What’s in Your Medicine Cabinet?
Kids and teens find opioids through adults' leftovers
The opioid crisis is big news these days. Misuse, abuse, addiction and overdose related to prescription opioids, such as oxycodone or hydrocodone, are epidemic in the U.S. In Oklahoma, the situation is particularly acute. According to a 2016 study prepared for the Oklahoma Department of Mental Health and Substance Abuse Services, more overdose deaths in this state involved hydrocodone or oxycodone than methamphetamines, heroin and cocaine combined. The statistics are alarming, and as they pertain to Oklahoma’s children, they can also be confusing.
Opioid Prescriptions for Adolescents
While there are many things to be proud of in our state, the number of deaths from drug overdose isn’t one. According to the substance abuse study, Oklahoma had the 10th highest overdose rate in the country in 2014, with opioids being the most common class of drugs involved in unintentional overdoses. While 15- 24-year-olds account for a smaller number of those deaths than their older counterparts, Oklahoma leads the nation in non-medical use of painkillers, with nearly 5 percent of the population aged 12 and older abusing or misusing painkillers.
For the most part, kids aren’t obtaining these drugs through legal prescriptions. In fact, outside of specific instances, such as post-operative pain or severe pain caused by conditions such as cancer or a chronic medical condition such as sickle cell anemia, opioid prescriptions for children are not that common.
“Honestly, we prescribe vanishingly little of the types of medicines that have become problematic, especially if you think about particularly problematic medicines like oxycodone and these new super long-release opioids,” said Dr. Don Zetik, a Tulsa pediatrician.
While Dr. Zetik notes that any sort of narcotic use can segue towards abuse, dependence or addiction, properly prescribed medications for adolescents are usually not the source of the problem.
“We pay closer attention to them, and we’re very cautious. These are not the scenarios that should provoke anxiety for families, and they’re not the scenarios out of which the opioid epidemic has grown,” Dr. Zetik noted. “I think, as a medical profession, we’re more highly attuned to keeping those doses low and duration limited, and we’re very wary of the longer acting opioid medications, particularly when it come to children.”
Unfortunately, the relatively low number of legal prescriptions written for adolescents doesn’t eliminate their access to opioids and the potential for abuse. For some kids, it’s a matter of simply opening a medicine cabinet. Adults often save their unused prescription painkillers “in case they need them later,” and this can be a problem. According to the study, most people who use prescription painkillers non-medically report getting their drugs from friends or family members.
“If you were going to do anything to try to help the problem, get them out of your drug cabinet because someone else can find them. Someone else can use them,” Zetik noted. “Maybe not your family member, but someone who’s visiting your house and decides to peruse the drug cabinet.”
The Oklahoma Bureau of Narcotics & Dangerous Drugs Control provides information about Disposal Boxes around the state, and www.takeasprescribed.org has disposal tips, too.
The profound consequences of opioid addiction and abuse aren’t just limited to the users. According to a 2016 Harvard study, an estimated one in five children in the U.S. grows up in a home in which someone has a substance use disorder. Children in these environments are subject to everything from increased risk of physical, sexual and emotional abuse to developmental and educational delays, and a greater likelihood of having their own abuse issues later in life.
“As far as young children go, they become collateral damage because of addicted or abusing adults,” Zetik commented. “They cease to be effective caregivers as addicts.”
Reports from across the U.S. suggest the opioid crisis is overwhelming the nation’s foster care systems, with more children being removed from homes with addicted caregivers. A 2017 article in Mother Jones magazine reported an 8 percent increase from 2011 to 2015 in the number of children in foster care at the same time federal funding for these children decreased by two percent. While exact data is hard to obtain, anecdotally, child welfare workers across the country attribute much of that increase to opioid addiction.
Hard data on deaths as a result of unintentional prescription opioid overdose in Oklahoma exists, however, with adults 45-54 years old most likely to die of such an overdose, followed closely by those in the 35-44 year-old range. Behind those statistics are increasing numbers of adolescents who have lost one or both parents (and countless caregivers) to this epidemic.
While Oklahoma has taken measures to gain control of the growing epidemic, it’s clear a real crisis exists. It’s a multi-faceted problem that impacts Oklahoma’s kids in multiple ways. Although legal prescriptions of opioids for children tend to be limited and carefully controlled, kids continue to have access to these painkillers, inadvertently and intentionally, through family and friends, in the form of unused prescription medications. In addition, adults with opioid abuse and addiction issues are incapable of providing adequate, safe care to their own offspring or those in their charge, resulting in myriad social, health and emotional problems for our state’s younger population. For more information, visit the Oklahoma Department of Mental Health and Substance Abuse Services at www.ok.gov/odmhsas.