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Opioid Pain Relievers: Protecting Our Children

August 28, 2015  |  Falmouth Enterprise

Dr. Michael Bihari

This is the fourth in a series of articles about opioid painkillers. Although opiate overdoses (especially heroin) are frequently in the news, how much do you actually know about these medications and how they are used to manage acute and chronic pain? 

Pain is the most common reason people seek medical treatment. In fact, 100 million Americans have chronic pain and many are treated with opioid painkillers, some for long periods of time. 

Teens who abuse prescription pain medications may start in one of two ways. Some teens begin abusing an opioid drug at a party or when offered by friends because they are curious or think it will make them look cool and feel good. Other teens and young adults may start using a painkiller legitimately when it is prescribed by a physician after an injury or by a dentist following a dental procedure, such as an extraction of a “wisdom” tooth. Occasionally, legitimate use turns to drug dependence, opiate pill addiction and then heroin use. 

Prescription Proof Your Home

Interestingly, many people who are given a prescription for a painkiller in an acute situation (after a surgical procedure or accident) do not use all their medication. In a medical study about opioid prescribing, 275 patients were surveyed two to four weeks after having a surgical procedure. Of these patients:

  • 63% received a prescription for a painkiller containing hydrocodone (Vicodin) 
  • 67% had leftover medication
  • 92% received no disposal instructions
  • 91% kept the extra medication at home

These leftover pills can easily find their way into the hands of teenagers; besides being illegal, prescription pill abuse is highly dangerous. Yet 1 in 6 teens will abuse a prescription pain reliever such as Oxycontin, Vicodin, or Percocet. So, who is supplying our kids with prescription medications? We are – almost 70% of teens who report abuse of prescription medicine are getting it from friends, family and acquaintances.

Prescription pain medications are highly addictive. Over time, a teen may develop tolerance to the “pleasant” effects of these drugs, resulting in the need to take more and more to get the same feelings. Teens who become addicted to opioids and stop them suddenly may go through withdrawal, an extremely unpleasant physical experience of intense restlessness, muscle and bone pain, insomnia, diarrhea, vomiting and cold flashes.

Taking too many opioids can cause an overdose; breathing slows down and eventually stops, and death may occur. Time-released (long-acting) pain medications that were developed to deliver pain-relieving medication into the system slowly over hours, are often crushed and snorted, causing the drug to enter the system all at once, sometimes resulting in death. Prescription painkillers are also a gateway to heroin use.

Prescription-proofing your home is an essential part of preventing teen prescription pill abuse. Here are three simple steps you can take:

SECURE: All medications should be safely stored in a medication lock box or placed where your teen or a younger child cannot access them.

MONITOR: It is important to know what medications you have at home and to regularly monitor to assure that no pills are missing. 

DISPOSE: Properly dispose of your unused or expired medication. The best way is to use the kiosk in the lobby of the Falmouth Police Department on Main Street. It is available 24/7 and is anonymous.

Talking to your kids about prescription drug abuse is also very important. There is no guarantee that your teen won’t use drugs, but drug use is much less likely to happen if you:

  • Provide guidance and clear rules.
  • Spend time with your child.
  • Do not use tobacco or other drugs yourself and, if you drink, do so in moderation, and never drive after drinking.
  • Help your child make good choices and good friends.
  • Teach your child different ways to say “No!”

When an Opioid Prescription Is Written for Your Child

Your teen may be prescribed a prescription painkiller to treat moderate-to-severe pain after surgery, a sports injury or a dental procedure. Be aware that dentists are the main prescriber of prescription pain medications for youth aged 10-19 years old. If your child is prescribed an opioid pain reliever, it’s very important for you to monitor appropriate use and disposal of unused medication.

The following anecdotes are examples of what happens all too often. These stories were related to me by parents of a young adult and have been written about in previous Risky Business articles.

Andrew, a 19 year old boy starting his freshman year at a large university developed a toothache and went to the dental clinic at the school’s student health center. After a wisdom tooth was pulled, the dentist gave him a 5-day supply of Vicodin. He was not given any information on other things he could do to relieve any pain and no instructions on what to do with a bottle of narcotics in a dorm filled with teenagers. He called his parents who advised him not to fill the prescription and to use over-the-counter medications. He had some mild aching in his jaw for several days, which did not interfere with his college activities.

Maggie, an 18 year old girl went to a local emergency room after falling off her bike. Although she had no broken bones or lacerations that required stitches, she did have several bruises and a sprained ankle. The physician suggested that she wear an ankle brace and take Percocet for her pain. The young woman (and her mother) said that she would not need the prescription and would take over-the-counter pain medications instead. The physician insisted that she would need the medication. When she refused again, the physician seemed annoyed and left the room. When she left the emergency room, a prescription for Percocet was waiting for her. She did not fill it, and used a cool pack and an over-the-counter painkiller.

Jason, a college sophomore, suffered a serious sports injury that required several surgical procedures. Throughout the long healing process at home his surgeon prescribed Oxycontin, a strong prescription painkiller. After six weeks of taking the painkillers, Jason noticed that the pills did not work as well or last as long. He began taking more pills than were prescribed by his surgeon. Jason quickly ran out of his painkillers and began stealing pills from his grandmother's house where she kept her medications in a basket on her kitchen counter, and then from a friend's medicine cabinet.  

Jason asked both his surgeon and his primary care physician (PCP) for more painkillers, but they refused. Jason's PCP recommended that he use a non-narcotic pain reliever. Jason could not find enough opioids and began to suffer from withdrawal. One of his college friends said he was not able to "score" any prescription painkillers but could get heroin. Jason never thought that he would use heroin, but felt desperate to stop the withdrawal symptoms. He started snorting heroin and then injecting it. 

These examples highlight the need for parents to be vigilant about the appropriate use of prescription painkillers. If your teen needs to use one of these medications make sure that you know for how long and what your healthcare provider’s plan is for switching to a pain-relief medication or type of therapy that is not addictive.

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