When I was younger and many friends were having babies, I would often send a hand-written note with a powerful message by Elizabeth Stone:
“Making the decision to have a child — it is momentous. It is to decide forever to have your heart go walking around outside your body.”
So when I read an article in our local paper about 6 overdose deaths in a 3-day period in our community, it felt like a gut-punch. How many more people have to grieve, mourn, and…wonder whether there was anything else they could have done? How many more parents must bury their children?
The Increase in Fentanyl and Heroin In Substance Use Disorders
When I started working in addiction medicine many years ago, most of our patients came for an outpatient Accelerated Opioid Detox using the Coleman Method to get off of Oxycontin® or heroin.
Although overdoses happened, they have climbed sharply with new drugs on the street — especially fentanyl, which is a synthetic opioid that can be easily and cheaply made. According to the DEA, fentanyl is approximately 100 times more powerful than morphine and 50 times more potent than heroin. 2 milligrams of fentanyl (equivalent to a few grains of table salt) can cause breathing to stop in more than 95 percent of the American public.
If you think your child is using heroin or fentanyl, here are 6 things you can do.
1. Do a little research.
Understand what options are available. Pick up the phone. Insurance coverage and cost will likely be part of the answer, so the first call might be to your child’s insurance company to find out what mental and behavioral health conditions they cover.
2. Recognize that different Substance Use Disorders (SUD) involve different modes of treatment.
Someone who needs help to stop drinking or to get off benzodiazepines might need medical assistance to do so safely. Someone who has become dependent on opioids will get extremely sick with flu-like symptoms: nausea, vomiting, runny nose, diarrhea, severe muscle aches and cramping if they stop cold turkey.
The most dangerous thing about opioids isn’t the withdrawal, but rather the possibility of overdosing. As awful as someone in withdrawal feels, it usually isn’t as dangerous as stopping alcohol or benzos. Unfortunately, most people are unable to do so without help.
3. If you believe your child is using opioids, please keep some emergency naloxone handy!
Naloxone (often referred to by the brand name Narcan) is an opioid-blocking drug. If someone has taken too much of an opiate like oxycodone, heroin, or fentanyl, naloxone can be delivered by spraying it in the unconscious person’s nose. You cannot hurt someone by using this medicine.
4. Learn about your loved one’s prescription medications.
Many patients supplement prescription pain and anxiety medicines with pressed pills they buy on the street. Many of our patients fervently dispute the notion that they are using fentanyl; they believe their dealer is trustworthy and they know exactly what they are purchasing.
I recently saw my first illegal pills when a patient’s spouse handed them over to me. They were small turquoise pills. When I looked online for other examples, I saw that they are produced in the full rainbow of colors: orange, pink, blue, grayish-purple, etc. They look incredibly legit. How simple it must be to add something that is the size of a few grains of salt to these pills…
5. Expect pushback when you ask a loved one about the possibility they are using illegal drugs.
Someone once described to me what it’s like to take away addictive substances from someone who is physically dependent. He said it was like cutting off his air supply.
However, many patients have told me over the years that it’s been a massive relief to finally share how much they need help. A young man who finished his accelerated opioid detox a few weeks ago said that he’d been a total slave to his drug. “This sh-t owned me. No matter what I needed to do for my job or my family, the first problem was figuring out where to get $200 to buy drugs so I wouldn’t get sick. I ended up stealing and dealing every day.” He could barely wait to just live a normal life again.
6. Try to get comfortable with the idea that someone with Substance Use Disorder has a chronic disease and will likely need to be in treatment for a long time.
Besides counseling, therapy, and group support, there are 3 Medication-Assisted Treatments (MATs) for Opioid Use Disorder (OUD): Methadone, Buprenorphine (often called by the brand name Suboxone), and Naltrexone.
Each of these medications are dispensed by trained medical professionals and involves some planning and understanding of the intake processes.
Even though your loved one may not instantly be grateful or excited about taking you up on your offer to help, you can still make progress. I used to believe a person had to be motivated and ready to ‘do it for himself’ to successfully stop using opioids, but evidence shows otherwise. People often stop using addictive substances even when they arrive for treatment as reluctant consumers. In a recent conference call, one of the doctors in the Coleman Network for Addiction Medicine riffed on the old adage: You can lead a horse to water, but you can’t make him drink… our job is to make them thirsty.
Detox Off Fentanyl and Heroin at The Coleman Network
Treating Substance Use Disorder isn’t a one-size-fits-all situation. Every one of us has our own unique personality, strengths, and opportunities. What works for someone at one time in their life may not work at another juncture. What works for one person will not be the best treatment for another person.
The Coleman Network for Addiction Medicine and our sister medical offices across the country use both long-acting naltrexone and Suboxone for patients with Opioid Use Disorder. If you are concerned about someone, please don’t wait to learn more about what options are available.