The Hidden Victims Of the
Opioid Epidemic
By Dr.Fourkan Ali
Take, for example,
the recent story that made national headlines. A 5-year-old boy awoke to find
both of his parents unresponsive on the floor. He ran two blocks to his
grandfather’s home, declaring his parents were dead. The grandfather called
911, and they raced back to the home. The father was reportedly responsive
after one dose of naloxone, used to treat opioid
overdoses, but after seven doses with no response, the mother was
transported to the local hospital. During a search of the home, the boy's
3-month-old sister was found in the car, screaming in her car seat. Tales like
this one are becoming more mainstream, with images going viral of children in
cars while their parents are unconscious from drug use.
Children of opioid
abusers suffer in many ways. Infants are often born addicted, a phenomenon
known as neonatal
abstinence syndrome, or NAS. In fact, in 2012, one baby with NAS was
born in the U.S.
Picture a newborn,
7 pounds and hours old, exhibiting all kinds of symptoms: tremor, irritability,
sleep issues, excessive or high-pitched crying, increased muscle tone and
reflexes, seizures and
yawning among other signs. The treatment requires prolonged stays in neonatal
care units lasting weeks to months, as well as drug weaning using morphine and
methadone. These babies cannot tolerate stimulation and generally cannot be
cuddled or loved. That's not the way we would expect little ones to
enter the world.
The societal costs
of stories like these are also significant. For most people
addicted to drugs, use can lead to increased episodes of domestic
violence, poor self-esteem and loss of life. Overdose is only one cause of
death in these parents. Violent death from drug deals gone wrong and infections
from needle use such as hepatitis C or HIV can
lead to deaths.
If not death, the
potential for abuse and
neglect of children is widespread, leaving children
functionally without their parents anyway. The opioid crisis has caused more
children than ever to be placed into the foster care system. In 2015, 428,000
kids were known to be in foster placement. Add to that those placed with
relatives or who are still in abusive or dysfunctional homes but not formally
in the system, and the estimate is probably more like 2.5 million children are
in foster care – or should be removed from their parent's homes. Of all these
cases, about a third of children are removed for substance
abuse by parents and 18 percent of these kids are less than a
year old. What's more, the epidemic, just like most others in history, has
epicenters, with five states responsible for 65 percent of the increase seen in
children needing services: Arizona , Florida , Georgia ,
Indiana and Minnesota
Given all of these
statistics documenting the tragedy that stems from opioid abuse, it seems we
should have a handle on the situation, including a solid plan of attack.
Rather, it appears almost the opposite is happening: Efforts to date have
actually worsened the situation rather than tempered the opioid epidemic.
The Drug
Enforcement Agency, or DEA, actually predicted the issue with some certainty.
The U.S.
These regulations
are substantial and were embraced by the medical community. Yet the abuse rages
on. Why? Out of the attempts to control the epidemic, there have been several
unanticipated consequences, including substitution of heroin for the previously
prescribed opiates. The unfortunate fact is that heroin is
extremely addictive and frequently overdosed. Lots of
additional high-risk behaviors are associated with heroin use such as needle sharing,
sex for drugs and high-risk interactions with dealers. These contribute to
additional fatal infections and violence.
Prescribed opioids
such as Vicodin and Oxycontin are hitting the black market and synthetic drugs
that are illicitly manufactured, such as fentanyl,
are increasing. These designer drugs and heroin have increased 426 percent
since 2014 and deaths have increased by 79 percent. Despite the best efforts by
the DEA and medical community, not only does the abuse go on, it is getting
more dangerous.
How can we even
begin to fight abuse of pandemic proportions? The answers are neither easy nor
inexpensive. Several steps have been enacted, some of which, like needle
exchange programs, make society feel uneasy. Perhaps we need to re-evaluate the
prescribing of opioids to put in a better weaning program and avoid the
substitution with heroin. Lastly, maybe health care reform needs to take a good
hard look at covering addiction
treatment programs. Maybe these things will work; possibly not. But
we have to try something.
So, back to our
5-year-old and his baby sister. They should wake up every morning with someone
to get their cereal and make sure they have their shoes on and their backpack
ready for school. They should be able to look to their parents as
role models, people who show them how to grow up and be productive
citizens. Instead, they may be destined for a life in the system, haunted by
the visual of waking to parents they were certain were dead and a frantic dash
for two blocks for help. Until perhaps they begin to use heroin and the cycle
repeats itself. We count on every generation doing better than the one before –
will that be in the form of even more accomplished addicts? If that is not
where we want to end up, we have to find a way to stop the merry go round.
Right now.
The writer Teacher
& Columnist
01611579267
dr.fourkanali@gmail.com
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