Of the calls Kristen Milun made and received in the days after her son’s death in 2015, one from a stranger stood out.
The woman was a reporter, who had obtained information about Milun’s son’s death from the coroner. She told Milun that she’d previously contacted parents in Milun’s position who had refused to speak publicly about their children’s deaths. They had told family and friends that their children died of an aneurysm, or a sudden illness, and had shrouded the truth: that their children had overdosed.
Though grieving for the child who had struggled with heroin addiction before his death, Milun made the decision to break the silence.
“I was proud to talk about my son because I’m proud of him, but clearly there is a lot of shame here,” said Milun, the mother of three Wayzata High School graduates. She shared her family’s story on the panel at the Hennepin County #NOverdose town hall meeting Monday, March 20, at her children’s alma mater.
Opioid deaths are on the rise, and young people are at particular risk. In response, Hennepin County has introduced the #NOverdose campaign to raise awareness.
Opioids include heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin.
Parents, grandparents and guardians at the town hall meeting gained insight into opioid addiction, its affect on young people and what they can do to support teens through prevention, intervention, treatment and recovery. Topics included:
Building relationships with young people
The panel stressed that parents, relatives, teachers and coaches have a significant influence on youth and their decisions to explore substance use. Plymouth Police Deputy Chief Dan Plekkenpol said he has been part of the Drug Abuse Resistance Education (D.A.R.E.) program for several years.
“We found a lot of value in it because of the relationships we built with the students, and families build relationships with people they can call,” he said.
He mentioned the presence of resource officers in Wayzata High School and the middle schools.
“We are seeing a spike in Plymouth with opioid use. Numbers aren’t staggering, but the increase is,” Plekkenpol said. “In 2015 we had one opioid death in Plymouth, but that’s one death; this could be preventable. In 2016 we had five. One to five — those are not big numbers, but that is a big jump.”
Understanding the teen brain
Alison Wobschall, director of Partners in Prevention, a community coalition serving the Wayzata School District and working to prevent and reduce youth substance use, discussed the prefrontal cortex of the brain, which houses decision making, control and inhibition. In young women, it develops around age 22 she said. In young men, around age 25.
“It’s a huge factor of this prevention puzzle,” said Wobschall. “It’s important for parents to understand that means science is working against us with prevention.” She also said substances can have long-lasting effects on a developing brain, and that some mental heath diagnoses are connected with use. “Drinking and drug use change the rewards circuits in the brain that underline lifelong problems with addiction.”
Starting the conversation early
According to Dr. Steven Delisi, assistant dean of the Hazelden Betty Ford Graduate School of Addiction Studies, professionals are seeing first opioid and marijuana use in patients as young as 11, 12 and 13. He said users who start with pills are 19 times more likely to move on to heroin.
It’s important to support children as young as grade school in their emotional and social development and coping skills, controlling emotions and managing disappointment, said Wobschall.
Wobschall said that by the time kids have their own cellphones or access to the internet, they are quickly exposed to an onslaught of information. “When that happens, they are learning way more than you think, so that would be a good time to introduce conversations about alcohol and drugs.”
Being a role model
Teens are more likely to engage in risky behaviors if they think their parents are OK with it, panel members stressed, and the more parents outline expectations, the less likely they are to engage in those behaviors. Modeling responsible behavior with alcohol and prescriptions in the home, talking about drug use and supporting siblings of those struggling with addiction were all mentioned — the last because siblings, especially those close in age, sometimes use together.
Taking control while they are minors
When kids are 17 and younger, parents have a certain amount of control over their health care, access to prescriptions and exposure to drugs — control that disappears the day they turn 18.
“When they go to the doctor for the wisdom teeth, flu, sprain, opioids are given out like candy,” Milun said. “We can absolutely tell kids, ‘We’re not taking that. How about a Tylenol? How about a cold pack?’ The world survived a long time without opioids. Our kids do not have to live on opioids to get through everything.”
Teens can’t use drugs that aren’t around. Families can cut down on access by taking unused portions of prescriptions, which often come with a 30-day supply but are only used a couple of times, to a drug collection site. Hennepin County has announced several locations. Panel members cited access to alcohol and drugs in the home and too much privacy or alone time as major risk factors that parents can minimize.
Knowing the warning signs
Milun and Wayzata High School mom Rose McKinney, whose son is three years in recovery from a heroin addiction, stressed that even attentive parents can miss warning signs. They were both tuned in to their sons, smart and accomplished young men with friends and supportive families.
“As a parent you have this, ‘I’ll go in their room, and if they’re using drugs I’ll find it.’ We didn’t find it. What we did find in hindsight were lots of clues,” said McKinney.
Both moms recalled things like mood and behavior changes that at first were attributed to regular teenage growing pains, itching arms, excessive sleeping, missing money and empty change jars, lying and elaborate stories to cover whereabouts. Receipts in cars and bedrooms showing strange times, like 2 a.m. at a McDonald’s in a neighboring town or a visit to a gas station during school hours, could indicate meetings with a dealer. Burned tinfoil, which seems like useless trash, could be a sign that drugs are being prepared in a bedroom.
“Talk to teachers and coaches. Visit your family doctor,” McKinney said. “Don’t question yourself. You owe it to your kid to act on it.”
Learning about Narcan
Narcan (drug name: naloxone) is a prescription medicine that can block the effects of opioids and reverse an overdose. Hennepin County Sheriff Rich Stanek said Narcan is not “the end all, be all,” but another tool that law enforcement officers and first responders can use to prevent overdoses. People who have come close to overdosing will still need to get help at the emergency room.
The sheriff said Narcan can be purchased without a prescription, so schools and other public locations will have to make decisions about whether to stock it, in a similar manner to first aid kits or defibrillators. Speaking from a parent’s perspective, Milun pointed out that Narcan and opioids seem like a cycle — perpetuated to benefit pharmaceutical companies.
“Is there any medicinal component to marijuana? That’s an important question and that needs to be the first question,” said Delisi. “Opioids are prescription medications and legal medication, and most people who develop heroin addiction start with legal pain pills.”
Delisi said there are associations with early marijuana use and development of schizophrenia and reduced IQ, and that of all drugs of abuse studied, marijuana is most likely to cause a prolonged psychosis when a patient experiences a psychotic break, more than methamphetamine, Adderall, cocaine or hallucinogens.
Panel members also cautioned that the marijuana of today, which Delisi said has a THC concentration of about 11-14 percent, is different from the marijuana of the 1960s, which had a THC concentration of about 3 to 4 percent.
“We need to be cautious when dealing with substances that can in fact target the reward pathways,” Delisi said. “We need to actually do the science behind whether there are medicinal purposes for marijuana and identify what it is that it can do.”
Keeping the lines of communication open with an addicted young person is often important for both them and their families. McKinney recalled hearing that some families try the tough love route, cutting off money and cellphones, but that she and her husband chose to keep their son’s phone line active.
“Every time I got a text from my son, even if it was ‘Leave me alone,’ or some horrible thing, it was a sign that he had survived another moment,” said McKinney. “Recovery is a difficult but rewarding journey.”
Every one was preventable
Earlier this month the sheriff’s office released an alarming set of numbers: in 2016, there were 153 opioid-related deaths in Hennepin County, a 39 percent increase from the previous year.
“Every one of the 153 deaths was tragic and every one was preventable,” Stanek said in a release from the sheriff’s office after the statistic was announced. “In response to this crisis, we will work together to build strong partnerships to reduce the number of opioid-related deaths.”