What We’ve Learned – Part One

By Rick Werner

In the year-plus since our son Jamie died from a fentanyl overdose, we have learned a lot about addiction, mental health, and treatments for both. I’m going to share some of that here. This is Part One of a multi-part series.

1) Be Careful with Prescription Pain Medications

• While heroin and fentanyl have been the drugs responsible for the most deaths in the past few years, most users didn’t start with those drugs. Research data show that nearly 80 percent of heroin users reported using prescription opioids before using heroin. In some cases, that usage began with leftover prescriptions in a medicine cabinet. Alternatively, it may start more innocently, as the result of a prescription for pain, perhaps post-surgical in nature.
• The key here is to nip these potential addictions in the bud – don’t leave old prescription opioids hanging around the house. Turn them in on National Prescription Drug Take Back Day or dispose of them at home, per these instructions: https://www.fda.gov/forconsumers/consumerupdates/ucm101653.htm
• Also, if you or a loved one is offered an opioid prescription for pain, consider first whether an over the counter drug like Tylenol or Advil will do the trick. A recent JAMA study showed that prescription opioids are no more effective than those over the counter drugs for reducing pain. My wife Debbie was recently offered a 30-day opioid prescription following an appendectomy. She didn’t fill that prescription, and instead used Tylenol for a couple of days and was just fine.
• If you are convinced that an opioid is necessary, then consider the length of the prescription. Addiction is possible after only a few days, but doctors often offer longer terms like 30 days so that they won’t have to spend time on a potential refill. If you are sure you need it – INSIST on a shorter term – like three days.

2) Signs of Potential Addiction – Here are several signs that a loved one may have a substance use disorder.

• Paraphernalia – Heroin (and fentanyl) can be smoked, injected or snorted. In addition to obvious signs like needles, tiny baggies with powdery residue inside, multiple lighters, cut-up straws and sticky or powdery residue left on counters or bureaus. (Note – be careful, fentanyl is 50 times more powerful than heroin and just getting some on your skin can lead to an overdose.)
• Personal Appearance – Someone in the throes of an addiction may lose interest in their appearance, wear long sleeves, have tiny pupils at times as well as a runny nose, flushed skin and periodically nod off.
• Behavior – In general, addicts act differently than they used to, in many ways. Principally, they are more impulsive, agitated, erratic, and inattentive to things and people that they used to care about.
• Behavior – more specifically:
  • They may become constipated;
  • They may crave sugar and sweet foods;
  • They may spend lots of time in the bathroom with the shower running;
  • They are often incredibly good liars and seem to have an answer for everything;
  • They may suffer from ED;
  • They may lose their motivation in their work or studies;
  • They may lose interest in eating;
  • They have massive denial, about many things, but mostly about their substance use disorder.

Coming Soon: In What We’ve Learned Part Two: the link between addiction and mental health challenges