By Katie Marvin, MD, Stowe Family Practice
Until the 1920s, mothers gave their teething, ill, mildly aggravating children and infants a nip of Mrs. Winslow’s Soothing Syrup. It calmed them and helped them sleep. The syrup contained a significant amount of morphine, and was advertised to be safe, but there were many deaths related to the product. The American Medical Association called it a “Baby Killer” and finally it was pulled from the market after years in many families’ medicine cabinets.
Fast forward to today. We know so much more about opiates. We know they are addictive, have high street value, and are promoted by the pharmaceutical companies. And we know that they kill—frequently young people—surpassing car accidents in cause of death in many states. And yet, the prescriptions are written and the bottles continue to linger in our medicine cabinets, much like Mrs. Winslow’s syrup. Well, just as morphine is not good for a cranky baby, Vicodin is not an appropriate treatment for a teenager with an ankle sprain or tooth ache, or any other ailment short of serious trauma.
Prevention is the best way to keep teens from becoming addicted to opiates. Here are five ways that parents and local communities can do to help teens live clean and healthy lives without becoming addicted to opiates.
1. Remove exposure to the drug
Doctors are limiting prescriptions, so that teenagers, in particular, will not get opiates. Their pain can be managed to a tolerable level in other ways. Ibuprofen and acetaminophen actually perform better in studies than opiates in controlling acute pain. If your child is prescribed hydrocodone or oxycodone for a procedure or pain, consider not filling that prescription. Also, if old bottles of narcotics are in your house, take them to your local sheriff’s department and dispose of them safely.
2. Boost a community’s protective factors
Find ways to increase adult role modeling, a sense of belonging in a community, and parental involvement. What parents say and do matters. The website parentupvt.org
has great resources for parents who want help talking to their kids about drugs and alcohol. Towns need to promote drug and alcohol free events, and schools must be clear and consistent in their enforcement of rules concerning drug use. Consider community events with teens present be alcohol-free events.
3. Connect teens WITH a primary care provider
Annual wellness visits are an opportunity for teens to talk confidentially with their PCP about their own unique strengths and risk factors. Undiagnosed anxiety, depression, and post-traumatic stress make a person much more likely to develop an addiction. A teen who uses alcohol before age 15 is 5 times more likely to have a substance use disorder later in life than those who waited until 21 to drink. It’s all about the developing brain, and how malleable youth brains are.
4. Help diminish stigma; addiction can happen to anyone
Opiates are addictive because they make people feel good, pain free, confident, and happier, at least temporarily. Once dependence develops, people need the drugs daily, or they become sick from withdrawal. They need more and more, sometimes spending hundreds of dollars per day, just to not get sick. Heroin is cheaper than pills, and all of a sudden the 20-year-old who was taking Vicodin for an ACL tear is homeless and using IV drugs. This happens all the time and it happens fast. The person is often young and unaware that he or she can get in so deep so fast. No one chooses this.
5. Help is available
If a patient wants help, together we will find it. I ask my patients to call our MAT—Medication Assisted Therapy—team at 802-888-6009. You can also speak with your primary care provider or call Michele Salvadore at the Vermont Department of Health, 802-888-2581, or call Behavioral Health and Wellness Center at 802-888-8320. If a family member is not ready for treatment, do not enable him or her. Consider keeping available a dose of Narcan, an overdose antidote, but do not buy drugs for someone with an opiate addiction. Opiate withdrawal is unpleasant, and difficult to watch, but not lethal. Overdose is lethal. Just as it was with Mrs. Winslow’s syrup.
Dr. Katie Marvin practices family medicine at Stowe Family Practice. She has a special interest in helping teens prevent or recover from opiate addiction.