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Parent’s Guide to Understanding Teen Opioid Use

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT Meet The Team >

As a parent, witnessing your teen grapple with adolescence can be challenging, especially when it comes to substance use. Unfortunately, the increasing prevalence of teen opioid addiction is a critical issue that demands attention and understanding. 

At Evolve, we’re here to educate and support you. If you suspect that your child is using opioids, this guide aims to provide you with comprehensive insights into opioid abuse, its signs, risks, and the available treatments.

Teen Opioid Use

What Are Opioids?

Opioids are a class of drugs that are derived from the opium poppy plant, or synthetically manufactured. Opioid treatments are typically used for pain relief but are also known for their high potential for dependency and abuse. Opioids bind to receptors in the brain, releasing dopamine and creating feelings of euphoria. Common prescription opioids include tramadol and oxycodone, while heroin is a well-known illegal opioid.

Common Street Names for Opioids

Awareness of opioid street names can help you identify your teen’s potential drug abuse. It’s crucial to recognize these terms to better understand conversations your teen might be having. 

Common names include:

  • “Oxy”
  • “Percs”
  • “Vikes”
  • “Hillbilly Heroin”
  • “Blues”
  • “Norco”
  • “Dillies”
  • “Demmies”
  • “Juice”
  • “China White”

Drugs That Are Considered Opioids

Understanding the various types of opioids and their intended uses is crucial, especially given the risks associated with their misuse. While they are effective in medical settings for pain relief, the potential for abuse and addiction highlights the importance of careful monitoring and responsible use.Here’s a closer look at the types of drugs that are considered opioids:

Natural Opiates: These are directly derived from the opium poppy. Examples include morphine and codeine. Morphine is often used in hospitals for severe pain relief, while codeine is commonly found in prescription cough syrups and milder pain relief medications.

Semi-Synthetic Opioids: These are synthesized from natural opiates. Heroin, oxycodone (often known by brand names like OxyContin or Percocet), hydrocodone (Vicodin, Norco), and hydromorphone (Dilaudid) fall into this category. Heroin, an illegal drug, is known for its high potential for addiction and is often used recreationally for its euphoric effects.

Fully Synthetic Opioids: These are completely manufactured in a lab and include drugs like fentanyl, methadone, and tramadol opioid. Fentanyl is particularly potent, often used in medical settings for severe pain but also found illicitly on the streets. Methadone is commonly used in the treatment of heroin addiction, and tramadol is prescribed for moderate pain.

Meperidine: Known by its brand name Demerol, this synthetic opioid is used for moderate to severe pain. It’s less common than other opioids, but still carries a risk of dependence and abuse.

Buprenorphine: Often used in opioid use disorder medication, buprenorphine (found in products like Suboxone) is a partial opioid agonist. It can help reduce cravings and withdrawal symptoms in individuals addicted to other opioids.

Carfentanil: This is an extremely potent synthetic opioid, used primarily as a tranquilizer for large animals like elephants. Even a tiny amount can be lethal for humans and it’s not used medically for humans due to its high potency and risk.

Symptoms & Signs of Opioid Abuse

Opioid abuse can manifest in physical and behavioral symptoms. Some of these can be easily observed, while others might be more subtle. Understanding these signs can help in early identification and intervention. Here are some common symptoms and signs of opioid abuse:

  • Pinpoint Pupils: One of the most noticeable signs of opioid use is the constriction of pupils to a very small size, often referred to as pinpoint pupils. This reaction is due to the way opioids interact with the nervous system.
  • Drowsiness: Individuals abusing opioids often appear unusually sleepy or lethargic. This drowsiness is a result of the depressant effects opioids have on the central nervous system.
  • Slurred Speech: Opioid abuse can lead to impaired motor skills and cognitive functions, often evident in slurred or slow speech. This symptom reflects the drug’s impact on the brain’s speech centers.
  • Constipation: Opioids can significantly slow down the digestive system, leading to constipation. This is a common side effect even in prescribed use but can be more pronounced with abuse.
  • Nausea and Vomiting: Regular use of opioids can disrupt the gastrointestinal system, leading to feelings of nausea or instances of vomiting, especially in higher doses or during misuse.
  • Shallow Breathing: Opioids depress respiratory function, which can result in shallow or slow breathing. This is a particularly dangerous symptom as it can lead to hypoxia or, in severe cases, respiratory failure.
  • Itching or Flushed Skin: Users may experience itching or notice flushed skin. This is due to histamine release caused by opioids, leading to these allergic-like reactions.
  • Mood Swings: Abrupt and unexplained changes in mood can be a sign of opioid abuse. Users may swing between euphoria (while under the influence) and irritability or depression (as the effects wear off).
  • Social Withdrawal: A person abusing opioids may withdraw from social interactions and activities they previously enjoyed. This change often aligns with a growing focus on obtaining and using the drug.
  • Poor Coordination: Impaired physical coordination, such as difficulty walking or handling objects, is common. This lack of coordination is due to the drug’s impact on the brain areas controlling motor skills.

Recognizing these signs is crucial in identifying potential opioid abuse. If you notice these symptoms in your teen, it’s important to approach the situation with empathy and seek professional help.

Risks of Using Opioids

Opioid use, especially in teens, can lead to serious risks that can impact both physical and mental health. Here’s a detailed look at these risks:

  • Addiction: Opioids have a high potential for addiction, even after short-term use. Teens are particularly susceptible as their brains are still developing, making them more prone to addictive behaviors.
  • Overdose: The risk of overdose is a severe danger of opioid abuse. Overdosing on opioids can be fatal, especially when combined with other substances like alcohol or benzodiazepines.
  • Respiratory Depression: Opioids can significantly slow down breathing, which in extreme cases can lead to hypoxia (lack of oxygen to the brain), resulting in long-term neurological damage or death.
  • Physical Dependence: Regular use of opioids can lead to physical dependence, where the body requires the drug to function normally. Stopping or reducing the drug can lead to severe withdrawal symptoms.
  • Tolerance: Over time, the body becomes tolerant to opioids, necessitating higher doses to achieve the same effects. This increases the risk of overdose and other health complications.
  • Withdrawal Symptoms: Symptoms of opioid withdrawal can be painful and distressing, including muscle aches, anxiety, insomnia, sweating, nausea, and diarrhea.
  • Increased Risk of Accidents: Impaired motor skills and sedation from opioid use increase the risk of accidents, such as falls or car crashes, particularly if the teen is driving while under the influence.
  • Cognitive Impairment: Chronic opioid use can impair cognitive functions, affecting memory, attention, and decision-making skills. This can have a significant impact on a teen’s academic performance and future opportunities.
  • Gastrointestinal Issues: Opioids can cause various gastrointestinal problems, such as constipation, nausea, and vomiting, which can lead to further health complications if not properly managed.
  • Sedation: Opioids often cause drowsiness and sedation. This can affect a teen’s ability to participate in daily activities, including school and social interactions, and can increase the risk of accidents.
Side Effects of Opioid Drugs in Teens

Side Effects of Opioid Drugs in Teens

Opioid drugs, whether prescribed or used illicitly, can have a range of side effects on teenagers, with both short-term and long-term impacts. Here’s a breakdown:

Short-Term Effects

  • Pain Relief: Initially, opioids are effective in reducing pain, which is their primary medical use.
  • Euphoria: Opioids can produce feelings of intense happiness or pleasure, a sensation often sought after by those misusing these drugs.
  • Drowsiness and Sedation: Teens may experience significant drowsiness or sedation, affecting their ability to stay awake or focus.
  • Nausea and Vomiting: Opioids can upset the gastrointestinal system, leading to nausea and sometimes vomiting.
  • Constipation: A common side effect, constipation occurs due to the slowing down of the digestive system.
  • Respiratory Depression: Opioids can slow breathing, which can be dangerous, particularly at high doses.
  • Confusion and Poor Judgment: Teens may exhibit confusion and impaired decision-making skills, which can lead to risky behaviors.
  • Itching and Flushed Skin: Some teens might experience itching or flushed skin as a reaction to opioids.
  • Pinpoint Pupils: This is a physical sign of opioid use, where the pupils become unusually small.

Long-Term Effects

  • Addiction and Dependence: Over time, teens can develop an addiction to opioids, characterized by a compulsive need to use the drug and dependence where the body relies on the drug to function.
  • Tolerance: As the body becomes accustomed to the drug, higher doses are needed to achieve the same effects, leading to a greater risk of overdose.
  • Withdrawal Symptoms: Long-term use can lead to severe withdrawal symptoms when the drug use is reduced or stopped, including pain, insomnia, and severe mood swings.
  • Cognitive Impairment: Prolonged opioid use can affect cognitive functions like memory, attention, and decision-making.
  • Mental Health Issues: Chronic opioid use is associated with an increased risk of depression, anxiety, and other mental health disorders.
  • Physical Health Decline: Long-term use can lead to a general decline in physical health, including weakened immune system and potential liver or heart damage.
  • Social and Behavioral Changes: Teens may withdraw from social activities, lose interest in hobbies, and face difficulties in maintaining relationships and academic performance.
  • Increased Risk of Involvement in Criminal Activities: To support their addiction, some teens might engage in illegal activities such as theft or selling drugs.

The short-term and long-term side effects of opioid use in teens are serious and multifaceted, affecting their physical health, mental well-being, social life, and future prospects. Awareness and early intervention are key to preventing and treating opioid misuse in teenagers.

mom talking to sad teenaged daughter

How To Talk To Your Teen About The Dangers Of Opioids

Talking to your teen about the dangers of opioids requires a thoughtful, informed approach. Here’s our step-by-step guide to having this important conversation:

  • Educate Yourself First: Before initiating the conversation, educate yourself about opioids—their effects, risks, and the signs of abuse. This knowledge will make you more confident and credible.
  • Choose the Right Time and Place: Select a calm, private setting where you won’t be interrupted. Ensure both you and your teen are in a relaxed and open state of mind.
  • Be Open and Honest: Start the conversation with honesty and openness. Let your teen know your concerns come from a place of love and care.
  • Use Age-Appropriate Language: Tailor your language to suit your teen’s age and understanding. Avoid overly technical terms if they’re not necessary.
  • Discuss the Risks: Clearly explain the risks associated with opioid use, including addiction, health problems, and impacts on life goals and relationships.
  • Encourage Questions: Give your teen the space to ask questions and express their thoughts. It’s important they feel heard and that it’s a two-way conversation.
  • Listen Actively: Pay close attention to what your teen says and respond with empathy. Avoid dismissing or minimizing their feelings or opinions.
  • Avoid Scare Tactics: While it’s important to convey seriousness, avoid using fear as the primary motivator. Focus on facts and real-life consequences rather than exaggerated scenarios.
  • Highlight the Importance of Choices: Emphasize the power of making informed choices and the importance of thinking critically about peer pressure and media influences.
  • Discuss Ways to Say No: Equip your teen with strategies to refuse drugs. Role-playing scenarios can be an effective way to practice these skills.
  • Share Resources: Provide resources for further reading or help, such as websites, hotlines, or books that can offer more information. Educate them on Narcan, and how it can save lives. 
  • Keep the Dialogue Open: Make it clear that this conversation is not a one-off event. Encourage ongoing communication and let them know they can always come to you with questions or concerns.

Remember, your goal is to create an environment of trust and understanding. It’s not just about warning them of the dangers, but also about building a relationship where they feel comfortable discussing difficult topics with you.

Spotting Red Flags: Signs My Teenager is Using Opioids

Identifying early warning signs that your teen might be using opioids is crucial for intervening before the situation escalates. It’s important to remember that some of these signs can also be typical teenage behaviors or indicative of other issues not related to drug use. The key is to look for drastic, unexplained changes in behavior or multiple signs occurring simultaneously.

Here are some key indicators:

  • Changes in Physical Health:
    • Pinpoint Pupils: Opioids cause pupils to constrict, leading to noticeably small pupils.
    • Sudden Weight Loss: Unexplained weight loss can be a sign of drug use.
    • Frequent Flu-like Symptoms: Symptoms like nausea, vomiting, sweating, and shaking without an apparent illness could indicate withdrawal.
  • Behavioral Changes:
    • Loss of Interest in Activities: A sudden lack of interest in hobbies or activities they once enjoyed.
    • Decreased Motivation: A noticeable drop in energy levels or motivation, often seeming lethargic or indifferent.
    • Secretive Behavior: Being more secretive or deceptive, or a sudden need for privacy.
  • Mood Swings and Personality Changes:
    • Irritability or Agitation: Uncharacteristic irritability, moodiness, or aggression.
    • Changes in Personality: Shifts in personality traits or overall demeanor.
    • Depression or Anxiety: Signs of depression, anxiety, or other mental health changes.
  • Social Changes:
    • New Friends: Abruptly changing their friend group, especially if the new friends are unknown or seem to encourage risky behavior.
    • Social Withdrawal: Withdrawing from family and long-time friends.
    • Avoiding Eye Contact: Consistently avoiding eye contact could indicate they’re hiding something.
  • Academic or Professional Issues:
    • Declining Grades: A significant drop in academic performance or school engagement.
    • Skipping School or Work: Increased absenteeism or tardiness.
  • Physical Evidence:
    • Finding Drug Paraphernalia: Discovering items like pills, unknown prescription bottles, or drug paraphernalia in their room or belongings.
    • Unexplained Disappearance of Medications: Prescription medications, especially painkillers, going missing from the home.
  • Changes in Sleep Patterns:
    • Excessive Sleeping: Sleeping more than usual or at odd hours.
    • Insomnia: Difficulty sleeping or disrupted sleep patterns.
  • Financial Irregularities:
    • Unexplained Expenses: Money disappearing or unexplained requests for money.
    • Stealing Money or Valuables: Instances of money or valuables missing from the home.

Preventing Your Teen From Using Opioids

Maybe your teen hasn’t started using, but you’re concerned that they might. Preventing your teen from using opioids involves a combination of education, communication, vigilance, and creating a supportive environment. Here are some steps you can take:

  • Educate Yourself and Your Teen: Learn about opioids, their effects, risks, and the signs of misuse. Share this information with your teen in an age-appropriate manner. Emphasize the dangers of opioid abuse, including addiction and overdose.
  • Open Communication: Foster open and honest communication with your teen. Create a safe space where they feel comfortable sharing their feelings and concerns without fear of judgment or harsh consequences.
  • Discuss Peer Pressure: Talk about peer pressure and ways to handle it. Teach your teen to be assertive and practice ways to say “no” in uncomfortable situations.
  • Set Clear Expectations and Boundaries: Be clear about your expectations regarding drug use. Discuss the consequences of breaking these rules but ensure they are fair and consistent.
  • Monitor Prescription Use: If your teen is prescribed opioids for pain, closely monitor their use. Talk to their doctor about alternatives and the lowest effective dose for the shortest period.
  • Be a Good Role Model: Exhibit healthy behaviors and coping strategies yourself. Avoid misuse of substances, including prescription medications and alcohol.
  • Know Their World: Be involved in your teen’s life. Know their friends, where they go, and what they do in their free time. This isn’t about invasion of privacy but about showing interest and care.
  • Promote Healthy Activities: Encourage participation in sports, hobbies, or other engaging activities. Teens who are involved in positive activities are less likely to turn to drugs.
  • Strengthen Emotional Support: Ensure your teen feels emotionally supported. Be attentive to signs of stress, depression, or anxiety, and seek professional help if necessary.
  • School and Community Resources: Utilize resources available in schools and communities, such as drug education programs, counseling services, and extracurricular activities.
  • Regular Check-ins: Have regular, casual check-ins to talk about their life and feelings. This keeps the lines of communication open and can help you spot any troubling changes.
  • Build a Strong Support Network: Encourage relationships with family members, mentors, and peers who positively influence your teen.

Remember, prevention is not just about stopping drug use before it starts; it’s also about guiding your teen to make healthy choices and providing support and guidance as they navigate their teenage years.

How To Seek Help For Your Teen Facing Addiction From Opioid Use

If you suspect your teen is struggling with opioid use, it’s crucial to seek professional help immediately. At Evolve, we offer specialized treatment for teens struggling with substance abuse and dual diagnosis. Remember, early intervention can lead to effective recovery and a brighter future for your teen. Reach out to us today to discuss next steps, logistics, insurance, and any concerns you may have. You’re not alone in this journey, and help is available.

Frequently Asked Questions (FAQs) About Teen Opioid Use 

Why do teenagers use opioids?

Teenagers may use opioids to manage pain or seek euphoric feelings. They’re often unaware of the addictive potential of these drugs.

Are prescription opioids safe for teenagers?

Prescription opioids can be safe for teenagers when used as directed by a healthcare professional, but misuse increases the risk of addiction and adverse effects.

How prevalent is opioid use among teenagers?

Opioid use among teenagers is a growing concern, with increasing instances of misuse and addiction to both prescription and illicit opioids.

What should parents do if they suspect their teen is using opioids?

If parents suspect their teen is using opioids, they should openly communicate their concerns, observe for further signs, and seek professional medical and psychological support.

Are all opioids illegal?

Not all opioids are illegal; many, such as tramadol and oxycodone, are legally prescribed for pain management but can be abused.

What role does peer pressure play in teen opioid use?

Peer pressure can significantly influence teen opioid use, as teenagers may feel compelled to use opioids to fit in or be accepted by their peers.

Can using opioids lead to other substance abuse issues?

Using opioids can indeed lead to other substance abuse issues, as it may increase the likelihood of experimenting with or becoming dependent on other drugs.

Is treatment available for teenagers struggling with opioid addiction?

Treatment for teenagers struggling with opioid addiction is available and includes therapy, medication treatment, and support from specialized programs.

How can schools address the opioid epidemic among teenagers?

Schools can address the opioid epidemic by implementing drug education programs, providing resources for students, and fostering an environment where students can seek help without stigma.

Are there specific risk factors for teen opioid abuse?

Specific risk factors for teen opioid abuse include a family history of substance abuse, exposure to high-risk environments, mental health issues, and peer pressure.

What signs of opioid use may be visible in a teen’s academic performance?

Signs of opioid use affecting a teen’s academic performance can include a noticeable drop in grades, lack of interest in school activities, and increased absenteeism.

Can occasional use of opioids be safe for teens?

Not unless it’s prescribed by a doctor. Even  infrequent use can lead to addiction and other serious health risks.

What resources are available for parents dealing with teen opioid use?

Resources for parents dealing with teen opioid use include support groups, counseling services, addiction treatment programs, and educational materials from health organizations.

Can opioids prescribed for pain management lead to addiction in teens?

Opioids prescribed for pain management can lead to addiction in teens, especially if used improperly or without close medical supervision.

What role does social media play in teen opioid use?

Social media can play a role in teen opioid use by exposing teens to drug use normalization, misinformation about drugs, and peer sharing of drug experiences.

How can parents differentiate between experimentation and a serious issue with opioids?

Parents can differentiate between experimentation and a serious issue with opioids by monitoring the frequency, behavior changes, and physical signs of drug use, and seeking professional assessment if concerned.

How can parents address opioid use if their teen is already using other substances?

Parents should address opioid use in a teen already using other substances by seeking professional help immediately, as polydrug use increases the risks and complexity of treatment.

Is there a link between opioid use and risky behaviors, such as driving under the influence, in teens?

There is a link between opioid use and risky behaviors in teens; opioid use can impair judgment and increase the likelihood of engaging in dangerous activities like driving under the influence.

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