This summer was not good.
In July, I received a call from my sister that was shattering. Her 26-year-old stepson had been found dead. The cause? Fentanyl poisoning. Fentanyl is a synthetic opioid that is 100 times more potent than morphine.
Alec had been struggling with opioid addiction for the last several years. He had been in and out of rehabilitation centers, often recovering but then falling back onto the landmines. The disease of addiction is so strong. My sister and her husband had fought alongside him in his battle, both helping him find treatments as well as providing the emotional support he needed. In the last several months, he had been “clean” and more committed to sobriety than ever. He had a new outlook on how to achieve long-term sobriety. In one of his last conversations with his dad, Alec said, “I am going to beat this disease and live my life with you and our family.”
At the funeral home in a small town in Connecticut, the director said this was the 8th young man he had done a service for in the last month because of fentanyl poisoning. Sadly, this is just a drop in the bucket of the crisis in our nation. Addiction disease does not discriminate. More than 72,000 people from all over our country died in 2017 because of overdose, and the biggest increase was in deaths related to fentanyl. Other opioids are being laced with fentanyl, with or without the user’s knowledge, making them super-potent and extremely dangerous. This is what killed my nephew.
After seeing what happened to Alec, I can’t stop asking myself how can we stop this epidemic. There’s no easy answer, of course, and many of the factors that contribute to addiction may seem like they are out of our control. But as a pediatrician, I would tell parents that one thing they can do is to try their best to keep their kids from being exposed to opioids in the first place.
A startling 84% of opioid addiction starts through prescribed medication, according to at least one study. And while it’s safe to assume that most prescriptions for opioid-based pain medication are written for adults, sometimes they are prescribed to kids – and not always with much explanation. My co-worker ran into this when he brought his 12-year-old son to the ER recently. The nurse wanted to give him something for the pain (a 4 out of 10 in intensity, according to the boy). But because they weren’t sure what was wrong with him and weren’t sure if he’d need surgery, they didn’t want to give him any oral medications. Instead, the nurse suggested a pain medication they could administer via nose spray: fentanyl. Thankfully, my co-worker stepped in and assured her that his son could get through the pain without medication.
Of course, there are circumstances where a prescription pain killer may be appropriate, like a surgery, for example. But there are times that a pain killer may not really be necessary and the pain could be managed with other methods first. Any time a pain killer may be prescribed to your child or to you, ask the following questions:
- Is the medication an opioid?
- Is this medication absolutely necessary?
- Is there a non-opioid pain medication we can try first?
- If my child does need this opioid-based pain killer, can we start with the lowest possible dose?
- What dangers or side-effects should we be aware of?
Also, be sure to make your doctor aware of any family history of addiction or if your child has any mental health concerns (these factors, as well as others, increase risk of addiction).
I would also tell parents that they can be intentional about the tone they are setting in their home in regards to medications, in general. We currently in a “throw a pill at it” culture – when, often, medication is not the only solution (and may not really be necessary at all). Like muscle pain, for example. Decades ago, we didn’t necessarily reach for the pill or prescription – we just applied a warm towel, or an ice pack, to the area, elevated our leg and just rested. And we were okay with that. If we can teach our kids to turn to other methods of relief first, they’ll grow up to be less likely to take prescription medications – including opioids – unless they are really needed. And if we can limit their exposure, we’re limiting their risk.
Here are some ideas to handle some of those aches and pains first, before reaching for that pill:
- Warm packs or cold packs: This is an age-old treatment that often can reduce pain. Our parents turned to this first, as did our grandparents.
- Compression: For sprains and mild injuries, this can help, as it can for insect bites and other minor ailments.
- Alternative therapies: Some of these treatments have been used for thousands of years. Acupuncture has been proven to be effective for some types of back pain, and tai chi can help with arthritis
- Resting and being with family/friends or community. Talking and socializing can help your mindset so that pain is perceived differently. Think about it: if you are depressed or lonely, you may be more sensitive to your pain.
- Yoga and meditation: These ancient practices can truly move the needle in terms of focus and mood. And they help you physically and emotionally manage health conditions.
We couldn’t prevent what happened to Alec, but we’re all hoping that by telling Alec’s story and urging parents to guard their kids from opioid exposure, we might help prevent another family from losing a loved one through addiction.