Stranger Than Fiction

30 years ago actor Michael Keaton portrayed a recovering addict in the movie "Clean and Sober." Now in 2021, he returns to an addiction storyline as a small-town physician on Hulu's hit TV show Dopesick. The 8-episode miniseries chronicles the rise of the prescription narcotic Oxycontin from an unknown painkiller in the 1990s to one of the root causes of our country's ongoing opioid epidemic.

In real life, the crisis just took an even more dramatic turn. This summer the CDC reported that U.S. overdose deaths had skyrocketed to 93,000 in 2020. COVID-related turmoil and isolation had helped push a massive jump of around 30% over 2019. And even as the pandemic's effects are starting to fade, overdose rates are still continuing to rise.

New numbers just released show that more than 100,000 overdose deaths occurred in the previous 12 months. This 50% increase in preventable fatalities from just a few years ago marked the first time deaths had ever reached the 7-figure range. The crisis is forcing a strategy shift from treatment efforts to harm-reduction measures, including overdose awareness/education and over-the-counter availability of the overdose medication naloxone (trademark Narcan).

As with many other aspects of the pandemic, BIPOC communities were disproportionately affected by the overdose surge. St. Louis was the focus of an Associated Press feature that reported black men in Missouri were four times more likely than a white person to die of an overdose.

Children and teens are also being deeply affected. SAMHSA research showed that children 12 and up are part of the 1.6 million people with an opioid use disorder. Safe and Sober has actively addressed this issue in our past school videos and will continue to make it a focus of our substance misuse messages.

WARNING SIGNS

As reported by the American Psychiatric Association, Opioid Use Disorder is defined as "a problematic pattern of opioid use leading to problems or distress". Red flags include at least two of the following situations occurring within a 12-month period:

• Taking larger amounts or taking drugs over a longer period than intended.
• Persistent desire or unsuccessful efforts to cut down or control opioid use.
• Spending a great deal of time obtaining or using the opioid or recovering from its effects.
• Craving, or a strong desire or urge to use opioids
• Problems fulfilling obligations at work, school, or home.
• Continued opioid use despite having recurring social or interpersonal problems.
• Giving up or reducing activities because of opioid use.
• Using opioids in physically hazardous situations.
• Continued opioid use despite ongoing physical or psychological problems likely to have been caused or worsened by opioids.
• Tolerance (i.e., need for increased amounts or diminished effect with continued use of the same amount)
• Experiencing withdrawal (opioid withdrawal syndrome) or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms.

OTHER RESOURCES

• The National Institute on Drug Abuse has commonly used drug charts to help parents understand the different types of substances, including opioid-specific details.
• SAMHSA has compiled a great list of talking points to start the conversation with your teen about dangers and strategies for confronting opioid use in their world.
• Fentanyl remains one of the most deadly substances for both teens and adults who misuse opioids. The non-profit organization Song for Charlie has a complete video series on fake prescription pills and avoiding the dangers of fentanyl.