Northwestern University Series

5 Tips On How To Openly Talk To Your Teen About Fentanyl. A Guide with Useful Information And Resources For Parents.

The opioid epidemic continues to plague communities, with youth increasingly at risk. In the US, the child and adolescent death rate related to opioids has risen by 268% from 1999 to 2016 (Gaither, et al., 2018). A recent study (Bohm and Layton, 2020) demonstrated the involvement of illicit opioids, such as fentanyl in prescription opioid-related deaths surged from 5.5% in 2010 to 25.0% in 2016. These statistics underscore the urgency for parents to engage in open dialogues about the dangers of street drugs, particularly fentanyl.
 
Following prescription opioids and heroin, a recent study by Britch and Walsh (2022) emphasizes the rising prevalence and heightened risks associated with fentanyl, making it a critical subject for parental discussion. Fentanyl is not only more popular than other drugs, it is also much more dangerous. Its high potency, 100x stronger than morphine, greatly increases the risk of overdose and poisoning compared to other opioids. 
 

Why is the young generation more at risk?

According to Peavy and Banta-Green (2021), adolescents and young adults specifically might be at a higher risk for optimistic bias assuming they are immune to overdose and that “it would never happen to me, it only happens to other people”. Gunn and colleagues (2021) agree that adolescents might think they are “immune” to the lethality of the drug and addiction itself, exacerbating the risk of dependence, overdose, and poisoning.
 
Compounding the issue is the prevalence of fentanyl-laced street drugs, amplifying the dangers of unknowing exposure. A recent cohort study in Canada including 423 participants found that a large number of adolescents tested positive for fentanyl although reporting not having used fentanyl (Douglas et al., 2021). Additionally, the accessibility of fentanyl in pill form heightens the risk for adolescents, given their propensity for risk-taking behavior and disregard for consequences (CDC, 2023; Peavy & Banta-Green, 2021).
 
Recognizing the signs of fentanyl overdose is crucial for parents. The CDC (2023) outlines warning signs such as pinpoint pupils, unconsciousness, shallow breathing, and clammy skin. Immediate action, including calling 911 and administering naloxone if available, is vital in suspected overdose situations.
 

The CDC (2023) offered a quick list of warning signs to look out for:

• Small, constricted “pinpoint pupils.”
• Falling asleep or losing consciousness
• Slow, weak, or no breathing
• Choking or gurgling sounds
• Limp body
• Cold and/or clammy skin
• Discolored skin (especially on lips and nails)
 

If you suspect an overdose or poisoning:

  1. Call 911

  2. Administer Naloxone (if available)

  3. Get your teen in a side-lying position (see first aid)
 

To try and prevent your teen from using fentanyl, here are some tips on how you can talk to your teen about fentanyl abuse and the risk of poisoning/overdose:

1. Have an honest conversation with your children about drugs including marijuana, alcohol, prescription, and “street” drugs. Provide information that is short and objective.

2. Avoid shaming; instead, express gratitude if your teen shares their experiences.

3. Ask about friends’ behavior and if they have ever felt pressured to do any kind of drug.

4. Maintain open communication and support if your teen is already using drugs.

5. Utilize "I-statements" to express concern without instilling fear, focusing on factual information and describing feelings.
 

Talking points to consider when discussing fentanyl with your teen:

Fentanyl is an extremely dangerous substance that can be found in various forms, including street drugs, candy, weed, and even coffee. It’s crucial to be cautious and aware of the potential risks. Here are some key points to remember:

• Stay Alert: Fentanyl can be mixed with other substances without your knowledge. It only takes a tiny amount (two grains of salt) to cause severe harm or even death.

• Trust Your Sources: Never accept anything from a non-trusted source, including food, drinks, and substances.

• Seek Help: If you suspect that fentanyl is present or has contaminated something, do not hesitate to contact a trusted adult immediately.

• Spread Awareness: Share this information with your friends and family to help keep everyone safe.

Know the difference:
Fentanyl Poisoning: Involves unintentional ingestion or exposure to fentanyl, often through contaminated drugs.
Fentanyl Overdose: Occurs when an individual knowingly consumes a toxic amount of fentanyl, leading to life-threatening symptoms.

Parents can engage with their teen's social circle, offering support and monitoring for signs of drug involvement. Persistence and support are essential if a teen is already using drugs, emphasizing the importance of parental involvement in seeking treatment.
After all, you know your child best and will know what normal behavior is. If you suspect drug use or abuse in general, you can take those steps above and see if they are open for treatment.

Online Resources For Substance Use:

SAMHSA helpline: 1-800-662-4357
Booklet about what is Substance Use Treatment: https://store.samhsa.gov/product/what-substance-abuse-treatment-booklet-families/sma14-4126
 

References

Bohm, M. K., & Clayton, H. B. (2020). Nonmedical use of prescription opioids, heroin use, injection drug use, and overdose mortality in U.S. adolescents. Journal of Studies on Alcohol and Drugs, 81(4), 484–488. https://doi.org/10.15288/jsad.2020.81.484

Britch, S. C., & Walsh, S. L. (2022). Treatment of opioid overdose: current approaches and recent advances. Psychopharmacology, 239(7), 2063–2081. https://doi.org/10.1007/s00213-022-06125-5

Centers for Disease Control and Prevention. (2023, September 6). Fentanyl facts. Centers for Disease Control and Prevention. https://www.cdc.gov/stopoverdose/fentanyl/index.html#:~:text=Over%20150%20people%20die%20every,to%20synthetic%20opioids%20like%20fentanyl.&text=Drugs%20may%20contain%20deadly%20levels,taste%20it%2C%20or%20smell%20it

Douglas, S., Hayashi, K., Richardson, L., DeBeck, K., & Kerr, T. (2021). Social-structural predictors of fentanyl exposure among street-involved youth. Substance Use & Misuse, 57(1), 21–26. https://doi.org/10.1080/10826084.2021.1975746 

Gaither, J. R., Shabanova, V., & Leventhal, J. M. (2018). US national trends in pediatric deaths from prescription and illicit opioids, 1999-2016. JAMA Network Open, 1(8), e186558-e186558.

Gunn, C. M., Maschke, A., Harris, M., Schoenberger, S. F., Sampath, S., Walley, A. Y., & Bagley, S. M. (2021). Age-based preferences for risk communication in the fentanyl era: 'A lot of people keep seeing other people die and that's not enough for them'. Addiction (Abingdon, England), 116(6), 1495–1504. https://doi.org/10.1111/add.15305