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Talking with Adolescents about Opioid and Stimulant Misuse

Montana State University Extension, Family & Consumer Sciences Rural Opioid &        Stimulant Education, Awareness, & Outreach Project

According to research, the adolescent brain is not fully developed until about age 25. Because of this, adolescence ranges from about 10 to 12 years of age through the mid-20s. This research explains why     adolescents are risk-takers, including being prone to experimenting with illegal substances and prescription medications. (Arian, M., et al., 2013)

Fentanyl                                       

A synthetic opioid developed to help relieve pain in situations such as cancer treatment and surgery. Fentanyl is 100 times more potent than morphine and 50 times stronger than heroin (DEA; CDC). This drug has found its way into the counterfeit market, which has no regulation on potency. Even a small amount  (2mg) is considered a potentially lethal dose (see picture on to the right).

Counterfeit Pills                

Opioid and stimulant pills (e.g., Vicodin® and Adderall®) along with  marijuana and vape pens, are being laced with lethal doses of illegal fentanyl.

OVER HALF of deaths from opioids are in the age group of adolescents up to age 25     (Wilson et al., 2020).

Middle School IS NOT too early

Talk    

For serious and difficult conversations about subjects such as substance misuse, the discussions should start early in adolescence, around ages 10-12, and continue through young adulthood. The concerns about the misuse of prescriptions, counterfeit drugs, vaping, and the lethalness of fentanyl that is being added to counterfeit drugs requires early and consistent discussions.

Listen

Always use active listening to show……

  • Concern: I noticed you seem (sad, angry, etc.). I care about you and would like to know if I can help.
  • Empathy: This sounds like a difficult situation you are having with your friend. How are you doing? 

 Always…...

  • Paraphrase: Sounds like you are pretty upset with your friend. 
  • Clarify: Are you planning to talk to your friend about what happened? 

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  1. DON’T ASSUME THEY KNOW! Begin by asking your preadolescent or adolescent if they know what it means to misuse a drug (prescription or illicit). Misuse of prescription drugs means using a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to feel euphoria (i.e. to get high).
    • ASK: Do you know what it means to misuse a drug?
  2. Draw upon “teachable moments” those that come about because of something you or your adolescent have seen or read. For example, “I see that a 13-year-old died in Connecticut. He thought he was taking oxycodone but it ended up being a counterfeit pill that was laced with fentanyl. I feel so bad for his family. This is very scary to me as a parent.” 
    • Ask:Do your friends talk about taking prescription medicines?
  3. Be inquisitive but not accusative. It’s ok to ask them what they know. 
    • Ask:How do you feel about those who are using drugs?
  4. Do not make the discussion a one– time event. Continue to ask your teen what they know and how they feel about substance misuse. 

Taking the discussion to the next level 

Once your adolescent is in late middle school or high school they will be pushing for more freedom, especially on topics of curfews, driving a car, and hanging out with friends.  Keep the conversation going.

  1. Have a set dinner time where you can casually talk about what’s going on at the school socially.
  2. Talk about curfews that their friends have, along with other rules such as grades, hanging out with friends, and driving. Listen to what your adolescent has to say rather than jumping in and judging what they are hearing from their friends. 
  3. Schedule a time for the family to talk and determine the freedom and limits you, as the parents, will have for them.
  4. Use the active listening techniques from page 1
  5. Avoid solving the problem. Instead ask questions like, “How might you approach your friend about their behavior?, “Would you like to talk about ideas?”
  6. Although you will have the final say, allow them to express their ideas and solutions. Work through any discrepancies and find common ground or compromise. Compromising with set expectations can help them learn responsibility.
  7. Set clear expectations and discuss consequences for each. This will help your teen know what to expect if they break a rule. Make sure you follow through. Examples on page 3.
  8. Model good practices when making decisions and using substances like alcohol.
  9. Be honest with them and let them know you are concerned about the types of opioids and stimulants that they may come in contact with.

Above all, let your adolecent know you love and respect them

 

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Your adolescent wants an 11:00 curfew on weekends and you want 10:00. You may find a common ground at 10:30 pm – with restrictions. For example: “We will try for 10:30, however, wherever you are at (movie, school sports game, etc.) you will call me when the event ends and let me know who you are with and where you are going.”

Examples of Setting Expectations

“My stance on illegal substances is a zero-use policy. This is because I am your parent, I love you, and my job is to protect you.”

“If you find yourself in a situation where others are using illegal substances, I expect you to call me and ask me to come get you. I can meet you where you are or nearby. We will discuss the situation later, however, if you haven’t used any illegal substances, you will not be grounded. I do not expect you to be perfect, however, I expect you to understand that I know the dangers of these substances and my job is to love you and keep you safe. I do expect you to respect that.”

“If you have used an illegal substance, I expect you to call me and ask me to come get you. We will discuss the situation later, however there will be consequences.” 

Examples of Setting Consequences

“Breaking curfew would entail a discussion and change in curfew may need to be implemented for a set amount of time.”

“Having others in the car who you did not authorize when your teen was    driving may result in revoking privileges for using the car.”

“Being at an unchaperoned party could result in grounding for a period of time. “

“If established rules are continually broken, more privileges will be denied because I love and care for you and need to keep you safe.”

Resources:

Arian, M., et al. (2013). Maturation of the adolescent brain. Neuropsychiatric Brain and Treatment, 9, 449-461. 

Wilson, A. C., Morasco, B. J., Holley, A. L., & Feldstein Ewing, S. W. (2020). Patterns of opioid use in adolescents receiving prescriptions: The role of psychological and pain factors. American Psychologist, 75(6), 748–760.​