Addiction is a complicated subject. It is said, for some people, as little as 5 doses of opiod use can make you addicted to the drug. A pain pill taken every 12 hours, if needed, means in as little as 3 days, one might have a real problem. This article references the child perspective. Opiods... are they the only choice for pain relief?
MICHAEL MILOBSKY, MD
MAY 10, 2019
What if I told you that your adolescent child could contract a disease that can never be cured, but only maintained? That it would be a lifelong struggle that could change their personality, compromise their potential and values, destroy their relationships and have a long-term detrimental effect on their overall and mental health? That this disease can even be fatal, when ineffectively maintained? What if I told you that the number one place your child risked contracting this disease was a doctor’s office, emergency room, or urgent care facility?
I want to start this out by saying that I am not criticizing any particular doctor, surgeon or facility. This post is intended to educate my parents enough to prevent their children from falling victim to one of the most insidious epidemics facing our generation. I cannot change the system overnight, but I can make sure that my families know enough to keep their children safe within it.
Two weeks ago, my teenage daughter, Maya, went in for an uncomplicated wisdom tooth extraction. In her pre-op visit, Maya was given a routine prescription for 24 Percocet, a six-day opioid prescription to manage her post-op pain.
Maya is a studious, responsible and smart young woman. She is cheerful, well-liked and incredibly talented. But what Maya never could have known, is that those 24 pills alone, could trigger a disease that would rob her of everything she had worked for 16 years to become.
What Maya couldn’t have known, is that her brain is so uniquely vulnerable to addiction, that those 24 pills could have been enough to activate a lifelong dependency.
You see, due to its window of development, the adolescent brain has a unique vulnerability to addiction. The reward center that pumps out dopamine — that “feel good” sensation they get — from scoring high on a test, from devouring junk food, from physical contact with their latest “crush,” from 1,000 likes on their Insta post — that system is really well-developed. But the part of the brain that tempers the dopamine response — the prefrontal cortex — is immature and underdeveloped. Imagine a Ferrari with only an accelerator and no brake, and you can better understand the adolescent brain. So, when faced with feel-good, dopamine-inducing opioids, the teenage brain can very quickly, and very intensely, start seeking more meds.
We disposed of Maya’s prescription, and offered her Motrin and Tylenol to manage her pain, because studies show that Motrin and Tylenol offer pain control comparable to morphine when used for injuries like fractures.
But you don’t have to be an addiction-specialized pediatrician to protect your own child. One of my greatest motivations in opening our clinic seven days a week, is so my patients aren’t prescribed unnecessary pain killers or antibiotics over weekends and holidays.
But I am not in every dentist appointment or surgeon’s office or urgent care facility. I don’t see every prescription being dispensed to my patients. So, I have to ask you, my parents: When someone reassures you that: “You cannot become addicted to opioids when you are in pain,” or, “One week isn’t enough to become addicted,” remember this post. For some, their statement might prove true. But if your child happens to be one of the many who are genetically predisposed, they run the risk of becoming victim to the most sinister illness facing our generation. It is never worth the risk.
Michael Milobsky is a pediatrician.