Teens and young adults often experiment with substances, including opioids. Opioids are a class of drugs that are commonly misused. They are highly addictive and provide a mellow and euphoric “high.”
Nearly 50,000 people in the United States died from an opioid overdose in 2019. The opioid misuse and opioid use disorder (OUD) epidemic is rampant.[1] Of the 4,777 drug overdose deaths in youth and young adults between the ages of 15 and 24, most of them (almost 4,000) involved an opioid drug.[2]
Prescription pain relievers are often viewed as “safe” by teens and adolescents, as they are obtained through a medical professional and therefore not seen as quite as dangerous as street drugs. These are highly potent drugs, however. They are highly addictive, and they can lead to an unintentional and fatal overdose in as little as one use.
The majority of teens who misuse these medications get them from a friend or family member who often has a legitimate prescription. The risk for overdose and addiction goes up when these medications are mixed with other drugs or alcohol, which is common.
Opioids are one of the most addictive classes of drugs. Opioids include both prescription painkillers like OxyContin (oxycodone) and Vicodin (hydrocodone/acetaminophen) as well as the illegal opioid drug heroin and the extremely potent synthetic fentanyl.
Prescription pain relievers are misused more than the illicit opioid heroin. In 2020, approximately 9.5 million people ages 12 and older misused prescription pain relievers compared with just over 900,000 abusing heroin.[3] 4.1% of youths between the ages of 18 and 25 report misuse of prescription opioids. Just over 1.5% of teens between the ages of 12 and 17 report misusing these medications.
As many as one out of every five adolescents and young adults reports misusing an opioid at some time in their life.[4] Misusing opioid drugs before the brain is fully formed can increase the risk for an opioid use disorder (OUD) later in life Two thirds of adults with OUD first used an opioid drug before the age of 25.
Opioids are used illicitly to cause euphoric “high”. Using an opioid drug can lead to physical, social, emotional, and behavioral changes particularly in adolescents.
The following are signs that your child could be using an opioid drug:
Adolescence is a time of great change, and it brings many challenges. Peer pressure and the desire to fit in can be risk factors for trying drugs or alcohol.
High stress and pressures as well as childhood trauma, neglect, and a lack of family support or supervision can all make teens more vulnerable to opioid misuse. Teens and young adults who are homeless, those who live in stressful or dangerous environments, minority populations, and those in the child welfare system are particularly vulnerable to opioid misuse.
The brain is not fully formed until the mid-20s, which makes teens and young adults more impulsive and less able to fully comprehend or think through the potential consequences of their actions. In addition,mental health conditions like depression and anxiety increase the risk for alcohol or drug misuse. Addiction also has a genetic component and is observed to often run in families.
A teen is more likely to misuse an opioid drug if their parent has a legitimate prescription for these medications that they can easily access.[5] Ease of access to opioid drugs can be a serious risk factor.
Using prescription opioids as a teenager even with a medically necessary and legitimate prescription, raises the risk of future opioid misuse by as much as 33%.[6]
Young adults and older adolescents, those between the ages of 16 and 30, are at the highest risk for starting opioid use, misusing opioids, OUD, and death from overdose.[7] There are many factors that can help protect a teen or young adult from OUD and opioid misuse:
Both academic and social involvement are important. Teens who are involved in school, sports, and a healthy social life are less likely to misuse drugs.
Parental involvement is key also. Parents who are supportive and engaged with their teenagers can be a protective factor against drug misuse and addiction.
Teenagers who are engaged in the world around them and forward thinking tend to misuse drugs less. Those who have good self-esteem, healthy and supportive peer and family relationships, and the ability to regulate emotions successfully have less risk for misusing drugs or developing an OUD. These can all be protective factors against substance use.
Myth: Addiction is a choice people make, and they could stop doing drugs if they tried hard enough.
Fact: Addiction is a disease that impacts brain chemistry and changes the way the brain works, making it difficult to stop using drugs without professional help. It is not just a matter of willpower and often requires professional therapy and in some cases medication assisted treatment (MAT).
Myth: Addiction is a behavior problem, and only “bad” kids are addicts.
Fact: Addiction makes physical, emotional, and behavioral changes to a person. The drive to continue using drugs becomes a compulsion, not a decision. Drug use and addiction are not character flaws, and anyone can be impacted by addiction. Many vibrant, successful young adults develop addiction disorders. All parents should therefore monitor their children for substance use.
Myth: Addiction is a parent’s fault for lack of discipline.
Fact: While structure and a supportive and loving home can be protective factors for drug use, a single person is never to blame for SUD. Addiction is a chronic disease. It has many predisposing factors, and is never the result solely of one person such as a parent.
Myth: Only teens with no direction start using drugs.
Fact: Opioid drugs are often passed around among teens as “safe” since they are often gained via a medical prescription. People of all ages, cultures, genders, races, and walks of life struggle with opioid misuse and addiction.
Myth: Substance misuse is a “phase” and teens will “grow out of it.”
Fact: Opioids are highly addictive drugs. Once a physical and behavioral dependence has formed, it can be difficult to stop using these substances. Intense cravings and withdrawal symptoms can make a person “need” to keep taking these drugs to feel “even.” Opioid use in teens puts them at high risk for developing an OUD later in life.
Teens and young adults are particularly vulnerable to mental health conditions, and mental health problems such as mood disorders are on the rise for this age group.[8] Young adults between the ages of 18 and 25 are some of the most prone to mental health conditions, with nearly 10% of Americans in this age demographic having serious mental illness (SMI) in 2020 — the highest of any age group.
Mental health conditions can increase the risk for substance misuse. The reverse is also true. Opioid misuse and OUD can exacerbate and increase severity of mental health conditions.
These are common mental health conditions among teens and young adults:
It is important to have the conversation about opioid drugs early and often. Opening the door to an honest and open dialogue can go a long way toward preventing future issues.
Talk to your child about what opioid drugs are. Make it clear that they are not safe to take without a prescription for any reason. Most prescription opioid drugs that are misused are obtained from a family member or friend. If you have opioids in the house, make sure they are secured while being used and properly disposed of once they are no longer needed.
Keep talking to your child about the risks and hazards of these drugs. Even if it seems like they are not listening, they hear you.
Prevention often starts with a conversation. Talk to your teen about drugs and alcohol — what they are, how they work, and the hazards they present. Stay engaged and present in their lives. Ask questions about what they are doing, where they are going, and whom they are with. Know who their friends are and what if any experimentation they are doing with alcohol or other substances.
Be supportive and loving, and provide them with an outlet when needed. It can be helpful to work together to create an exit strategy in case they are ever in a situation where drugs are being offered.
These are additional tips for substance use prevention:
Find a treatment program that understands the specific needs and circumstances of teens and young adults. These programs can have varying levels of care, depending on what you need.
In extreme cases, inpatient or residential treatment program might be necessary. Residential or inpatient programs provide on-site for structured programming and around-the-clock monitoring and support.
Outpatient programs are more flexible, as programming can often be scheduled around school or other obligations. This is often a good option if you have a solid family support system at home.
Treatment programs will often include group and individual behavioral therapies that can help to identify problem behaviors and negative thought patterns as well as to develop healthy habits, emotional regulation skills, and coping mechanisms. Group and individual counseling sessions aim to improve self-esteem and self-reliance.
Family and peer support is important. Support groups made up of other teens or young adults can foster healthy social interactions. Family members can also engage in counseling sessions and educational programs to learn how to offer the best support to their loved one.
OUD treatment often involves Medication for Addiction Treatment (MAT). These medications can help to reduce opioid misuse, minimize cravings, and manage difficult withdrawal symptoms. Ultimately, MAT promotes long-term recovery. People often remain on medication for months or years safely in order to prevent relapse.
