Parents get tips on discussing opioids with teens

Tahlequah Daily Press - 7/25/2019

Jul. 25--An expert explained Wednesday to attendees of the Oklahoma State University Center for Wellness & Recovery's Opioid Epidemic Response event how the use of opioids can impact adolescents, and how parents and adults can help prevent substance abuse

Dr. Julie Croff, executive director of OSU for Wellness & Recovery, said the there are various ways opioids can be misused, such as taking medicine in ways other than prescribed by a physician. Oftentimes patients will decide to take a second dose, because the first did not kick in soon enough, or will forget they've taken medicine and proceed to take more.

Sometimes children are prescribed opioids, but Croff said that kids often obtain prescription medications from friend or family members.

"We know that this happens more with young adults and adolescents," said Croff. "So 40 percent of teens reported they got a prescription and, whether that was a medical use or not, they got it from a family member's medicine cabinet."

Statistics show that one in five teenagers abuse prescription drugs before they graduate from high school. The impact of opioids on the adolescent brain is also more significant than that of adults. Croff said brains do not become fully developed until age 25.

"It's much easier to become addicted to a substance while the brain is growing, because it's not done growing yet," she said. "The decision-making center of the brain is what matures last. That's where parents and adults come in. We have to be their undeveloped brain. They can't make good decisions. We have to help create the situation where the best decisions are already made for them."

People react differently to prescription opioids. The initial response is a feeling of euphoria, but it can also cause nausea, confusion and sedation. Those who experience nausea after taking opioids are less likely to want to take the medication again.

"That can make all the difference in what happens next," said Croff. "So as a parent, you want to really be able to monitor what that initial response is and keep an eye on it."

Opiates can depress or even shut down the central nervous system, and breathing can become shallower or even stop altogether. That can also happen from taking a combination of prescription drugs. Adolescents have an increased risk of becoming tolerant, addicted or dependent on opiates.

"Tolerance is a biological action, so the more opportunities someone has to take an opioid, the more their brain is going to change, and the receptors in their brain are going to change, and they're going to become more tolerant to that opioid," said Croff. "It's also a part of how we define dependence and addiction in adults."

The signs of opioid dependence among young adults and children are different than signs an adult would show. Croff said any use of opioids outside of a prescription is considered "dependent."

"If they're using an opioid, that's dependence," she said. "It doesn't matter if they have withdraw symptoms or not. They're using more of it and they're developing tolerance, and that's something of concern."

Teens often are prescribed opioids because of routine dental surgery or a sports injury. A less common reason is due to chronic pain from illness or disability.

Croff offered solutions for dealing with opioids with adolescents. The first is to treat pain cautiously, and not to start with an opioid if it's not needed.

"Start with a stronger over-the-counter medication," she said. "If an opioid is necessary, then be really cautious about how long someone is on that opioid. There's now a state law that we don't want that first prescription to exceed one week. Really, for some of these sports injuries, unless they're more severe, three days is probably appropriate. That's something the patient and the patient's advocate -- parents -- can renegotiate with whoever's writing the prescription."

Parents and guardians are encouraged to keep their medication stored securely. Having prescription lockboxes in the home can help parents make sure the right amount of medication is being distributed to adolescents. It will help also with monitoring the dosage. Lastly, unused opioid medications should be disposed of, once they're no longer needed.

Reasons that adolescents might decide to use opioids also include peer environments, curiosity, social media influence, depression, anxiety, and observing drug misuse patterns among family members.

Other solutions to addressing opioid abuse are for parents to monitor an adolescent's peer and family environment. Keeping an open line of communication, offering opportunities for adolescents to try new things, and conducting screenings and regular check-ins for mental health can prevent a child from abusing opioids.

Croff said parents can sometimes feel a sense of guilt if they believe their child is showing signs of opioid dependence. She said most people who die from choking are within proximity of someone who could help them, but people tend to isolate themselves when they realize others are watching.

"That's how people die from choking," said Croff. "They go isolate themselves and walk away from the support systems that are there for them. It's the same thing for parenting. The support systems might be other parents and they might be individuals who are working with the students in other capacities."

When parents or adults discuss opioids with adolescents, they're encouraged to get on the teen's level, literally, to make eye contact easy. Turning off smartphones and avoiding distractions are useful in keeping the child's attention. Parents shouldn't start the conversation while the teen is impaired, and setting aside anger and fears can create a more open line of communication, as the adult's demeanor will set the tone. People should also listen as much as they talk.

"Starting the conversation is maybe one of the most difficult things," said Croff.

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