The opioid epidemic is currently killing tens of thousands of people every year, and the majority of opioid-related fatalities are people under the age of 19. Some responsibility for the current crisis — which the U.S. Department of Health and Human Services declared a public health emergency as of 2017 — can be assigned to pharmaceutical companies and healthcare providers that have been prescribing opioids more freely since the 1990s. But there are other root causes contributing to the escalation of this crisis among young people, and that is where attention should be focused to prevent drugs from further dictating the health and lifespan of future generations.
Efforts to combat the opioid crisis have traditionally been concentrated on:
- Addressing poor education and misinformation about opioids
- Law enforcement
- Stopping the illegal flow of the drugs into the country
This approach has been insufficient because none of these strategies focus on the underlying issues that cause pre-teens and teens to use these substances in the first place. As long as these pre-existing conditions are left untreated or improperly treated, opioid addiction and its consequences will remain a threat to the lives and well-being of young people and their families. Treating opiate dependence and mental health symptoms — and addiction is a symptom — instead of addressing the real epidemic behind the opioid crisis is little more than a societal Band-Aid doomed to fail.
The Real Epidemic: Unaddressed Mental Health Issues
The real epidemic faced by adolescents is a combination of loneliness, isolation, anxiety and fear that causes extreme emotional distress. A breakdown in family structure and societal support systems has created an environment ripe for drug abuse. Examples of environmental instability and uncertainty contributing to this problem include:
- Broken families and absent parents or caregivers
- Too much screen time, leaving children inundated by alarmist messaging
- Lack of purpose or strong sense of identity rooted in reality
- Little or no sense of community in neighborhoods or larger surrounding areas to foster beneficial relationships
- Lack of faith or hope due to no connection with a church or other community support group or program
Previous generations that had some or all of the above-listed support systems sometimes turned to drugs for short-term recreational purposes. Children from the 1980s to today, however, have increasingly sought drugs like opiates as a means for long-term self-medicating or escape from environmental and mental health problems.
Young Adults Battling Drug Abuse Feel Alone, Unheard and Hopeless
All ages or backgrounds of people suffering from or struggling with addiction often experience feeling further isolated in an already isolating world, but that feeling of separation seems to take a more significant emotional toll on young adults. Most parents and guardians try to do their best with the limited time, resources, and knowledge they have. But many have been misguided in taking a tough approach.
Unfortunately, this approach typically backfires. It is often perceived by young adults as proof of not being understood — that their misguided cries for help are still heard — which creates an even greater disconnect and feeling of loneliness. These kids already feel like misfits in a world that seems to have no place for them, and the tough-love approach reinforces that to a degree, sabotaging any motivation on their part to stop using drugs and causing their self-esteem to plummet. At this low point, drug use can have an even greater attraction, and it’s easy for addiction to take over and ruin their lives completely.
Why Drug Rehabs Are Unsuccessful in Fighting the Opioid Crisis
Traditional drug rehabs often provide another form of toxic reality for adolescents struggling with opioid abuse. In a rehab setting, they’re labeled as addicts from the moment they walk in the door of these places, which carries a connotation of failure and lifelong struggle. They are expected to follow a preset treatment protocol that was created based on old notions of addiction, judgmental assumptions and misinformed theories. They are convinced that they have a chronic disease, that relapse is an inevitable part of treatment, and that they will always be “an addict.” Consequently, the feelings of being “lesser than” and hopeless creates a painful, false and detrimental mindset.
There Is a Better Way to Help Adolescents with Opioid Use Disorder
Both the tough love and the inpatient rehab approaches have proven to deepen the isolation in adolescents that provides the foundation for a distorted perception of reality. Young people do not have to continue on a downward spiral that can lead to a deep and sometimes fatal depression, however.
More productive and better methods of treating drug dependence and addiction exist. First and foremost, effective treatment begins with an understanding that addiction is a consequence of an untreated condition; it does not need to become a terminal disease. Second, treatment must be centered on hearing, seeing and seeking to understand why people feel the way they do. Once the source of their underlying pain is identified, then a treatment plan can be constructed to alleviate their pain.
Prevention is an ideal approach to keeping the opioid crisis from further escalating, and there is no better prevention than adequate mental health care. For the young people currently struggling with addiction and facing suffering and potential overdose, however, better mental health care will be critical in relieving and ending their pain as much as possible so that they can rebuild their lives. Other methods of support and treatment for adolescent opioid use disorder include:
- In-community healing that allows people to receive emotional support and guidance, which can actively prevent the need to self-medicate with drugs
- Medical doctors who can better diagnose depression, anxiety and other conditions that can cause severe emotional distress
- Recognizing that medical care for mental health issues has less of a stigma than being sent to a rehab facility, and overcoming stigma is half the battle in getting someone to a treatment program
- Understanding that there is no one-size-fits-all solution to opioid treatment and that better care starts with focusing on the individual needs of each patient
- Multifaceted approaches to treatment might be necessary to help a young person detox from a physical dependence on a drug so that they can then address underlying mental health issues
New Resources for Doctors and Families Can Improve Adolescent Opioid Use Treatment
It is essential to treat the whole patient, and primary care physicians need to be better equipped with the critical skills, education, and resources to understand the specific needs of young adults. Prioritizing the full scope of young adults health needs so that they receive better resources and care can be a more effective tactic in fighting the war on opioid addiction. It can, in turn, have a beneficial ripple effect on society.
The Boston Children’s Hospital, for example, offers a program designed to educate primary care doctors to provide care for young patients who are currently experiencing opioid use disorder or are at risk of developing it. Program developer Dr. Sharon Levy is an associate professor of pediatrics at Harvard as well as the director of Boston Children’s Hospital’s Adolescent Substance Use and Addiction Program. Levy hopes to see in-community healing and treatment become a commonplace and easily accessible resource for all young adults struggling with opioid disorder.
Efforts like these in the medical community to start treating patients holistically, not just their symptoms can have a greater impact in stopping the opioid crisis. This shift in thinking, awareness and treatment can start to turn the tide of the disastrous consequences of addiction. And adolescent opioid use, as well as general opioid use disorder, can become rare as more adequate and effective preventive measures are taken.
Published February 6, 2019