TEANECK, N.J. — After years of decline, U.S. teen drug overdoses are beginning to rise again, according to Holy Name Medical Center Co-Director of Emergency Medicine Randy Tartacoff and a recent report released by the U.S. government.
The study focused on adolescents from 15 to 19 years old.
When the epidemic began in 1999, the death rate among adolescents was 1.6 per 100,000, Tartacoff said. It has since quadrupled.
Overall, the overdose death rate — mainly accidental and caused by heroin — rose from 3.1 per 100,000 in 2014 to 3.7 in 2015, the physician said, citing the report.
The rate among boys rose from 4 per 100,000 to 4.6, and the rate among girls increased from 2.2 to 2.7.
Tartacoff zoomed the lens back to the 1990s, when the epidemic began, ironically enough following the addition of the fifth vital sign — the pain score.
Soon after that, pharmaceutical companies introduced oxies.
"It was the perfect storm," Tartacoff said. "We were set up for the beginning of the opioid epidemic."
Physicians were allowed to prescribe 30 to 60 days of pain medication and, as a result, ended up with many people who had not chronic pain, but rather a very serious and dangerous addiction, Tartacoff said.
"We created not only these addicts, but now we had to try to reduce them," he said. "Along with the fact that some people would lose insurance because of addiction — without that, these medications are expensive."
A $20 bag of heroin would completely satisfy the habit, and was much cheaper than payig $1 per milligram of oxycodone, the physician explained.
That was the beginning of the heroin epidemic, which had doctors putting patients on methadone.
"That's a great drug, but the way we address it as at a clinic, and you have contacts with every other addict at that line," Tartacoff said.
Dealers would approach people waiting in the line with bags of black tar and boom — another addiction right there.
There are several ways for adolescents to develop an addiction, Tartacoff said.
"The typical kid that I see in my emergency department who has overdosed is 15, falls on the playground and breaks his arm," the physician said. "We give him three weeks of narcotics. That's excessive, but we didn't know because they kept complaining of pain.
"They liked the feeling they got when they were on oxies, and that created adolescent addicts accidentally."
Other kids stole pills from their parents, the physician said.
"Mom's got a bad back," Tartacoff said. "We give her 90 days of pills — that's a lot. She uses them as she needs and guess who's stealing them? The kids start using them as a recreational drug on weekends."
Addiction is a difficult disease in that it runs in families anyway, according to Tartacoff. Children of addicts are especially at risk to develop the same addiction as their parents, he said.
"Each individual chooses their drug of choice," the doctor said. "Sex, shopping, drugs.
"We realize that addiction is the issue, and it's about how you are going to satisfy that disease process."
- LOOKING AHEAD
Thanks to a new law, physicians must limit the pain medication that can be prescribed, Tartacoff said. But it can be a tricky maneuver.
"As compassionate physicians, we like to think it’s chronic pain," Tartacoff said. "But legislature has allowed us to say we can’t do this anymore — it’s illegal."
The physician says it's a good start, but addiction is a disease that can tear families apart, and stigmatization isn't helping.
Equally ineffective is the concept that insurance doesn’t cover good addicted care, he said.
"It's very distressing to me," the physician said. "There’s too much blame to go around.
"Fortunately, we’re starting to address it, but it’s a very difficult problem to address."
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