Wheeler's Special Education Spotlight: Student Use of Opioids and Other Illicit Substances
Michael Russo, Psy.D.
Vice President of Education and Early Childhood Services
Illicit opioid use and misuse is a national crisis and public health emergency, and has received much attention in the media over the past few years. While opioid misuse is more prevalent with adults, many children and adolescents are also at serious risk. This risk emanates from their own illicit opioid use, as well as the secondary impact from parental use.
The impact of opioid addiction on families is far reaching and often devastating. Prenatal exposure to opioids and other drugs can result in premature births and developmental delays. Parents who use opioids may become withdrawn, indifferent to their children’s needs, unable to provide adequate supervision, and a risk to their children’s well-being. Recent media reports have highlighted the connection between parental opioid use and sex trafficking of children and to a serious increase in the number of children entering the foster care system. All of these issues have a direct impact on schools.
Educators are all too familiar with the problems that substance use can cause for our students: decline in academic performance, erratic behavior in and out of school, difficulties with peers, problems at home, health problems, and court involvement. However, substance use is also a leading cause of teen death or injury related to car crashes, suicide, violence, and drowning. Even casual use of certain drugs, such as opioids, can cause severe problems, including death; in fact, deaths from opioid use exceed deaths from all other illicit drugs combined.
Illicit substance use is a serious concern in schools throughout Connecticut. No district is immune and all districts need to be actively addressing this issue through prevention initiatives and direct intervention. Prevention-focused programs are effective and consistent efforts to educate youth about the risks associated with substance use have had a positive impact. In December of 2017 the NIH released data indicating that reported substance use among teens is at the lowest level in two decades. However, the national trend of legalizing gateway drugs such as marijuana in many states throughout the country draws into question how long these downward trends among teens will continue. Despite the decline in reported use, the report also contended that the perceptions teenagers maintain regarding the risk of harm from illicit drug use has also declined. In addition, the number of teens who are misusing prescription drugs is on the rise.
The Centers for Disease Control (CDC) reports that 1 in 5 high school students acknowledge they have misused prescription drugs. Of particular concern is that nearly half of young people who use heroin start by using prescription pain medicine such as Vicodin, OxyContin, Percocet, Codeine, and Fentora—all of which are opioids typically found in their homes or homes of their friends. Reports indicate that two-thirds of students who acknowledge misuse of prescription opioids are getting them from friends, family and acquaintances. Concerns regarding opioid overdose are significant and must not be ignored. The increased risk of opioid related overdose and death in Connecticut and across the country is so great that many school districts have adapted policies to keep Narcan (Naloxone) on hand in high schools; this prescription medication is designed to reverse the effects of an opioid overdose and save lives.
Student use of substances such as opioids transcends experimentation. Many use opioids to get relief from building pressures, such as academic, social, or familial stressors. The euphoria often experienced by opioid use is followed by feelings of dysphoria, which leads to an insidious cycle of use, overuse and addiction. As this cycle deepens, the need for continued use of opioids just to maintain “normal functioning” increases, while availability and affordability of illicit prescription medication decreases. As a result, students who misuse prescription opioids often turn to more dangerous, but less expensive and more readily available, options such as heroin.
Risk factors for opioid and other substance use include teens who feel that they are disconnected or undervalued, have poor self-esteem, struggle with untreated mental health issues (such as depression, anxiety, PTSD), experience chronic pain, or have family members who misuse substances. Teens with family members who have problems with illicit drugs are at increased risk of having serious substance use problems themselves. As educators, it is important to be aware of these factors as they may signal that a student is at risk of developing a problem with opioids or other drugs.
Given the seriousness of opioid misuse and addiction, it’s important for educators and parents to know what to look for that may indicate that a student is using opioids. The following changes may suggest opioid use:
- Mood (elation/euphoria, sedation, shifting moods, anxiety, depression)
- Academic performance (declining grades, poor attendance, disciplinary action)
- Behavior (low energy, tired,, lack of motivation, irritability, agitated, hypervigilance)
- Peer group (new peers not known to parents, withdrawal from former friends)
- Interests (indifference, apathy, lack of involvement in former interests)
- Eating habits (decreased appetite)
- Physical appearance (constricted pupils, slowed breathing, gaunt, disheveled, lack coordination)
- Mental or emotional state (confusion, memory lapses, poor concentration, spacey, flat affect)
While these warning signs may signal problems in a number of areas, as they relate to opioid use it’s important to be mindful of rapid or hard to explain changes. It’s also imperative not to explain away these changes, think that someone else will do something about them or that someone else already is intervening. Chances are, concerns expressed by school staff may be the impetus a parent needs to take notice and start to seek help for their child.
What can educators do?
Be proactive: Prevention efforts work. Providing substance use education starting in Kindergarten and following through high school has been a critical weapon in this battle. It is critical to bring parents in on these efforts by providing them with information to reinforce at home. Children who learn about the risks of illicit drug use from their parents are at least 20% less likely to use drugs than those who do not. Wheeler’s Connecticut Clearinghouse is a great resource for information regarding alcohol and drug use, misuse and addiction information and services. Check out the Clearinghouse website at www.ctclearinghouse.org or call 800.232.4424.
Share your concerns: If you have a student who you are concerned may be using substances, talk about your concerns confidentially with a supervisor, school counselor or school social worker. Together, develop a plan for how the issue will be addressed with the student and his or her family.
Intervene early: If there is suspicion that a youth is misusing opioids or other substances, it is important to have a school counselor or social worker speak with the youth and with his or her parents/guardians about the concerns and where to seek help (i.e., substance use recovery counseling by a trained professional at Wheeler or another organization that provides these services in your community, medication assisted treatment, and coordination of care with the student’s pediatrician).
Provide information and support: Provide parents with information and resources so they can support their child and reinforce the school’s efforts. Encourage them to keep prescription medicine in a locked cabinet and monitor it for tampering and/or unauthorized use. If it is unclear where to can get help, they can call 1.800.563.4086 (for students 17 or older) or 2-1-1 (for students younger than 17) for assistance in finding opioid treatment in Connecticut. Parents can also visit the Partnership for Drug-Free Kids website at drugfree.org/get-help or call their toll-free helpline to speak to a parent specialist: 1.855.DRUGFREE (1.855.378.4373).
If you have concerns about a student who is struggling with substance use and you have questions about how best to help, please contact us at Wheeler at 860.793.3717. We will be happy to be of assistance.