Despite state laws expanding access to the opioids without prescription, a new study suggests that many pharmacies don’t stock the drug or dispense it to young people who need it. In the 10 U.S. states with the most opioid overdose deaths in 2016, roughly four in five drugstores stocked naloxone, a survey of 120 pharmacists found. But nearly half of these pharmacists incorrectly thought that they could only dispense the treatment to adults. “Hindering access to naloxone to youth who are able to recognize the signs of an overdose and administer this life-saving medication undermines the effectiveness of these policies,” said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center of New York in Lake Success and senior author of the study.
Overdoses of opioids like morphine or heroin can be deadly because these drugs slow breathing, thereby reducing the supply of oxygen to the body.Naloxone blocks the ability of opioids to affect the nervous system, including the regulation of breathing. The trouble with any delays or roadblocks in access to naloxone is that it needs to be given quickly to be effective in countering the potentially fatal effects of an opioid overdose. “If a pharmacy was not willing to provide naloxone to an adolescent, they could still obtain the medication through a prescription from their doctor, or, theoretically, if they were accompanied by a parent or other adult,” said Kirk Evoy of the University of Texas at Austin College of Pharmacy and University Health System in San Antonio.
“I think the biggest concern would be teens who didn’t feel comfortable disclosing opioid use to a doctor or parent, whether it be their own use or a friend’s use, and thus decided to give up trying to obtain it after initially being turned away,” Evoy, who wasn’t involved in the study, said by email. Most pharmacy employees surveyed correctly stated that no prescription was needed for naloxone, researchers report in the Journal of Adolescent Health. And most also understood that people were allowed to get naloxone to use for another individual who might be at risk for an overdose.But only 52% of pharmacists correctly stated that there was no minimum age for purchasing naloxone.
Among chain drugstores in the survey, Walmart and Walgreens were more likely to stock naloxone than CVS. Where drugstores did stock naloxone, 67% carried only the nasal spray form of the drug and 12% only dispensed injected versions. The study wasn’t a controlled experiment designed to prove whether or how drugstore availability of naloxone might directly impact teen access to the treatment or overdose deaths. One limitation is that it only focused on 20 drugstores in each of the states examined, and it’s possible survey results from this small sample of pharmacists might not reflect naloxone access nationwide. It’s also possible that some pharmacists incorrectly believe there are age restrictions for naloxone because there are other drugs with age restrictions like smoking cessation aids, said Talia Puzantian, a researcher at the Keck Graduate Institute School of Pharmacy and Health Sciences at the University of Southern California in Los Angeles. “Without naloxone on hand, the risk for fatal overdose is significant,” Puzantian, who wasn’t involved in the study, said by email.
“Increasingly, adolescents are using and misusing both prescription opioids and illicit opioids,” Puzantian said. “As prescription opioids become more difficult and costly to obtain, users are increasingly using the riskier illicitly manufactured pills or heroin which are increasingly adulterated with the more potent opioid fentanyl which is now driving the majority of opioid overdose deaths.”
Should Your Teen Take that Opioid Prescription?
But with the nationwide opioid addiction epidemic constantly on the news, you probably have some hesitation about letting your teen take the prescription.
On one hand, you don’t want your child to suffer intense pain; but then again you also don’t want that one prescription to lead to addiction or act as a gateway to other drugs.
And that fear isn’t completely unwarranted. According to the latest National Survey on Drug Use and Health, almost 900,000 young people between the ages of 12 and 17 misused pain relievers within the past year. Here’s another scary fact: many heroin users start off by abusing prescription medication.
So what should you do?
Obviously you know your teen best, but below are some things to consider if you’re thinking about letting them use prescription pain medication.
Keep in mind: there is a responsible way to use opioid prescriptions.
Because we hear so much about the misuse of painkillers, we can sometimes forget that the majority of teens use them with no issue.
Follow these steps to make sure your young loved one is using prescription pain medication responsibly:
Talk to your teen before his/her appointment. Before your trip to the doctor or dental office for the procedure, have a chat with your teen about prescription opioid painkillers.
Don’t forget to mention:
- Doctors prescribe pain medication for severe or moderately severe pain.
- Many pain meds are very addictive.
- Do not share your medication! It’s specifically prescribed for you, and you should be the only one taking it. What’s a normal dose for you, could be fatal for someone else.
- Mixing prescription painkillers with alcohol is deadly (even though it’s illegal for you to drink anyway).
- You can also take over-the-counter pain meds or try other more natural ways to lessen your pain.
Also have a chat with the doctor. Internet research alone might not cut it. So you may also want to have a discussion with the doctor about the different prescription options, any concerns you have about addiction, different painkiller options, what to expect after the procedure, how long the teen should be on the medication, dosage, etc.
After your teen gets the prescription …
Monitor usage closely. Before leaving office, have the doctor clearly explain to the both of you the medicine he or she is prescribing, side effects, overdose risk, the proper dosage, and the duration. Since the painkillers are so powerful, many prescriptions will call for them to be taken at least six to eight hours apart (some as much as 10 hours apart). But when the pain hits, your teen (just like many adults) could be tempted to take them before they are supposed to.
Keep the meds with you. Yes, you (and probably the doctor) have had the conversation with your teen about painkiller misuse. And, yes, you respect and trust your teenager. But is there really any good reason to allow him or her to keep an entire bottle of powerful painkillers? If you really can’t think of any, you might just want to keep the prescription with you. For your teen, it removes the temptation to overuse or share with friends. Each day, you can give your teen the appropriate amount of pills they will need.
Get rid of extra pills. When the prescription days are over, make sure you get any leftover pills out of your house. You can drop it off at an official prescription drop off location (find one here) or properly dispose of the medication at home.
As we mentioned earlier, most teens take prescription painkillers without any problems. Being thoughtful, and taking these precautions can help make the experience successful and result in a lifetime of responsible use of prescriptions.
With drugs being so accessible, as a parent or caregiver, you may feel a little overwhelmed or even helpless when it comes to keeping your young loved ones away from them.
Here are some ways you can protect your kids and prevent them from purchasing drugs online
- Keep the communication lines open. Make sure to always have an open line of communication with your young loved ones. Let them keep you in the know about their friends, what’s happening in their school, their interests, and more. Being close to him or her also helps you to notice changes in behavior that could point to drug use.
- Make sure they know the consequences. Because the drugs can be so readily available online, kids may sometimes believe that they aren’t really that dangerous. But from overdose to death to possible jail time if they are caught, using and buying drugs can lead to serious consequences. There are many cases where someone is sentenced to prison for giving a pill to someone who later overdosed.
- Check out their “searches” (if you suspect drug use). Look through their browser or Google searches (on their computer or cell phones). Keep an eye out for any “How to buy ____ online” -type searches. Bring up anything that causes strong suspicion. This may be an uncomfortable conversation and you may also be accused of spying (which you are technically doing). But be sure to let him or her know that you are worried and only want to keep them safe. Make sure you point out recent cases in the news about young people overdosing on drugs. You may also want to invest in one of these “Parental-Control and Monitoring Apps.”
- Monitor their delivered packages (if you suspect drug use). For obvious reasons, drugs are often delivered in unmarked and discreet packages. If you find your loved one getting such mail, or packages that you don’t expect, ask them about it. You may want to stick around when they are opening the package.
With drugs being more accessible than ever, the most important things you can do are to educate yourself. This should be on the potential danger while maintaining a good relationship with your child.