Daniel just had his wisdom teeth removed. His cheeks were as swollen as a chipmunk, and he could barely open his mouth because of the pain. As soon as he started taking the Vicodin that the dentist prescribed, things got better. It was a blessed relief that the pain went away. He felt like he was floating on clouds. A week later, the pain was completely gone, but he had half of the opioid medication leftover. He kept it, on the off chance that he or a family member might need some in the future. 

Opioid addiction often starts with a scenario like just like that.

How Prescription Painkillers Lead to Addiction

It all begins with a prescription for pain medication. After a teen has an injury or a dental procedure, the pain can be debilitating. The opioids prescribed—hydrocodone, oxycodone, morphine, and codeine—are welcome reprieves from the agony. Vicodin, OxyContin, Percocet, Kadian… their brand names are well known by now. The opioids block the brain’s sensation of pain, so many teens (and adults) find the euphoric effects to be a huge relief.

However, they work so well, that many teens can’t bear parting ways. Some teens will keep taking their medication even after their pain is gone. They have half a bottle left, and the opioids make them feel so good…it would be a waste to throw it away, they think. They’ll self-medicate minor aches. They’ll also share them with family members and friends who complain about pain. By now, they’ve become big fans of their medication.

When it’s all done, they’ll start itching to get more. Mom having surgery, or sister broke her leg? They’ll “borrow” a few Oxycontin. Grandpa taking Vicodin? They’ll ask for some, or just steal it from their medicine cabinet. Family members have stopped taking them, or have caught on? They’ll start buying the pills off a friend at school…or from a dealer. At this point, their dependence has become so all-consuming that they need to take the drugs just to not feel sick.

But then money gets in the way. It can get super expensive to feed an opioid habit in the drug world. For example, on the street, Oxycontin can be “more expensive than the price of gold.” Many teens don’t have that steady supply of money. Plus, prescription painkillers are hard to obtain in the drug world.

So then they find out about heroin, from either their friends or a dealer. Heroin is easier to get in the black market. It’s a faster high, and it’s much cheaper than prescription painkillers.

And once a teen starts with heroin, it’s all downhill from there.

Effects of Heroin

Heroin’s extremely addictive nature makes it impossible to stop using without going into extreme withdrawal. Addicted teens will do anything to get the drug. They’ll steal, beg, and put themselves in risky situations for heroin. Going for a day without it will feel terrible and all-consuming, so their entire day is devoted to seeking and taking heroin. If they started snorting or smoking it, they’ll just inject it to get a faster, more powerful high. But injecting heroin comes with its own additional risks, like infections and overdose.

Using heroin leads to impaired cognition, impaired mental faculties, and slowed breathing, which can cause coma. It will damage your teen’s brain, heart, lungs, kidneys, liver, immune system, digestive system, and endocrine system. It also leads to mental health issues.

Heroin use accounts for thousands of young deaths a year. In 2017, opioid overdose caused more than 3,400 deaths of youth ages 15-24 (National Institute of Drug Abuse).

Prescription Opioids: How to Keep Your Teen Safe

If your teen’s doctor is recommending opioids, ask whether you can start out with weaker medication first. For example, Acetaminophen (found in Tylenol) is usually the first line of defense against pain. NSAIDs are also useful for minor aches and pains. (Some examples of NSAIDs include naproxen, ibuprofen, and aspirin.) Of course, if your doctor feels that your teen needs stronger narcotics, follow professional advice – and these guidelines:

• Keep the medication locked up, away from all children and teens. Dispense the medication yourself to make sure it is not overused in dose or frequency.
• Ensure your teen only takes the drug as directed. Opioids should never be crushed. Some teens abuse opioids by crushing them to snort or inject them, which overcomes the slow-release mechanism and allows the drug to be absorbed faster. This can lead to overdose and death. According to the FDA, the most commonly abused narcotics include codeine, Oxycontin, Vicodin, and Demerol.
• Tell your doctor if your teen has a hostory of drug abuse.
• Get rid of the medicine when the pain is gone. Flush it down the toilet. Make sure you are not letting your teen take the drug for longer than prescribed.
• Do not take opioids with benzodiazepines (anti-anxiety medicine) or alcohol. Combined, these substances cause breathing to be slowed to a dangerous level. Make sure your teen isn’t drinking or taking benzos while on painkillers.

Prescription Opioids: The Statistics

Washington State recently developed Guidelines on Prescribing Opioids for Pain Management. This fascinating read gives you a behind-the-scenes look at what healthcare professionals are doing to mitigate adolescent access to prescription opioids. While the data is geared towards dentists, the booklet contains two important statistics:

• The majority of new heroin users start out with prescribed opioids. (Cicero, 2014)
• Adolescents in high school who receive an opioid prescription are 33% more likely than those who do not receive a prescription to misuse opioids in the future. (Miech, 2015)

Is Your Teen Addicted to Prescription Opiates or Heroin?

If your teen is addicted to prescription painkillers or heroin, you need to get them into an adolescent drug rehabilitation program immediately. Depending on the severity of their addiction, your teen may need a residential treatment center (RTC), partial hospitalization program (PHP), or intensive outpatient program (IOP). If your teen also has mental health issues, they need a dual-diagnosis treatment center. A substance abuse treatment center can help them detox safely and teach them how to achieve recovery from addiction. It will also treat the underlying issues of their addictive behavior and teach them coping skills to move forward in life.