Drug overdoses are now the leading cause of accidental death in the U.S.—doubling between 1999 and 2015. More than car accidents. More than falls. More than homicide. Opioids are the main force behind this epidemic, which affects all ages and communities everywhere.
The American Academy of Pediatrics (AAP) is dedicated to ensuring that families have access to the care that they need, in order to give children the best possible chance at a happy and healthy life. Treating and preventing opioid use disorder will help assure this outcome and—given the opioid epidemic in this country—it is a responsibility we must accept and share together.
What are Opioids?
Opioids are a category of highly addictive narcotic drugs that include prescription pain medicine and illegal substances like heroin. They are products, or synthetic versions, of the opium produced in small amounts by poppy plants. Large doses can slow body's heart and breathing rate to the point of stopping completely.
Killing More than Pain
Opioid overdoses were involved in more than 33,000 deaths in 2015—more than any year on record. Nearly half of all opioid overdose deaths involve a prescription opioid, which can be found in millions of households across the country. In fact, the U.S. consumes the majority of the world's prescription opioid supply.
According to the Centers for Disease Control and Prevention (CDC), there are more opioid prescriptions reported in some states than there are people living in those states.
Commonly Misused Prescription Opioid Drugs in the United States
Oxycodone - Found in brands such as OxyContin, Percocet, Oxecta, and Roxicodone. Kicker is one of the common street names for this drug.
Fentanyl - Including Actiq, Duragesic, Fentora, and Sublimaze. Street names for fentanyl or for fentanyl-laced heroin include Apache, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, Tango, and Cash.
Hydrocodone – Found in Vicodin, Zohydro, Hysingla Co-gesic, Liquicet, Lorcet, Dolacet, Anexsia, Zydone, and Xodol. Vic is a common street name for the pill version. Cough syrup forms have nicknames such as Robo or Tuss.
Codeine, like hydrocodone - Sometimes found in cough syrup form, so it may be called syrup on the street. Brands of acetaminophen, such as Tylenol, that include codeine might be called schoolboy or Cody.
Morphine - Including brands such as AVINza or Kadian. It may be referred to as Mister blue or dreamer.
How Opioids Cause Addiction
Opioids cause a temporary "high" by creating artificial endorphins—hormones normally made in the body to decrease pain. Continued opioid use can make the brain stop producing its own endorphins and build up tolerance. This, in turn, leads people to take increasingly higher doses to feel good and avoid severe, flu-like withdrawal symptoms.
When a prescription runs out, someone who has become addicted to opioids may start buying them from street dealers or turn to another illegal and even more dangerous form—heroin. Studies show four out of five new heroin users started by misusing prescription painkillers. See Prescription Pain Medicine & Heroin: The Link Parents Need to Know for more information.
The Opioid Epidemic's Effect on Children & Teens
Addiction doesn't care. Opioid misuse harms children and teens in many ways. Families may be broken apart when a parent is arrested for buying illegal opioids and goes to jail. Parents who become addicted often neglect to properly care for their children; getting and taking the drug takes over their priorities. Heartbreaking news reports describe tragic examples of babies who died of thirst or starvation, for example, after their parents overdosed.
Prenatal exposure. Federal reports show a fivefold increase in the number of children born with neonatal abstinence syndrome (NAS) since 2000 after opioid exposure during their mother's pregnancy. Facing lengthy hospital stays, babies with NAS are more likely to have low birthweight, respiratory complications, feeding difficulties and seizures, as well as developmental problems that affect learning and behavior.
Poisoning and overdose. Children and teens hospitalized for opioid poisoning tripled between 1997 and 2012. While most of the overdose patients were teens, the largest overall increase in poisonings was among the youngest children—toddlers and preschoolers. A study published in Pediatrics found that children whose mothers are prescribed opioids face a much higher overdose risk compared to children whose mothers received a non-steroidal anti-inflammatory drug, such as ibuprofen, for pain.
What Can Parents Do?
Talk to your kids. Tell your children about how deadly opioid drugs can be. Children who learn about the risks of drugs at home are less likely to use drugs than those who don't. Make sure they know sharing opioids is a felony crime punishable with jail time. Surveys show two-thirds of teens who misuse prescription painkillers got them from friends, family members, and acquaintances.
Safe storage. Keep opioids and other prescription medicine in a secure place. Count and monitor the number of pills you have and lock them up. Ask your friends, family members, and babysitters to do the same.
Dispose leftover prescription medication. Return leftover opioid prescriptions to a hospital, doctor's office, or pharmacy. Many counties now offer "take-back" events to collect unused painkillers. For more information, see Promote Safe Storage and Disposal of Opioids and All Medications.
Talk to your doctor. Discuss alternatives to opioids for pain relief with your doctor. Many people believe taking opioids are the best to treat pain, but recent studies show that non-addictive medicines such as ibuprofen and naproxen can be just as effective. Your doctor may also suggest trying certain complementary and alternative treatments—such as acupuncture—as a first step for treating chronic pain.
Ask for help. If you think you or your child may be misusing opioid drugs or developing addiction, don't hesitate to seek help. The AAP policy statement, Medication-Assisted Treatment of Adolescents with Opioid Use Disorders, outlines how pediatricians can provide medication-assisted treatments to their teen and young adult patients with opioid use disorders or refer them to other providers who can. In another policy statement, the AAP endorses similar treatment for pregnant women addicted to opioids as part of a comprehensive public health approach to the problem.
Know what to do in an overdose emergency. Ask your pediatrician about Naloxone, which can prevent opioid overdose deaths. Always call 911 if you believe someone is experiencing an overdose. Know that Good Samaritan laws provide legal protection to people acting to help someone who has overdosed on illegal drugs.
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