Four Common Beliefs Parents Have About Fentanyl That Put Their Teens and Young Adults At Risk For Overdose, with Brenda Zane
Host: Brenda Zane, brenda@brendazane.com
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Episode resources:
Teens under-report their substance use (NIH report)
Article: Shipping to the U.S. (how fentanyl gets moved around the world)
DEA Seizes Enough Fentanyl in 2021 to Provide A Lethal Dose to Every American (press release from DEA)
Rapid onset opioid use disorder from fentanyl use (video, start at 31:53)
Flow of fentanyl (DEA) - download here
Youth Fentanyl Guide: how to have a conversation about fentanyl - download here
Intervention e-book: What to do if your child is drinking or using drugs - download here
Understanding and Supporting Adolescents with an Opioid Use Disorder - download here
Images of lethal dose and fake Percocet pills - download here
Transcript:
I want to take a moment and dedicate this episode to Graham. And to Graham's mom, Elisabeth who is a friend and a very special member in The Stream. Graham is one of the incredible humans that we lost this past year, just after his COVID senior year of high school, a barely 18-year-old who was not addicted, not an addict, who bought a fake Percocet had it delivered and did not wake up.
This episode is my way of making sure Graham's death, and Elisabeth's incredible pain might be able to make a difference.
Graham David Wicker
01:18
Well, friends, we did it. We have made it through 2021, almost, which required a lot of mental fortitude on everyone's part. And so the fact that you're here today is a really, really big deal. If you're listening in real-time, it's December 23, 2021. And I realized it's been almost two months since I've done a solo episode, which is really weird. And I kind of miss just talking with you. So today is going to be a solo episode. I wish I could say it will be a holly jolly festive episode. But let's just say it's going to be more educational. I also want to give a warm welcome to new listeners, we have a lot of new listeners from the UK and Australia, which I'm so happy about because really regardless of where you plant your feet, if your son or daughter is misusing drugs or alcohol, the fear and confusion are the same. So we are all just human beings trying to figure this out. So a big welcome to you if you're listening from outside North America.
And have you found the podcast playlists yet? I talked about this back in October on Episode 84, which was the casserole episode that some of you might remember, but the playlists are live. So you can find a playlist of all of the episodes around a specific topic. Like what there's one for craft parenting skills, there's one for recovery stories. There's one about siblings, and there is also one of the top 10 episodes of Hope stream. So you can go to Brenda zane.com For slash playlists with an S playlists, plural. And let me know if you like them how it's helpful or not. And if there is a specific playlist that you'd like me to put together, and I can do that and put that there for you.
Okay, if you have listened to episode one of hopestream where I tell our family story, you'll remember that my son experienced two overdoses, which both included fentanyl. And you may have also seen the numbers that were recently released I think about two weeks ago about this staggering number of people who died in 2020 from overdoses. It is something I can't not talk about. And it's been a while since I sounded the fentanyl alarm here on the podcast. So today I am going to do that. I'll share with you a bit about what's going on with fentanyl, why you keep hearing about it in the news. Or if you haven't heard about it in the news, why you need to know. And I will also dispel a couple of myths and a little bit of hysteria that are out there about it. And then I'm going to share the four reasons why parents think this whole conversation about that Nol and overdoses doesn't apply to them and why that is putting their kids at risk. In the shownotes you will find the data sources for everything I talked about. I want to take time to read them off as I go because that would actually get really annoying. But if you go to Brenda zane.com forward slash podcast and scroll or you can just do a search there for episode number 93 You will find everything right there.
So we all know that the opioid crisis, which was the epidemic going on prior to COVID, didn't get put on hold when COVID took over our world. It very stealthily expanded, actually. And it took over 100,000 people in the US between April 2020 and May of 21. That is someone dying every five minutes from a drug overdose. Every five minutes.
05:48
There was this trifecta of circumstances that came together during that time, that really exacerbated substance use. So we had forced isolation, obviously, we all had this increased level of anxiety. And then there was just a reduced amount of access to treatment and recovery resources. And so while everybody's eyes were tracking virus cases, hospitalizations, variance, and the number of deaths from COVID, not as many people were noticing the thud of bodies that were falling primarily from deadly doses of illegal fentanyl.
So friends, we are losing over 275 people every single day, it seems likely if a commercial jet with 275 passengers crashed, and everyone on board was killed. Every single day, there would be more alarms ringing, more family members would be screaming from the rooftops and they would be getting heard, we would have more safety measures enforced. I would even go as far to say that airports would probably be shut down indefinitely until these plane crashes stopped. Yet, here we are, the bodies keep falling and what is being done. And I'm not going to focus as much today on what is being done, because that's a whole nother topic.
But I do want to talk about some of the reasons why you or people that you know, may be feeling like this isn't really relevant to you. And I want to just impress upon you why it is. So first to get a baseline understanding about fentanyl. Let's start with why there are so many bodies falling every day. If you're unfamiliar, that Na is illegal, scheduled to opioid created in the 60s, for extreme post-surgery or cancer-related pain. It's 80 to 100 times stronger than morphine, which is a little hard to put into context. But if you have ever had morphine or you know somebody that has like after having surgery during surgery, you know how out of it they so multiply that times 100 And you're at fentanyl and because it was designed for surgery and extreme pain like stage four cancer pain. It has a really fast effect. And it's also very short-acting. So the medical formulations that are prescribed are prescribed for those conditions. And you'll see these the medical formulations are often patches and lollipops. But those are not the fentanyl that is to blame. Most of the time when you see news headlines about overdoses, the fentanyl there that is involved is most often illegally made in China or Mexico, mixed into a pill and sold as Oxycontin, Percocet Xanax, and they look legit right down to the near-perfect replica color and dosage imprint and overdose deaths involving this illegally made fentanyl Rose 55.6% between 2020 and 2021. So there you go. That is why the bodies are falling. Another really alarming statistic is that from 2019 to 2020, pre COVID overdose deaths from fentanyl in people under 30 doubled. So this is really impacting our young people exponentially. And I'm going to go into the reason why that is
10:00
But just know that even pre COVID The deaths from fentanyl in people under 30 years old, doubled. The point here though, is not to vilify fentanyl. So if you have stage four cancer, or some other debilitating pain, or you're going into surgery and your doctor is using fentanyl are prescribing it, it's absolutely necessary and it's a very effective medication. But again, legally prescribed fentanyl is not what we're talking about here. For context, two milligrams of fentanyl, about the size of three or four grains of salt can be lethal.
And in DEA analysis, they have found these counterfeit pills have fentanyl levels ranging from point oh two milligrams to over five milligrams, so that is more than twice the lethal dose in each tablet. And there is no consistency. So these pills are not being made in professional labs where there are controlled strict controls, and quality assurance these are being mixed and pressed. in environments where there is no measuring going on to make sure that the amount of fentanyl isn't deadly, and that it's mixed into pills evenly. If you're interested in learning more about how fentanyl gets manufactured, how it comes into the United States and gets moved around the world, there's a PDF and some other resources in the show notes that you can check out I kind of like that stuff. I'd like to know the back end of stuff. So that is there. If you're like me, and you like to dig into that.
A few other important things to know about fentanyl, 42% of the pills that the DEA tested recently for fentanyl contained at least two milligrams which is the potentially fatal dose so almost half and drug trafficking organizations who are creating these pills, typically distribute fentanyl by the kilogram. So doing the math, one kilogram of fentanyl has the potential to kill 500,000 people, half a million people. By the way, I look that up. I can't do that kind of math, especially when it's in the metric system. So just trust me on that one. I did look it up and do the math on a computer. Now you guys know that I work daily with parents of tweens and teens and 20 Somethings. And I am telling you, it astounds me how many people are not talking to their kids about fentanyl.
12:43
They are not asking their kids whether they or their friends are experimenting with pills or what they know about fentanyl. And I know it is not an easy conversation to have trust me that over the next few minutes, I hope that you will start to realize how vitally important it is to have those conversations anyway.
13:05
And at this point, you might be saying to yourself really well, I am glad this is not my problem.
13:11
And if that is you, please keep listening. Because I'm going to talk about four observations, from my experience working with parents that might help save your child's life as much as you think this is not relevant to you. The thing is fentanyl overdoses and poisonings don't happen to other people's kids. They happen to athletic kids, preppy kids, nerdy kids, 4.0 students, LGBTQ kids, straight kids, it doesn't matter. Truly, it does not matter fat, Na is fat and Hall, and no one is exempt. So here are the reasons that I hear from parents why they assume that this conversation around opioids, overdoses and fentanyl isn't relevant to them. See if any of these sound like something that you might be thinking.
I know my kids probably smoking weed and drinking sometimes, but that's all.
My kid would never take pills they know about the opioid crisis.
My kid wouldn't even know where to get drugs.
And we're close. I would know if my kid was taking drugs.
14:31
The truth is, these four assumptions actually prevent parents from having that potentially life-saving and maybe uncomfortable conversation about what is happening in their world and with their friends when it comes to drugs. I want to go through these four mindsets or beliefs to give you some deeper insight around them. So the first one I think my kid probably smokes weed and drink sometimes but that's all
15:00
The truth here is that kids are most often underreporting what they're using, and how often they're using it. Think about when you go to the dentist and they ask How often are you flossing? Yeah. So in one study that was published in pediatrics, it's a journal, teens were 52% more likely to test positive when the study did an actual test for cocaine use than if they self-reported on a confidential questionnaire. Now, this was one study, it was done with higher-risk youth. But it is telling that what kids say they're doing and what they're actually doing are often not necessarily in sync. So not saying that you can't trust your child, but just know that they do tend to underreport because they don't want to stress you out, they don't want you to know what they're doing. They're trying to have that independence. And so you can't necessarily take that at face value.
16:03
Then my kid would never take pills, they know about the opioid crisis. Even when kids are aware of fentanyl and the dangers of opioids, it doesn't mean that they're not using anything. So kids today are definitely more aware of opioids. And when they steer away from those, which means they're steering away from oxycontin or Percocet or heroin. What they might do is shift to something that they believe would be safer. So they might think that a benzodiazepine-like a Xanax, Ativan, Klonopin, or something like cocaine, or some of the party drugs, LSD, the hallucinogens, Molly, even the ADHD drugs are being made counterfeit. So kids who think they are buying Adderall for their finals, may not know that it is completely fake. A pill that looks like a legal prescription opioid might be the thing that gives kids that false sense of safety, especially younger tweens and teens, who are new to substance use. So these are not experienced drug users. They're just less experienced.
And in general, they underestimate their personal risk compared to people who are older people who have who've used substances for a longer period of time. And also that prefrontal cortex that helps them with detecting risk just isn't developed yet. And younger people also believe that they can't become addicted to fentanyl, because they're healthy, They're young, they're just taking a pill, it doesn't look illegal, and they're not injecting it. So there's this false sense of safety around taking these pills, that that now has a very rapid and a very short effect, which means it has very high addiction potential, and obviously very high overdose potential. So because it causes rapid tolerance, people very quickly need more drug to get that equal effect. And what's happening is people are quickly becoming addicted to opioids who have used no opioid other than fentanyl, and who have never injected it.
So this is not the scenario that we see in our mind of somebody becoming addicted to drugs, is not just about having this one conversation with your child and then being done. Assuming I've told them they know, they're fine. Just know you've got to keep having that conversation over and over. They need to know that any pill, regardless of what color it is, what it says on the pill, the imprint the shape, it is going to have fentanyl and it gets will also say that they'll take pills, but they're prescription they know they are because they're in a prescription bottle. Or they'll say that they cut the pill in half, or they cut it in quarters so that they won't overdose, they're very careful. But there's no guarantee again, that the half or the quarter of the pill that they're taking isn't the part of it with the lethal amount of fentanyl, they are not being produced with any kind of quality control or measuring going on. So you just don't know. And dealers will have pills and prescription bottles. But it's completely irrelevant because those are not real. Our young people though may not be able to detect these things may not want to see the things that are happening. So we have to be really aware in the show notes you can find some images of pills that are counterfeit and you'll be able to see the imprint on them and the color of them. So be sure to check those out. It's very, very important to know what they look like.
Okay, third assumption I hear my kid wouldn't even know where to get drugs. This one is really common because parents might not be aware that dealers sell on social media apps.
They deliver to homes, to parks, to schools. I've had parents tell me they thought their kid was meeting an Uber or Lyft driver, and it was actually somebody delivering drugs to them. So Snapchat and Instagram are two of the top places where kids are getting pills, but dealers are also using Facebook, Facebook Messenger, Tik Tok and YouTube. Kids are also buying pills directly from people. It's not always on social media. And the University of Washington did some research lately, and they did a really deep dive with young people about their use. And what they found is that there is a really high level of trust for the people that our kids are buying drugs from. They have really easy access either on social media or just directly with people. And I think this is most important. One of the findings in this research was that these kids did not perceive themselves as a risk for a fentanyl overdose. On the other hand, they were open to messaging about the increased deaths from Vietnam. So they're willing to accept information and that door is open.
21:12
So back to social media, kids go on these apps, they can connect with people buy the drugs, and then the person will deliver them to wherever they decide to meet up. This is how Graham got the pill that killed him. And you may have heard of Dr. Laura Berman's story. She is a Therapist and Relationship Expert on the Oprah network. I think she's on Dr. Oz, she has her own national radio show. And her son Sammy was 16, a straight-A student getting ready for college. And she and her husband found out that he had been experimenting with marijuana. So they did all the things. They got him a therapist, they got him a drug counselor, they did drug testing regularly. And one night he went on Snapchat, and he ordered some pills that he thought were Percocet, and they turned out to be laced with fentanyl, and he did not make it. The same thing happens every day, in every state in every town. And parents are shocked. Their lives are devastated. And we have to be having these conversations with our kids
22:27
then the last one. Were close, I could tell if my kid was taking drugs. Some parents I work with will say this, but we're really close, I talked to my son or daughter every day I see them all the time, I would know. Or they'll say he or she is doing better. They went through a real downtime, especially with COVID. But now they seem so much better. Here is the tricky thing. Sometimes kids will not be doing well. The parents get worried because the kids are depressed, they're isolating. And then after a bit, they seem better. And sometimes that is because they are functioning better. Because they are self-medicating. In research. The two key motivations kids give as their reason for using our coping, and sensation seeking. So it's not that you have to have a kid who is out partying and being crazy. They may just be very quiet and very normal, but looking for a way to cope with day-to-day life. Now, I'm not saying this to freak you out and make you neurotic, I know it can start to feel like that, like oh my gosh, I thought we were in a good place now. And you may be in a good place in a better place. But if you see rapid changes, your kiddo has been really down really quiet, isolated, depressed, having a lot of anxiety, and then pretty quickly, without other interventions, like therapy or some mental health diagnosis and treatment. If they then quickly seem to be different, happier, less anxious, more social, it might be because they have found something that's working for them. It may be marijuana, it may be a stimulant, it may be these pills that have phenol in them. So it is something to really be aware of. Again, please, please, please don't assume that if your son or daughter is doing well, that it means they're taking drugs, that is not the message. It's more around noticeable changes that you can't contribute to anything else that was going on anything that you have intentionally done to work on correcting the negative behavior or the undesired behavior. The other thing is unlike marijuana or alcohol, which can be pretty easy to smell. Sometimes pills are tiny. They are really easy to hide. And obviously, they don't have a smell or anything else that you would be able to notice, so just be aware watch for those unexplained changes.
Watch for noticeable drowsiness or slurring if they're really hard to wake up. And overall, they're just very slow. This is a different appearance than being drunk. And if you're seeing these things, it is definitely worth digging deeper into. Because those are some red flags for pills and pills today mean fat.
Now, before we go on to some things that you can do, because I don't know I have you completely worried and stressed out. I want to clarify two myths that might be out there that you've heard about that are worth mentioning.
The first myth is that you can overdose on fentanyl by touching it. So this is not true. You can't overdose on fentanyl by touching it it has to get into the bloodstream or into a mucous membrane like in the nose in order to impact you. So if you see reports of people touching fentanyl, or if you hear this somebody was near it and they overdosed, those are incorrect.
The second myth is that fentanyl is resistant to Naloxone or Narcan. Fentanyl is not resistant to Narcan. Some people might believe or have heard that fentanyl is too strong to be counteracted by Narcan. But Narcan actually does work to reverse a lethal dose of fentanyl. I know that for a fact because my son is alive today because of Narcan and he had overdosed on fentanyl. So two things just to be really aware of if you've heard those myths. Now we have corrected those.
Okay, so what do you do? Well, speaking of Narcan, you need to get educated about what it is and have it in your home. I know that probably sounds extreme, and it might sound alarmist, but trust me, you would rather have it on hand and never ever need it versus needing it and not having any. So Narcan is the brand name for naloxone. Narcan is a nasal spray that can reverse an opioid overdose. If you can use an allergy medicine like Flonase, which I do every morning, you spray it in your nose, you can give somebody Narcan. So put it this way, if your son or daughter was deathly allergic to bees, or peanuts, or any kind of nuts, would you have an epi-pen with you at all times per probably, this is the same, there is a very, very good chance that your child will have the opportunity to take a pill that's got a lethal level of fentanyl in it. And you need to have that epi-pen equivalent close by.
There's a fact that I was surprised by that you might be surprised by that over 60% of fatal overdoses happen in the person's home. So this is not the guy in the alley with a needle in his arm. This is your 18-year-old soccer player honor student in their bedroom with their iPhone in their hand.
Narcan is available in every single state in every single state, you do not need a prescription, you can use your medical insurance to cover it. And there is no reason not to get some and have it in your house, probably also want to have some in your car, and let your kids know that you have it. I have moms who I've talked to who have done this, given it to their kids and their kids have thanked them. And I think that goes a long way to show what our kids are actually dealing with.
Another thing that you can do is be hyper-aware, get educated about this. And don't rationalize away occasional use or that nagging suspicion that maybe there is a little bit of use going on. That's one of the very first steps. And so you're doing that now by being here and listening. So check that box. That's awesome. And then we really, really need to create open and direct and also very empathetic conversations with our kids to understand their lives. We want to show them that we're curious about their needs. We're curious about their dreams and their goals and what's going on with them. And what that does is it gives them a safe space where they know that they can have the good fun conversations with you and they know that they can have hard conversations with you and that you are a safe place to have those. Those conversations will also help you understand how your son or daughter is coping. What tools do they have to deal with the pressures of life? And then the COVID pressure that stacked on top of regular life? How are they having fun,? Do they even have time to have fun?
30:00
And as a side note, there's an awesome episode. It's number 75. With Denise Pope from Stanford, it's all about the pressure that our kids are under today, and why they're turning to substances. So that's a really, really good one. If you want some additional kind of context and insight, episode number 75. There's so much more that I would love to share with you on this. But I know it's a lot. I know it's scary. So do check out the show notes because I put a ton of resources there for you. There's even a PDF that's called Youth fentanyl discussion guide. And that will give you ideas on how to have a conversation with your kids. I did this episode and I am so passionate about this because there is just no longer time to delay having this dialogue around drugs around fentanyl around overdoses with our kids, regardless of their age. I say that not with young super young kids, obviously. But if you've got tweens, if you've got teens, if you got 20 Somethings, this is a conversation you can not afford not to have. Might they react badly? Might it feel awkward? Might you stumble on your words? Yes, yes to all of that. It's gonna be awkward. They might react badly, you might stumble on all of your words. But that's okay. Those are going to be temporary things, temporary feelings. And as you talk more, you're going to get more comfortable with it. And I would say, considering the alternative, being awkward is absolutely preferable.
31:47
Thank you so much for doing the hard thing, which is listening to Hopestream, it means that you are doing everything possible to educate yourself. To help your child it is so brave of view. And I want to tell you that because there are a lot of other things that you could be doing with this hour. And I know that sometimes taking that first step is the hardest.
32:14
Thank you so much for listening. If you'd like to go to the show notes, you can always find those at Brendazane.com/podcast. Each episode is listed there with a full transcript, all of the resources that we mentioned, as well as a place to leave comments if you would like to do that. You might also want to download a free ebook I wrote called hindsight. Three things I wish I knew when my son was addicted to drugs. It's full of the information I wish I would have known when my son was struggling with his addiction. You can grab that at Brendazane.com/hindsight. Thanks again for listening and I will meet you right back here next week.