Though the opioid epidemic has been well publicized, the landscape of this epidemic is ever evolving and changing; and ultimately the prevalence of these harmful drugs persists. So how do we support our young people in developing an awareness and understanding of the dangers of opioids? Increased education. It appears that young people are more aware of the dangers surrounding both legal and illegal opioids however it is still concerning that 1.7% of 12th graders are using opioids other than heroin. The good news, that also means that 98.3% of 12th graders are not using these opioids. Better news: 22.9% of eighth graders reported perceiving a “great risk” of opioids other than heroin and 52.9% of 12th graders reported the same [1]. We are making progress but ultimately our goal is for every student to understand:

• If prescribed an opioid, make sure they are educated on how to properly use these medications.
• Make sure they understand the risks that are involved when someone misuses or abuses these medications.
• Make sure that everyone – young or not – understands that any illegally bought medicine can have traces of fentanyl and can have fatal consequences.
• How do we ensure they have the dangers of opioid use continues to improve? Start early and provide age-appropriate information.

Conversations for the Elementary Years may look something like this:

• What is a Drug?
• How do Drugs Impact the Brain and Body? (slow down, speed up or confuse the nervous system)
• Over-the-Counter vs. Prescription Medication
• Always Taken with Adult Supervision
• Why and How to Read the Labels on Medication
• Only Taking Medication that is Prescribed to You

As the discussion becomes more advanced, the conversations in the Middle School Years may focus more on:

• Brain Development – Dramatic Changes During Adolescence
• What is Addiction? What is Withdrawal?
• What is an Opioid?
• Why Would People Use Opioids?

To assist with the above discussion, here is an overview of opioids and the concerns with use.

• Opioids are a very broad class of drugs, mainly used for its pain-relieving effects.
• Sometimes called narcotics or painkillers, they are derived from natural substances found in the opium poppy plant – thus, the name opioids.
• Some opioids are synthetic, where substances are created to mimic the effects of these natural substances.
• There are over 100 different types of opioids – all of which vary between natural, synthetic, and semi-synthetic varieties. Included in the opioid class of drugs are heroin and fentanyl, some of the drugs with the highest addiction and mortality rates.
• Common opioids include medicines such as hydrocodone (common brand include Vicodin), oxycodone (common brands include OxyContin and Percocet), and morphine. Another common opioid is codeine, more commonly known for its use as a cough suppressant. Every single opioid has a sanctioned, legal medical use – except for one. Heroin is the only completely banned opioid and has no legal medical use.

What are the concerns about Opioids?

• The high risk of addiction and overdose, particularly the rise in prescription opioid overdoses. In 2017, over 191 million opioid prescriptions were dispensed to patients in the US [2]. In 2021, it is estimated that 45 people a day died from a prescription opioid overdose [3]. The rate at which doctors prescribe opioids can vary from state to state, but one thing for certain is that more and more Americans are taking opioids legally at a higher rate.
•  The progression from prescription opioid use to heroin use. About 80% of new heroin users in the US report pills as their initiation to opioid use and subsequent Opioid Use Disorder [4]. Many of those who use heroin first started using a prescription form of opioids and then progressed to heroin, regardless of whether that prescription opioid was prescribed by a doctor or used nonmedically.
• The rise of synthetic opioids – specifically, fentanyl. Fentanyl is about 50 times stronger than heroin [3]. Overdose death rates have risen in direct correlation of the rise of fentanyl – including the dramatic rise in overdoses for ages 14-18. Many drugs bought illegally can be contaminated with traces of fentanyl without the user’s knowledge, increasing the chance of accidental overdose.

We can all agree that the first step to tackling this tragic epidemic is education. If we provide age-appropriate information to our young people early and often, they will understand the risks associated with opioids and be able to practice the refusal skills that are critical. There is a light at the end of the tunnel, it’s just urgent that we provide the guidance necessary.

Written by: Daniel Delgado – Health Educator

References:

1. National Institute on Drug Abuse. Most Reported Substance Use among Adolescents Held Steady in 2022 [Internet]. National Institute on Drug Abuse; 2022. Available from: https://nida.nih.gov/news-events/news-releases/2022/12/most-reported-substance-use-among-adolescents-held-steady-in-2022
2. CDC. Prescription Opioids | CDC’s Response to the Opioid Overdose Epidemic | CDC [Internet]. www.cdc.gov. 2021. Available from: https://www.cdc.gov/opioids/basics/prescribed.html
3. Teen Newsletter: Opioids | David J. Sencer CDC Museum | CDC [Internet]. www.cdc.gov. 2023 [cited 2023 Oct 16]. Available from: https://www.cdc.gov/museum/education/newsletter/2022/july/index.html#approach
4. Huecker MR, Azadfard M, Leaming JM. Opioid Addiction [Internet]. Nih.gov. StatPearls Publishing; 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448203/