A Parent’s Guide To Fentanyl and Opioids

This guide will help you discuss the following questions:

• What are opioids, and what are their effects and prevalence in American culture?
• What might my teens know about opioids, and how might they get them?
• How should I talk to my teens about opioids and their effects?

A New Epidemic

While it’s not unusual for the entertainment industry to glorify drug use, it’s also not uncommon for us to read about celebrities dying from drug overdoses. In 2018, 26 year old rapper Mac Miller was found dead after overdosing on fentanyl and his dealer was sentenced to 17.5 years in prison. In 2019 rapper Juice WRLD overdosed on Percocet and died despite the administration of Narcan (an emergency opioid overdose treatment). In 2022 Foo Fighters drummer Taylor Hawkins passed away and was discovered to have several opioids and benzodiazepines in his system.

The Centers for Disease Control and Preventions (the CDC) report that opioid deaths increased by 5% from 2018 to 2019 and that 70% of the 70,630 overdose deaths in 2019 involved opioids. In 2020, almost 92,000 people died of drug overdoses, with over 61% of those deaths involving opioids.

Fentanyl specifically has become the most deadly opioid in recent years. This fast- acting synthetic painkiller is extremely fat-soluble and almost 40 times more powerful than heroin. Additionally, O. Trent Hall, an addiction specialist at Ohio State University, says, “We’re seeing fentanyl disguised as common medications for ADHD, or for pain, or for anxiety, and the pills that are being purchased look exactly like those medications.” New fentanyl coming out of Mexico, “rainbow fentanyl” is specifically colored to look like candy.

In this guide, we want to make you aware of the dangers that fentanyl and other opioids pose to your teens and give you some practical advice on what you can do to address those dangers.

What are opioids?

Drs. Kuhn, Swartzwelder, and Wilson are the authors of Buzzed: The Straight Facts About the Most Used and Abused Drugs from Alcohol to Ecstasy. They define “opiates” as “any drugs, natural or synthetic, that produce the characteristic opiate effects: the combination of a dreamy, euphoric state; lessened sensation of pain; slowed breathing; constipation; and pinpoint pupils.” The term “opioid,” which we will be using, is a slightly more generic word referring to substances that cause these effects.

You’ve probably heard of opium, a drug prepared from one species of the poppy. The painkiller morphine is derived from the poppy’s seedpod and was developed in the early 1800s. Later in that same century, the drug company Bayer wanted to make morphine more soluble in fat (so that it could reach the brain more quickly). So they added a chemical compound to morphine and created heroin, which they sold as a “non-addictive” morphine substitute for some years.

More recently, scientists have developed various prescription opioids, such as oxycodone, hydrocodone, and meperidine. You might recognize some of these under their brand names of OxyContin, Vicodin, and Demerol, respectively. Fentanyl, which we mentioned above, fits within this group. The abuse of opioids has become so much of a concern across the country that many states have declared a public health crisis. President Joe Biden has even created a $1.5 billion grant program to assist states with response programs to the crisis.

Reflection: What do you know about opioids? Do you have any personal experience with them, or know anyone who does?

How do opioids affect the body?

Opioids can be consumed in a variety of ways, including snorting, smoking, swallowing pills, or injecting needles. The way people consume opioids impacts the speed at which the drugs enter the bloodstream and make it to the brain, thus affecting how much of a “rush” users feel. Taking opioids in a manner that allows them to enter the brain quickly (such as intravenously) causes an acute high. The body absorbs powder faster than it absorbs pills, which is why people will crush OxyContin into powder and snort it.

Opioids act on receptors in the brain and impact systems responsible for regulating emotions and physical movement, as well as a person’s body temperature, digestive system, sensitivity to pain, and ability to breathe. The pleasurable feelings people experience as a result of taking opioids include sexual arousal, decreased pain, and sleepiness. Opioids are “downers,” so users feel calm and relaxed. Pupils contract and breathing decreases. Other side effects include vomiting and constipation.

The most dangerous quality of opioids is arguably the fact that they inhibit breathing. It’s therefore possible for someone to overdose and die during his or her first time consuming an opioid. Opioids are even more life-threatening if someone takes them along with another substance that affects breathing, such as alcohol or sedatives.

Opioid withdrawal symptoms include having a runny nose, watery eyes, and flu-like symptoms. The drugs can cause constipation, so diarrhea is the body’s response to an absence of opioids after it’s adapted to them. Other symptoms could be muscle spasms, sweating, shivering, and increased pain (since opioids are pain suppressors). And of course, there’s the craving for the drug with its accompanying malaise and depression.

Opioids actually rewire the brain. As noted in the opening quotation, NIH Director Dr. Francis Collins says that opioid addicts are basically incapable of overcoming their addictions on their own.

Reflection: What is your experience with addiction, either for yourself or with others? What depictions of addiction have you seen in media?

Which opioids are teens using?

Fentanyl is by far the most used drug in America, with pills being obtained illegally as well as through prescriptions. Fentanyl-related overdose deaths are more than double the number of other prescription opioid overdose deaths, and soar high above deaths related to other drugs like cocaine, heroine, and methamphetamine.

While in previous years these other illicit drugs may have seemed more alarming than any prescription opioid, fentanyl’s impact on young people must not be ignored. Though rates of teens using any drug actually decreased during the COVID-19 pandemic, teen overdose deaths more than doubled from 2018 to 2019, due specifically to the popularity and availability of fentanyl. Joseph Friedman, an addiction researcher at UCLA says, “Drug use is becoming more dangerous, not more common.”

There are a variety of reasons teens start using opioids and other drugs, including:

• dependence on an opioid prescription;
• pressure from peers or other people in their lives;
• teenage rebellion;
• academic stress;
• partying;
• boredom;
• self-medication; or
• curiosity (which can stem from friends who use them, media that portrays alcohol and drugs in a positive light, or people they follow on social media talking about them positively).

It’s also worth mentioning the prolific portrayal of drug use, both as a positive and a negative experience, in pop culture. Recent songs like “Keep Driving” by Harry Styles and “Numb Little Bug” by Em Beihold portray drug use as something normal and fun with the added benefit of numbing pain. Rapper Lil Xan takes his name from the anxiety medication Xanax, and the lyric “pop a perc and I blackout” from the song “Blackout” by Lil Kapow, referencing the painkiller Percocet, has become a popular sound on TikTok. The 2015 song “I Took a Pill in Ibiza” by Mike Posner actually gives a more realistic portrayal of the effects of drugs, as well as sheds some light on why so many people try drugs in the first place.

The mega-popular HBO Max show Euphoria centers around a teen named Rue, played by Zendaya, who has been a drug addict since childhood. The show’s attempt to realistically portray the effects of teen drug use are undercut by its gorgeous stylization and cinematography, impressive soundtrack, and beautiful actors. Ultimately, the show glamorizes not only drug use, but teen sex, drinking, and other dangerous behaviors. We talk about this show specifically because of its massive viewership; HBO Max reports that season 2 averages over 16 millions viewers per episode, many of which are teens.

Because pop culture has a huge influence on teens, we need to be aware of what it’s saying about drug use so that we can talk to our kids about those ideas.

Reflection: Have you seen opiate use portrayed in media? Is it depicted positively or negatively?

Where do teens find opioids?

Friends and family. It’s not unusual for people, many of whom have good intentions, to share prescription medication with one another. Sharing medication with someone you know might seem innocent, but is actually quite dangerous. The majority of teenagers who abuse prescription opioids obtain them from friends or family members.

There are other reasons, apart from the risk of addiction, why sharing prescribed medication is a dangerous practice. One is that you don’t know how one person’s pain meds might affect someone else. You might not have any side effects to a medication your doctor prescribed, but your friend might have some that are severe and unexpected. And if you use a painkiller without seeing a doctor about your problem, whatever medical problem you have could worsen.

Social media. This article from the New York Times describes how teens are using apps like Snapchat, TikTok, and Instagram to get drugs, and describes how the biggest danger to this practice is not, in fact, the pursuit of drugs, but the fact that almost all of them are laced with fentanyl. “‘Social media is almost exclusively the way they get the pills,’ said Morgan Gire, district attorney for Placer County, Calif., where 40 people died from fentanyl poisoning last year…’About 90 percent of the pills that you’re buying from a dealer on social media now are fentanyl.’”

Selling drugs is against the policies of social media platforms like Instagram. But these platforms rely on users to report inappropriate content, and users can’t catch every shady person.

The Dark Web. You might have heard of the website Silk Road, an online black market that was commonly used for selling illegal drugs. The FBI took down the Silk Road in 2013, but the “dark web” is still an active place. It’s quite possible for people to do many illegal activities online if they want to, including buying drugs. They do so by using a virtual private network (VPN), the TOR browser, and cryptocurrency, all of which help to preserve anonymity.

The good old-fashioned street. We should note that despite the prevalence of the internet, when we talked to a narcotics officer in Colorado Springs, he said that (at least in this area) it’s unusual to hear of teens purchasing drugs online. They mainly still buy them on the street. Most kids who are into heroin, said the officer, are out till 10 or 11 at night, and their parents simply don’t know where they are.

It’s really not that difficult for a teen (or even younger) to find someone who does drugs (and who can point them to a dealer), whether at school or elsewhere in peer groups. It’s worth noting, as this site points out, that drug use is different in different locations.

Here’s an article on how easy it was for one Seattle teen to find heroin where she lives. She believes that the overwhelming reason why teenagers do drugs is pressure from their friends.

Once obtained, hiding drugs is fairly easy because they are so small in size. This Chicago Tribune article lists the most common places where teens hide drugs, such as:

• battery compartments;
• heating vents;
• cars;
• candy wrappers;
• shoes;
• stuffed animals; and
• highlighters.

This local news story highlighted all the places where teenagers might be hiding drugs in their bedrooms.

Reflection: What do you know about drug use in the area where you live, especially opioid use?

Does my teen have a drug problem?

The National Institute on Drug Abuse has comprehensive information on what teens should do if they are struggling with a drug addiction. Here are signs you should look for in order to tell if your child has a drug problem:

• Not spending time with friends and family;
• Changes in behavior, such as increased anger, depression, or defensiveness;
• Apathy toward former hobbies or interests;
• New eating and sleeping patterns;
• Problems at school, such as poor grades or missing class; and
• Trouble with law enforcement.

Signs of addiction to painkillers can also include:

• Blackouts and poor memory;
• Increased sensitivity (emotional or physical) to normal experiences; and
• Coughing, runny nose, and red and watery eyes.

If you discover that your children have abused opioids or have developed an addiction to them, it’s vital that you react in a way that communicates grace, truth, and love. Don’t lose your temper, and don’t despair. It’s easy to focus on the fact that your kids have deceived you, made some horrible decisions, and are now addicted. But there are always reasons why people make the choices they do.

Maybe it was curiosity that caused them to try drugs, but it could very well be they are using because of some pain they have been hiding from you or because of a void they are trying to fill. Part of their journey toward wholeness might be uncovering deep rooted issues that have potentially led them toward drug addiction. In many cases, drug use is a manifestation of a larger problem.

Make sure your kids know you still love them, and remind them that God does, too. But set clear boundaries and take steps to get them help (see the resources linked within this guide, as well as the ones listed below). Look into rehab if at all possible. With a situation such as this one, going to a licensed therapist is likely a better option than merely trying on your own to get your kids to open up to you. It might be tempting to want to deal with the problem yourself, instead of seeking outside help. But if seeing a professional is what is truly necessary, it’s important to do what is best for your son or daughter.

Be aware that if your teen has an opioid addiction, it’s important that you keep an eye on your valuables. Do not allow your kids to be home alone. Teens who are addicted may steal from you, as well as manipulate their grandparents, in order to find the money to feed their habit.

Something else that is crucial to remember is that community and prayer are both powerful resources at your disposal. 1 Corinthians 12 tells us that all Christians are members of Christ’s body. We suffer together, and we rejoice together. Galatians 6 tells us to bear one another’s burdens. Invite people you trust into the suffering of your family, and allow them to support you through prayer (Eph. 6:18) or by any other means possible.

Reflection: Have you had conversations with your teens about opioid and drug use? How do you start conversations about other difficult topics with your teen?

How do I prevent my teen from using opioids?

Don’t assume anything. We pray your child isn’t addicted to opioids, but don’t be fooled into thinking that your teen is not “the type of person” who fits the profile of becoming a drug addict because there is no such profile. Drug addiction could happen to anyone, and it’s easy to hide. We’re not trying to make you fearful or paranoid. But you should be aware of the dangers, particularly because most people who do become addicted start using at a young age.

Be alert about media. Be aware that media affects how we think about life and can impact what we do. Watching violent movies and listening to angry music doesn’t necessarily mean people will commit acts of violence. But it can make them angrier people than they would have been otherwise. In the same way, the DEA reports that teens who consume a lot of media depicting drug use are more likely to experiment with drugs.

Be careful about your own drug use. Helping your children avoid a drug addiction starts with you being careful with drugs yourself. This cautiousness includes not lending prescription meds to someone else, even if you think doing so would be safe. If you do have prescription painkillers in the house, make sure you keep an eye on them. Count them, remember how many pills you have so you will know if any go missing. Lock them up if necessary. It’s also wise for you to have a thorough understanding of what painkillers (or other drugs) your doctor is prescribing you and your children and why. Your goal should be to get off of prescription opioids as soon as possible. Just because they’re legal and can help with managing pain does not mean they’re safe.

Have rules and monitor your teens’ behavior. You can take the following preventative measures with your teenagers:

• Keep an eye on your credit card statements;
• Check browsers and social media apps, looking not only for suspicious sites but also to see if your kids have recently cleared their history;
• Get to know your kids’ friends and their families;
• Be aware of your children’s general habits so that you’re also aware of any odd changes;
• Know where they’re spending their time.

You should also have clear guidelines and house rules for drug and alcohol use. One of your main rules will obviously be that they’re not allowed to use anything illegal. But your house rules could also establish guidelines about not spending time with or getting rides from people who might be high or under the influence.

Cultivate healthy connection and community. This powerful video, based on Johann Hari’s New York Times best-selling book Chasing The Scream: The First and Last Days of the War on Drugs, helps us to rethink how to attack addiction. If you do only one thing suggested in this guide, watch this video. (Also, check out the related website ChasingTheScream.com.)

Conversation is huge. One of the most important steps you can take for your kids to help them not to try drugs is to have an open and ongoing dialogue with them. Educate them on the drugs that are out there and their dangers. Make sure your children know what tactics dealers use to try to get them to buy. They should also know that dealers could easily sell them a corrupt product, the wrong product, or a product with a more powerful effect than they will expect, potentially leading to overdose and death (for example, a drug could be laced with fentanyl, which, as we have discussed, can easily lead to an overdose).

Reflection: How can you take steps to educate yourself and your teens about the dangers of opioid use? What are some things you can pray for in your conversations with your teens?

Salt and Light

One of the resources linked above (from the NCADD) recommends promoting healthy family activities. This advice is on track. All of us need to know more than what not to do in life. We need to know what we can do that is good. How can you cast a vision for “the good life” and help your teen live it out? God created a beautiful world, and it’s right to relish His generosity and be thankful for all of His gifts. But He didn’t create us merely to live for our own enjoyment (although there’s certainly nothing wrong with enjoying our lives!). He created us to love and serve others. Helping people overcome pain or evil in their lives can be deeply meaningful experiences.

What are you doing as a family to serve Him and to serve others? In a world of pain, depression, and anxiety, how is your family cultivating truth, beauty, and goodness? Consider going on a mission trip as a family or serving at a food shelter in your city. Save your money and surprise the people behind you in the fast food line by paying for their meals. It’s true that it’s possible to do these activities in a self-centered way. But if we have the right motives, God often blesses us with joy as we generously bless others. The experience of genuinely helping someone else is far greater than the temporary pleasure and long-term slavery that are the only “gifts” drugs can offer.

The opioid crisis presents a very real danger for all of us. Even if we aren’t directly affected (yet), there are people all around us who are struggling with addiction. These people need us and our teens to help, to show them Christ’s love and compassion, and to help them find healing, both physically and spiritually.

Though there’s no sure-fire, guaranteed way to prevent opioid use and abuse in our kids, we can begin the conversation now, exposing not just the ugly truth about drugs, but also the lies in how our culture tends to glamorize drug use. Above all, we need to cast a better vision for pleasure, enjoyment, and purpose in this world. When compared with the abundant life of Christ, being high pales in comparison! How are we cultivating that perspective in our children?

Our kids need us for oh so many reasons, but opioids remind us that they need us to protect them—not by sheltering them or shaming them into submission, but by inviting them into a larger narrative and by being their safe haven. Whether you find yourself in the midst of dealing with an opioid addiction or are simply concerned about the risks, never stop reminding your kids that they can tell you anything and that you and God love them no matter what.

Reflection: How can you reflect the love of Christ to your teens? How can you share hope and truth with them where they are?

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