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Examining the opioid crisis: Addiction in adolescents and young adults

Mirmont Treatment Center September 12, 2017 Substance Use Disorders

We hear about the opioid crisis in the headlines nearly every day yet most of us have a hard time making the mental leap from using pain-relieving medication prescribed by a doctor to overdosing on painkillers or progressing to heroin injection.

“Opioids” is an umbrella term for drugs derived from the poppy plant (opiates), such as morphine and codeine, as well as those manufactured synthetically, which behave like opiates, such as OxyContin, Vicodin and Percocet. Heroin can be manufactured in different ways, but is generally referred to as an opioid. Opioids work by interrupting pain signals to the brain and producing a pleasurable effect.

Kids reaching for prescription painkillers to relieve stress, anxiety

When we think about our kids’ exposure to these types of drugs, it can still be difficult to grasp how one thing leads to another. Yet some telling statistics published in a 2015 study* sheds light on how kids get started on opioids and can progress to dependency and addiction. Of the young adult respondents 18 to 24 years old:

  • 61.2 percent say they have tried pain medications to reduce anxiety or stress
  • 52.8 percent say they have used pain meds for sleep
  • 34.8 percent have used them to get high

* Hazelden Betty Ford Foundation, The Christie Foundation. Youth opioid study: attitudes and usage – young adults ages 18 to 24 in the United States.  April 30, 2015. Accessed August 28, 2017.

Some might find it surprising that the percentage of youth surveyed are seeking out stress relief and sleep remedies at a much higher rate than they’re seeking out “getting high.”

Jessica Cirillo, MA, CRPS, who provides clinical outreach and education about addiction on behalf of Mirmont Treatment Center, part of the Main Line Health system, explains, “Today’s generation is wired for instant gratification, everything is available immediately. Yet instant gratification lowers their tolerance for stress.” So while stress is mounting due to pressures from school, social media, and peer relationships, many young people are finding ways to self-medicate. Cirillo adds, “Kids don’t get enough exposure to healthy coping skills so when they’re overwhelmed and stressed and introduced to a substance that gives them instant relief, they’re more likely to get hooked on something that makes them feel better right away.”

And with the wider availability of prescription drugs, the age of onset use is now younger. “It used to be that adolescents wouldn’t try prescription pills until age 18,” she says. “Now they’re trying them closer to age 15.” At Mirmont Treatment Center, clinicians see teens that are starting to abuse prescription pills or are struggling with addiction issues.

How an opioid dependency can turn into heroin addiction

This is where the slippery slope begins.

Imagine a teenage girl goes exploring in her parents’ medicine cabinet. She finds a half-used bottle of five-milligram Percocet (acetaminophen/oxycodone) that her father’s doctor had prescribed him when he threw his back out. She tries it. The opioid releases immediate feel-good hormones. She likes the effect. She wants more—and she tells her friend about it. (Percocet, according to Cirillo, is the “new marijuana.”)

Realizing she can’t keep robbing her parents’ medicine cabinet, she asks around. Prescription drugs “on the street” could be a locker or two down at school or through an older friend or relative. Soon she has built up tolerance and needs a higher dosage to get the same desired effect. She experiments with crushing the pills, then snorting the powder (her experimentation just became more dangerous and addictive), or combining the pills with alcohol or other drugs for greater euphoric effect. Meanwhile, she progresses to 30-milligram Percocet—about $30 per pill on the street—and is now focused on how and where to come up with the money she needs to feed the good feeling.

“That’s where the addictive behaviors like stealing and manipulating come into play,” Cirillo explains. “If she stops, she’ll become very sick and very desperate, very quickly.”

Then someone introduces the girl to heroin. For $10 a bag, she’ll get a much greater effect, and faster. Cirillo points out, “No one starts out with heroin, they start out with lower milligram substances. But I don’t think kids can grasp experimenting with substances and then progressing to heroin addiction. They don’t understand the connection. Most people don’t.”

Nearly one-third of respondents know someone who has overdosed on prescribed pain medication or heroin yet 37.2 percent say they have no idea where to go for help if they or someone they know experiences an overdose. – Youth Opioid Study, Hazelden Betty Ford Foundation | The Christie Foundation

Education key to preventing opioid use and misuse

Cirillo sees opportunity for education, especially at the elementary and middle school levels, to help kids have a better understanding of chemical dependency and what to do if it happens to them or to a friend. Unfortunately, says Cirillo, getting help for drug dependence or addiction still has shame and judgment associated with it. Kids are also afraid of the consequences for themselves or getting their friend into trouble. “Their instinct is to deal with it internally, ‘we’ll figure it out, it’ll be okay,’” she says. “Kids don’t understand how severe the situation can be. It gets very normalized.”

Pennsylvania’s Good Samaritan law provides immunity for people who witness an overdose and call 911 for emergency medical services. The law provides certain protections for callers, reassuring them that they cannot get in trouble for being present, witnessing or reporting an overdose.

Recovery works best when it includes holistic approaches to stress and trauma

Educating families and parents is critical. Parents need to feel comfortable talking to their kids and also need to be in tune to the stresses they’re facing, as well as the fact that their children—yes, even their children—are going to be exposed to prescription pain medication and more. It also helps to model relaxing behaviors that don’t involve drugs or alcohol. Yoga, acupuncture, chiropractic care, and regular physical activity are all healthy outlets for stress, overwhelm and anxiety.

Cirillo reminds us that despite the media focus on the devastating effects of opioid misuse and abuse, there is hope and motivation for those who are recovering and wish to recover. At Mirmont Treatment Center, mindfulness-based stress reduction, meditation, and other holistic and traditional approaches are used to help patients learn to cope and thrive amidst the daily stresses of life—whether they’re 14 or 64. Says Cirillo, “As long as there’s breath in someone’s body, there’s always hope to recover.”

Interested in hearing more about youth addiction trends and treatments? Join Jessica Cirillo on Thursday, September 28, at the Main Line Health Concordville to get the facts on binge drinking and opioid dependence.