A Toolkit for Teenagers

HOW TO HELP A LOVED ONE STRUGGLING WITH AN OPIOID USE DISORDER

 

Designed by a Teenager

Designed for a Teenager

OPIOIDS AND OPIOID CRISIS

OPIOID CRISIS

For the past 20 years, millions of individuals have developed opioid use disorders after initial use. This has become an epidemic in the United States that continues to bring devastation to society.

 

There are many causes to this crisis, most notably the pharmaceutical companies claiming that opioids did not cause dependence or substance use disorders, leading to an increase in prescriptions.

 

In around the year 2010, many people dependent on prescription opioids turned to illegal opioid drugs such as heroin because of its low cost and high availability. Nevertheless, prescription opioids were still overused, along with the rise of illegal opioids that led to even more deaths. By 2017, many types of opioids prevailed in the market, ranging from prescription and illegal opioids to newly manufactured synthetic opioids, creating an even sharper surge in the opioid epidemic. On top of the tremendous number of lives lost, the economy has also taken a huge toll: the opioid crisis cost $631 billion from 2015-2018, and $188 billion in 2019.

OPIOIDS

Opioids - powerful drugs prescribed for injuries, surgeries, or illnesses

  • Bind to the ‘reward pathway’ of the brain to relieve pain by producing pleasurable feelings

  • May possess side effects such as putting a person at risk of tolerance, in which higher doses are Needed to produce the same effects over time

  • Can ultimately cause dependence if the urge for the drugs becomes uncontrollable

 

Common opioids

  • Prescription drugs (morphine, hydrocodone - Vicodin, oxycodone - Oxycontin)

  • Illegal drugs (heroin)

  • Fentanyl

 

Every day, 130 lives are lost in the United States to opioid overdose

In 2018, 10.3 million people misused prescription opioids with 2 million misusing them for the first time

WHAT IS AN OPIOID USE DISORDER?

OPIOID USE DISORDERS

OPIOID USE DISORDER
CAUSES

Opioid use disorder (OUD) - dangerous cycle where people need to constantly use opioids to relieve pain even if they have good intentions to stop

 

Illness like any other medical disease that does NOT happen by choice and can be professionally treated

  • Prescription pain medications most commonly misused out of all opioids​​​

    • 80% of individuals who use heroin first misused prescription opioids​

  • 50% of opioid use disorders are due to individuals genetically being at a higher risk of developing one

    • Due to certain genes changing the wiring of the brain

    • Makes those individuals more susceptible to developing an OUD if opioids are taken

  • Family history of opioid and substance abuse

  • Social and other medical factors

    • Having a psychiatric disorder such as depression

    • Childhood abuse and neglect

    • Others in social circle involved with opioid use

    • Having easier access to these drugs

1 out of 10 individuals prescribed pain medications for chronic pain develop an opioid use disorder

HOW TO TELL IF ONE MAY HAVE AN OPIOID USE DISORDER
Note warning signs
  • Change in behavior

If somebody in the family takes an opioid medication and exhibits behavioral changes, stay alert and make sure that they do not become dependent on those opioids

  • Withdrawal symptoms that occur from stopping or reducing intake of a drug

    • Vomiting

    • Hallucinations

    • Anxiety

    • Severe fatigue

    • Sweating

    • Muscle pain

  • Mood swings

    • e.g. happy one moment to outrageously angry the next moment

  • Poor-decision making

  • Taking opioids more often and receiving many prescriptions

  • Social and physical isolation from family and friends

  • Loss of interest in activities

  • Abnormal sleep problems 

Seek the attention of a medical expert if such signs persist
SIGNS OF AN OPIOID OVERDOSE AND HOW TO RESPOND

Common signs

  • Unconscious and unresponsive

  • Limp body

  • Very pale skin (sometimes even bluish)

  • Erratic, very slow, or no heartbeat

  • Slow, shallow breathing

  • Choking, gurgling, snore-like sounds

Call 911 immediately if you think someone is experiencing an overdose​

Responses

  • Administer naloxone if available

    • Medication to reverse an opioid overdose

    • Sprayed into nose or injected into muscle

  • Lay person on side to prevent choking

  • Stay with them until emergency workers arrive

  • Perform CPR and rescue breaths if necessary

 

Act right away! Your prompt actions CAN save a life!

THE POWER OF TEENAGERS

WHY SHOULD TEENAGERS HELP
  • Opioid crisis has always been considered an adult problem that only adults can solve

  • But teenagers also HAVE a role to play

 

  • Current efforts have started to reduce the number of lives lost but more initiatives are needed to save many more lives

If teenagers also help combat the opioid crisis, more lives can be saved

  • This graph shows that with more intervention, more lives can be saved and opioid use disorder cases will not increase exponentially

Even if 1 in 10 cases are helped by teenagers, the curve can be significantly bent

  • These graphs highlight that if teenagers also join the battle against the opioid crisis, even more lives can be saved and the opioid overdose curve can bend

Note: Data provided by CDC up until 2019, following years are predictions based solely on teenager intervention

 

The younger population itself is a support group, we need to support one another

 

HOW TEENAGERS CAN HELP

ERASE THE STIGMA

Drug use disorders are currently stigmatized: looked upon as moral issues instead of treatable health conditions

  • this perspective primarily exists in the older population

  • Evokes feelings of fear, shame, and guilt among those who experience substance use disorders, whether they are young or old

In 2017, only 36% people with substance use disorders reported ever attending or seeking treatment due to fear of societal judgment

  • Teenagers are just starting to learn about these issues without such stigmatizing perspectives

    • Better positioned to help loved ones feel more comfortable to seek recovery options as they do not have the stigmatizing perspective

1 out of 3 people in the United States knows someone with an opioid use disorder

Use Non-Stigmatizing Phrases 

Stigmatizing Phrases

Non-Stigmatizing Phrases

addiction

opioid use disorder

addict or junkie

individual with opioid use disorder

clean or dirty

positive or negative; person in recovery

Refer to the disease rather than making the individual feel at fault

INITIATE THE CONVERSATION
  • Ask questions

    • ‘You don’t seem like your usual self. Is everything alright?’

    • ‘Is everything okay?’

    • ‘How can I help? Don’t worry, I’m here to support you.’

 

  • Emphasize that you are there to listen and offer help as needed - support exists

 

  • Chances exist that the individual will not open up immediately

    • Be empathetic - creates a more comfortable atmosphere for the individual

 

  • Can sometimes lead to an uncomfortable situation

    • Detach yourself and look at the story from an objective lens

    • Find a coping mechanism - best way is to not be the only individual listening to the story

  • ​Teenagers sometimes do not feel comfortable opening up and sharing their stories with adults, but feel better talking to a similar-aged friend like another teenager​

Report to a trusted individual if a friend or family member is battling an opioid or other substance use disorder (it can be a parent, teacher, doctor, therapist, etc.)

MIRROR THE CONVERSATION

People are willing to help: communicate your needs

  • Don't provide instructions such as:

    • 'you should go to receive treatment'

    • 'go get help'

  • Offer supportive statements instead

    • 'based on what you said, what do you feel is best for you to receive help?'

  • Center the conversation around health effects from the disease instead of making the individual feel at fault

Remember, your initiative to help can have the end result of turning someone’s life around

 

GENERAL RESOURCES

CALL A HOTLINE
  • all calls are confidential, free, 24/7, 365 days a year

  • provides treatment information and referral service in English and Spanish for individuals and families facing mental health and/or substance use disorder

  • ​​refer to a local treatment center/rehabilitation service

National Hotline: 1-800-662-HELP (4357)

Hotline provided by the Substance Abuse and Mental Health Services Administration (SAMHSA)

There is HOPE - people will get better when they receive the support they need

Currently, 22 million individuals in the United States are in long term recovery from a substance use disorder

The power lies in teenagers - YOU have the potential to help and save a loved one’s life

 
Pink Sugar

THE TOOLKIT

Pink Sandstone

LA GUÍA EN ESPAÑOL

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Pink Sugar Texture

OPIOID CRISIS TOOLKIT FOR TEENAGERS WORKSHOP

An Education Plan for High School Teachers to Cover Topics Related to the Current National Opioid Epidemic
Three modules with activities

Accompanying slides

Supplement to current drug & alcohol and mental health lessons taught at secondary schools 

 
 

ABOUT THE CREATOR OF THE TOOLKIT

Neha Skandan is an undergraduate student at Johns Hopkins University. She is intent on spreading awareness on how teenagers can help loved ones who are struggling with opioid use disorders. She has interacted with community experts in the front-lines of combating the opioid epidemic, including physicians and leaders of rehabilitation services. She created the Opioid Crisis Toolkit for Teenagers in high school, working with regional schools and educational centers to implement the workshop and make the toolkit readily available to adolescents. She has written articles in both English and Spanish for local newspapers on teenagers and the opioid crisis, and has delivered a TEDx Talk at the 2020 TEDx Lehigh River event. The title of her talk was Empowering Teenagers: A New Frontier in the Battle Against the Opioid Crisis.

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REFERENCES

1. https://www.cdc.gov/drugoverdose/epidemic/index.html

2. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis#three

3. https://www.physiciansbriefing.com/pharmacy-32/opioids-990/opioid-crisis-cost-united-states-36-631-billion-over-four-years-751307.html

4. https://www.hhs.gov/opioids/prevention/index.html

5. https://www.hhs.gov/opioids/about-the-epidemic/index.html

6. https://www.drugabuse.gov/publications/research-reports/prescription-opioids-heroin/prescription-opioid-use-risk-factor-heroin-use

7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741106/#:~:text=Twin%20studies%20of%20opioid%20addiction,(odds%20ratios%20%3C1.5) 

8. https://www.hopkinsmedicine.org/opioids/signs-of-opioid-abuse.html

9. https://www.cdc.gov/drugoverdose/pdf/patients/preventing-an-opioid-overdose-tip-card-a.pdf

10. https://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/responding-to-opioid-overdose/

11. https://www.cdc.gov/drugoverdose/data/index.html

12. https://www.healthline.com/health/opioids-stop-the-stigma#1

13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4228689/#R5

14. https://www.psychiatry.org/newsroom/news-releases/nearly-one-in-three-people-know-someone-addicted-to-opioids-more-than-half-of-millennials-believe-it-is-easy-to-get-illegal-opioids

15. https://www.naabt.org/documents/Languageofaddictionmedicine.pdf

16. https://www.samhsa.gov/find-help/national-helpline

17. https://www.sciencedirect.com/science/article/abs/pii/S0376871617305203