and insurance coverage protection is usually poor. Many households don’t search therapy due to the large stigma surrounding psychological well being and substance use.
However getting these companies is feasible – and demanding. As a primary step, speak to your teen’s physician, whose job it’s that will help you navigate the therapy system. To assist households and docs discover care, the US government maintains active lists of psychological well being and habit therapy packages in a searchable database. Many states even have phone hotlines. The US has a nationwide 988 Suicide and Crisis Lifeline households can name or textual content. A wealth of training for fogeys and high-quality instruments can be found by means of the Partnership to End Addiction.
The nationwide overdose disaster will not be new. Actually, the US is now quietly surpassing a darkish milestone: its millionth overdose death for the reason that flip of the century. Sadly, as a pediatrician, I’ve watched as a few of my sufferers had been born throughout these final twenty years and died younger from an overdose – their complete childhoods bookended by a public well being disaster now we have but to resolve.
However fentanyl is a brand new menace for teenagers, and there are key steps mother and father can take: Speak to teenagers about fentanyl, be ready to handle an overdose, and search out psychological well being and habit therapy when teenagers want it.
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