Parents

Opioids are powerful medications and it is important to learn the facts!

A doctor or dentist may want to prescribe an opioid for your child, perhaps after a sports injury or after wisdom teeth removal. While sometimes these medications are appropriate, it is important to ask questions, know the risks and get the facts.

Research shows that most teens who abuse these pills first got them from a doctor, according to a recent study published in the journal Pediatrics. More specifically, the researchers found that 85 percent of teens abused painkillers before trying heroin.

On average, the painkiller abuse started about two years before heroin use.

Thoughtful prescribing, patient education and alternative pain control methods help reduce the risks of using these prescriptions.

If your child’s doctor or dentist wants to prescribe painkillers:

  1.     Control and monitor the pills. Track doses on a log. Your local health department can also provide you with a locking pill bottle, or you can purchase one at most pharmacies.
  2.     Don’t allow your child to self-administer the pills.
  3.     Ask questions. Learn about the risks, side effects and potential for abuse.
  4.     Ask about non-opioid alternatives.
  5.     Talk with your child about the dangers of misuse.
  6.     Tell your doctor if anyone in your family has a history of substance abuse.
  7.     Ask for the lowest possible dosage for the shortest amount of time possible.
  8.     Ask when your child should stop taking the medication.
  9.     Take any unused medications to a drug drop box (click here for locations). You also can get a drug disposal bag for use at home from your local health department.

 

What do I do if I find out my child is using drugs?

First, sit down and take a deep breath. You don’t need to assume the worst but you do need to act as soon as possible! Here are some tips from the Partnership for Drug-Free Kids:

Talk with your spouse or partner:

Remind each other that no one is to blame.

Agree on a position.

Even if you don’t agree, commit to a unified front.

Pledge not to undermine each other.

Remember to come from a place of love when talking with your child.

Get ready for the ‘hypocrite’ defense:

Your child may ask whether you’ve done drugs. If you have, don’t let that become a justification for your child. Be honest, but let them know you don’t want them using drugs.

Experts disagree on how much information is too much. This is your family, and your child – you know your kid better than anyone. But, most agree dishonesty or lying are not good. Most experts say give an honest answer or none at all.

If you smoke, mention that you are an adult and it is legal but you know you should not. Also mention you want your child to avoid those same mistakes.

Gather evidence:

You may have reservations about ‘snooping,’ but remember your goal is your child’s well-being. If you find things, prepare for possible excuses.

Get ready for anger from your child.

The conversation may get uncomfortable for everyone, but resolve to remain calm no matter what. If things get too heated, end it until later.

Don’t forget to tell your child that you love him or her and that their health and safety are your priority.

Set a goal:

Find a reasonable, small goal, and try not to have unrealistic expectations. Your child may not admit to drug use at first. Set small goals and move toward them one step at a time.

Think about your consequences:

Before you have the talk, think about rules and consequences you’d like to set.

Listen to your teen’s feedback and let him or her help negotiate.

Don’t set rules you cannot or will not enforce.

If you have a history of substance use disorder in your family, discuss that.

Remember: you can never be too safe or speak too soon!

There are many valuable tips online at www.drugfree.org. It may also help to reach out to a trained professional or support group – your healthcare professional or local health department’s addiction program is a good place to start. You also can text IWIK to 71441 for information.

What if my child has a drug dependency?

It takes a lot of courage to seek help for a child with a possible drug problem. The decision is often difficult and sometimes painful.

If you’re ready to seek professional help for your child, the first step is to get your child assessed. An assessment, or screening helps determine the extent of use (if any) and the best pathway for treatment.

Here is a list of places on the Mid-Shore that offer adolescent assessments:

Corsica River Mental Health

Main Number: 410-758-2211

Centreville, Denton, Federalsburg, Cambridge, Easton, Chestertown

Accepts private insurance and medical assistance

Eastern Shore Psychological Services

Easton: 410-822-5007

Chestertown: 443-282-0102/0104

Accepts private insurance and medical assistance

Anne Arundel Counseling

101 Log Canoe Circle Suite C-3, Stevensville

AND

633 Railroad Avenue, Centreville, MD  21617

410-768-5988

Accepts private insurance and medical assistance

The Ross Center

114 Market Street, Suite 103, Denton

615-338-6341

Accepts private insurance and medical assistance

Life’s Energy Wellness Center

8737 Brooks Drive, Easton

443-496-0245

Accepts private insurance and medical assistance

Dorchester County Addictions Program

524 Race Street, Cambridge

410-228-7714

Accepts private insurance and medical assistance

Please bring your child’s social security card, insurance card and proof of income and any related legal paperwork.

If a doctor or other specialist recommends inpatient treatment, insurance may cover a stay. When deciding on a treatment facility, make sure and ask about costs ahead of time. If you need help finding a low-cost option, SAMHSA has a helpline at 1-800-662-HELP.

If your child is NOT insured, please call the following based upon the county in which you live:

Caroline County Health Department: 410-479-8004

Dorchester County: 1-800-332-6347

Kent County Health Department at 410-778-1350 or Kent County Department of Social Services at 410-810-7600

Queen Anne’s County Health Department at 410-758-0720 ext. 4508 or Queen Anne’s County Department of Social Services at 443-515-0084 (Tuesday, Thursday, Friday 9 a.m. until 3 p.m.)

Talbot County Health Department at 410-819-5600

You also may apply for coverage online.

Teens and Medication-Assisted Treatment (MAT)

In August 2016, the American Academy of Pediatrics (AAP) issued a formal policy statement that endorsed the use of medication-assisted treatment (MAT) in adolescents with opioid use disorders.

The statement also cited a shortage of treatment programs that provide MAT to young people.

As with adults, the options for treatment include methadone, buprenorphine (Suboxone) and naltrexone. These medications help relieve cravings and block the effects of opioids.

Here’s a snapshot of each option:

Methadone – Federal law prohibits most methadone programs from admitting anyone younger than 18. In some cases, people ages 16 to 18 can get methadone with documentation of at least two failed treatment attempts. Methadone is a liquid taken orally or tablets and under close supervision.

Patients on methadone should not take benzodiazepines, benzodiazepine receptor agonists or barbiturates.

Buprenorphine – This is FDA-approved in people ages 16 or older, and doctors who have completed eight hours of training can get a waiver to prescribe it.

The FDA has approved the following buprenorphine products:

  • Bunavail (buprenorphine and naloxone) buccal film
  • Suboxone (buprenorphine and naloxone) film
  • Zubsolv (buprenorphine and naloxone) sublingual tablets
  • Buprenorphine-containing transmucosal products for opioid dependency

The FDA DOES NOT recommend Suboxone or Subutex for patients younger than 16.

Patients on methadone should not take benzodiazepines, benzodiazepine receptor agonists or barbiturates.

Adolescent patients who meet the following criteria are considered good candidates for buprenorphine treatment:

  1. Age 16 or older
  2. Meet the criteria for opioid dependence
  3. Two documented, failed prior treatment attempts
  4. At least a 1-year history of opioid dependence

Before treating adolescent patients, verify federal, state, or insurance provider regulations that may require parental consent or notification prior to treatment. More than half of states allow patients under age 18 to consent for their own substance use disorder treatment (i.e. parental consent is NOT required).

Naltrexone (which also helps reduce alcohol cravings) – Talk to your child and his/her healthcare provider about prescription Naltrexone. Naltrexone is a medication used to treat opioid use disorders and alcohol use disorders.  Naltrexone blocks the effects of drugs such as heroin, morphine, and codeine and has limited potential for abuse or diversion. This comes either as tablets (ReVia or Depade) or a once-monthly shot (Vivitrol).  Naltrexone shouldn’t be taken if your child has opioids in his/her body as withdrawal will be severe.

It’s also important to know that if your child is taking naltrexone, they cannot get high from opioids. Sometime people take large amounts of opioids trying to overcome this block, which can cause overdose or death. And if someone stops taking naltrexone then uses opioids, they are at high risk for overdose or death.

Limited evidence exists on the effectiveness and safety of MAT in teens, according to the AAP. In adults, MAT includes not just medication but also therapy and other support, hence the term medication-assisted.

To find the best option for your child, first get an assessment with your doctor, behavioral health provider, or contact your local health department.

Family Support Resources

The Partnership for Drug-Free Kids offers a confidential, one-on-one family support line at 1-855-378-4373. The line is available weekdays 9 a.m. to 5 p.m. with live chat support also available at www.drugfree.org. All communications are free and confidential. The partnership also offers dedicated parent coaching, which provides additional support over the course of about five calls.

Maryland Coalition of Families offers information, resources, one-to-one counseling and family support specialists. Click here for a list of specialists in your area.

Local Family Support Groups

Together: Positive Approaches. Meets the second Wednesday each month from 6 to 7:30 p.m. at Talbot Partnership in Easton. Call 443-545-9927 for info.

Shattering the Silence. Meets the second Wednesday of each month from 6-7:30at Talbot Hospice. For anyone who has lost someone to an overdose, suicide or addiction.

HEART: Healing Everyday And Regaining Trust. Meets the second and fourth Tuesday every month from 6:30 to 9 p.m. at Bay Country Church in Cambridge. Call 443-521-0454.

Family Support Group – meets Tuesdays 6:30 to 7:30 p.m. at Queen Anne’s County Health Department, Nielsen Center in Centreville.  410-758-1306 X4525

RASP: Reconciling After a Substance Passing. For people dealing with the loss of a loved one from drug overdose. Third Thursdays, 6:30 to 8:30 p.m., The Hope & Healing Center, 255 Comet Drive, Centreville. 443-262-4100.

Dri-Dock Family Nights. Meets the third Wednesday each month from 5:30 to 7:30 p.m. in Cambridge. 410-228-3230