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.”
Because of this truth, when I saw a local newspaper article about 6 overdose deaths in a recent 3-day period in our city, it felt like a punch in my gut. How many more people must mourn, grieve, and wonder whether there was something else that they could have done? How many more parents must face the nightmare of burying their children?
The Increase in Fentanyl and Heroin In Substance Use Disorders
When I started specializing in addiction medicine about 13 years ago, most patients came for an outpatient opioid detox using the Coleman Method in order to get off of Oxycontin® or heroin. Although overdoses did occur in that era, they have skyrocketed with the current mix of drugs on the street–especially fentanyl, which is a synthetic opioid that is easy and inexpensive to produce.
According to the Drug Enforcement Administration, fentanyl is about 100 times more potent than morphine and 50 times more potent than heroin. 2 milligrams of fentanyl (equivalent to a few grains of table salt) will 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 Research. Research. Research.
Figure out what options are available. Make a few phone calls. Since insurance coverage and costs will likely be part of the answer, your first call might be to your child’s insurance company to find out about mental and behavioral health benefits.
#2 Understand that different methods of treatment are best for different Substance Use Disorders (SUD).
A person who needs help with drinking or benzodiazepine use might need medical support to do so safely. A person that’s dependent on opiates will get very sick with flu-like symptoms including severe muscle aches and cramping, nausea, vomiting, runny nose, and diarrhea if they stop suddenly.
The most dangerous part of opioid addiction isn’t the withdrawal, but rather the possibility of overdose. As terrible as opioid withdrawal feels, it usually isn’t as dangerous as stopping alcohol or benzodiazepine use. Unfortunately, once they have become physically dependent, most people are unable to successfully stop opiate use without assistance.
#3 If you think your child is using opiates, please get some emergency naloxone and keep it accessible!
Naloxone (often called by the brand name Narcan) is an opioid-blocking drug. If someone has taken too large of a dose of an opioid like hydrocodone, heroin, or fentanyl, naloxone can be administered by spraying it in the unconscious person’s nose. You will not hurt someone by using this medication.
#4 Be aware of your loved one’s prescription medicines.
Many patients end up supplementing prescription pain medications from pharmacies with pressed pills they buy from murkier places. The majority of our patients insist that they are NOT using fentanyl; they believe that their sources are trustworthy and they know precisely what they are taking.
I recently saw my first counterfeit pills when a patient’s wife surrendered them to me. They were turquoises. When I looked online for other examples, I saw that they are manufactured in a full array of colors, including pink, blue, orange, etc. They look completely legitimate. Imagine how easy it is to add something the size of a few grains of salt to these pills.
#5 Don’t be surprised when you encounter resistance when you ask a loved one about their drug use.
A patient once told me what it was like to remove access to addictive substances from someone who has become dependent on them: he said it was like choking off his air supply.
On the other hand, dozens of patients have shared over the years how much of a relief it was to finally share how much they needed help. A person who finished his accelerated outpatient detox last month acknowledged that he’d been a slave to his drug of choice. “This sh-t owned me. Every day my first problem was figuring out where to find $200 to get drugs so I wouldn’t get sick. I wound up stealing and dealing almost every day.” He couldn’t wait to live a normal life again.
#6 Come to terms with the reality a person with Substance Use Disorder has a chronic illness and will likely need to be in treatment for a long time.
Besides counseling, therapy, and group support, there are three forms of Medication-Assisted Treatment (MAT) for Opioid Use Disorder (OUD): Methadone, Buprenorphine (often called by the brand name Suboxone), and Naltrexone. Each of these medicines are dispensed by trained medical specialists and involve some planning and understanding of their respective intake procedures.
While your loved one may not immediately be thankful or excited about accepting your offer to help, you can still move forward. Once upon a time, I thought that a person had to be motivated and ready to ‘do it for him- or herself’ to stop using opiates, but evidence shows something different. People often stop using addictive substances even when they initially show up for treatment as reluctant consumers. In a recent meeting, one of our practitioners updated the old saying: 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 doesn’t lend itself to cookie-cutter solutions. Each of us has a unique personality, with individual strengths, and challenges. What works for someone at one point in their life may not work in another time frame. The best treatment approach for one person will not be optimal for someone else.
Coleman Addiction Medicine specializes in the use of long-acting naltrexone (a non-addictive opioid blocker) for patients with Opioid Use Disorder.