When it comes to acknowledging the opioid epidemic, the U.S. has been faced with some harsh realities over the past several months. Perhaps most notable is a recent report from the Centers for Disease Control and Prevention that indicates the leading cause of death for Americans under 50 is now accidental death by drug overdose. The 2016 count of lives lost exceeds 64,000, a 19 percent increase from the previous year’s 52,000. These figures are heartbreaking.
Perhaps a more important statistic is that overdose deaths among adolescents (those ages 12 to 17) are up as well, with a strikingly similar 19 percent increase in the past year. This information is significant, and not just because it’s alarming. It also begs a different approach in how to address the problem.
Several governmental actions have been taken to curb the effects of this devastating crisis. Many states have adopted Good Samaritan laws, which encourage bystanders to call law enforcement for help if there’s concern for a potential overdose, without fear of prosecution for being involved in illicit activities themselves. There are also federal regulations with heavy sanctions on misguided prescribers who may be buffering their revenues by pumping out scripts for prescription opioids. Plus, there’s the overdose-reversing drug Narcan and subsequent funding for free community trainings, with ease of access through your physician or local pharmacy.
But where is the haste toward prevention?
In my 13 years working in the mental health and addictions counseling field, I can list over a dozen adolescent treatment programs (that I was personally acquainted with) that have closed simply due to lack of census. Services were being offered, but few were using them. Some of these programs, responding to an increase of young adults (18- to 26- year-olds) in need of treatment, converted their juvenile programs to fit the business’s needs.
Alongside the trend for more young adults seeking treatment, service providers continued to see further declines in adolescents accessing services. In essence, what we’re seeing is a decrease of identification in teens, and an increase as they transition into adulthood. There’s something horribly wrong with this picture. As a culture, we’re being reactive to a crisis as opposed to placing efforts to be proactive. This, unfortunately, is a making of the tragedy we see on the news each and every day.
Yes, prevention does exist; however, it’s fragmented at best. Most common prevention efforts take place in the school setting. One of the most frequently used school-based prevention programs has been empirically suggested to be ineffective, and yet the program gets renewed year after year in some states. Some states’ education departments require that school boards employ a specialist to handle substance use and other crises in their students; however, these professionals often occupy several roles within the district, and their time is often stretched too thin. Programming targeting parents to provide information on current trends and concerns regarding substance use are lightly attended. I’ve facilitated many of these workshops myself; in a student population of 1,200, if you can get 20 parents to attend, you’re in luck.
One thing is blatantly clear: When we’re not appropriately addressing substance use and addiction in adolescence, we are inundated with young adults literally fighting for their lives shortly thereafter.
I’m not saying that the approach we’re taking to the opioid crisis is wrong. Rather, it’s incomplete. We need to start the conversation about drug use and addiction at an early age. And no, “just say no” isn’t an acceptable means of prevention. “Just say no” is something that we feel more comfortable doing. We can just check it off the list, say that we “had the conversation,” and be done with it. In order to create change, we have to be OK with getting uncomfortable. This is how we’re going to save these kids lives.
Talk to your families about substance use. If you have a family history of addiction, there’s all the more reason to do this – your children may have a predisposition. Go to prevention programs offered in your community. Most, if not all, are free. Bring your kids with you. Talk about the program on the drive home. Have family dinners once in a while. Bring up any pop-culture or media references to overdose deaths, and listen to their reactions. Reach out and call the school your child attends to find out how they address prevention. Acquaint yourself with the personnel who coordinate it. Introduce your child, too. Research other agencies in your community, and participate or volunteer in their events from time to time.
There are limitless ways that we can make small impacts in our families and our communities. Stigma usually hold us back. Stigma also adds to this crisis. However, if we’re more active in our prevention efforts, not only will we see a reduction in adolescent overdoses, but over time we will not have an opioid epidemic on our hands.