by Emily Freehling

Opioid abuse has been declared a public health emergency in Virginia, and the annual number of drug overdose deaths continues to grow in the state and nationwide. While most of the overdose deaths seen in the Fredericksburg region stem from heroin and fentanyl, addiction to these drugs can begin with abuse of substances commonly found in many households with children.

Research by the Partnership for Drug-Free Kids indicates that 1 in 4 children say they have taken a prescription medicine that was not prescribed to them at least once in their lifetime. Research from the same organization states that 1 in 8 teens report that they have gotten high off over-the-counter cough syrup.

Prevention starts when parents educate themselves about the risks and take active steps to manage what comes into their house, how it’s stored and what children know about the consequences of misusing medicines.

The Rappahannock Area Community Services Board’s Prevention Services program works with law enforcement and other community groups to spread the word about prescription drug abuse. RACSB’s REVIVE! training sessions are held throughout the year, teaching participants how to recognize an opioid overdose and how to use naloxone to reverse an overdose. The Spotsylvania Sheriff’s Office has also held town-hall meetings and regularly speaks to high school students about the problem.

Q: How early should parents talk to their children about responsible use of medicines?

Michelle Wagaman, RACSB Prevention Services Coordinator: We start as early as preschool. It’s a different language than you would use in high school, but children can understand the basic concepts that what we put in our bodies is important, and that we want to make good decisions for our body and brain health. We have a program called Healthy Alternatives for Little Ones (HALO) that teaches about making good choices. Messages like, if you see a syringe or pill on the playground, don’t touch it. Get an adult, don’t pick it up.

If you can teach children not to put their fingers in electrical sockets, you can teach them not to put other things in their bodies.

Detective First Sergeant M. Woodard, Spotsylvania Sheriff’s Office: As soon as I felt like my kids were able to comprehend what medicine was, I started driving home the fact that the only medicine you put in your body is something we—your parents—give you. And then you expand that into: who are the people who can give you medicine? The doctor, mom, dad, the nurse at the doctor’s office. You start trying to build that solid foundation that there is only a core group of people you can take medicine from. You want to make sure they understand that it’s not OK for somebody else’s parents to give medicine without permission from your parents.

Wagaman: It’s also important to tell your kids not to share their medicine with others. It’s prescribed to them for a reason.

Q: Who is at risk for addiction to opiates and other prescription drugs?

Wagaman: Drug addiction affects all socioeconomic levels, all races and genders. The face of addiction perhaps has changed over the years.

For some children, experiences they have had in early childhood may make them more predisposed to addiction. When infants experience toxic stress—abuse, neglect, household dysfunction—it rewires their brains. We may not see the effect of that until adolescence. It may show up as cognitive challenges, delays in the classroom, but also the inability to feel pleasure. That leads these children to seek pleasure elsewhere, often through risky behaviors.

Woodard: A 2016 study by the Center for Disease Control and Prevention stated that the average age for new opiate users was 18 to 25. What a lot of parents don’t understand is that the first experience that a lot of adolescents have with an opiate is for a legitimate medical reason. That really is key.

Q: How can we as parents make sure our children’s experiences with prescription medications don’t cause them harm?

Woodard: A high school athlete who has a major athletic injury is highly likely to be prescribed an opiate for pain, but parents should know that there are alternatives. It’s also important to read labels with a critical eye. A bottle of pain pills typically reads, “Take two pills every 4-6 hours, as needed for pain.” That doesn’t mean you automatically dispense two pills every four hours. Talk to your child. Assess their pain. See if you can push past that 4-6-hour window before giving out more pills.

Wagaman: As parents, we don’t want our kids to hurt. We want to make it better and take away their pain, but we can teach them the life skill of properly and safely using medications if we help manage their expectations. We can tell them, “This is going to hurt, we are going to give you something to make it hurt less, but we can’t make it go away magically.” Building some of those expectations up front is important, as is educating yourself and having a conversation with your physician or pediatrician. You can say, “I am not comfortable with this medication. What are some alternatives?” Be sure to communicate with your medical provider–whether that’s an orthopedic or dentist or family practitioner–if there is a family history of addiction.

Q: What is the best way to manage and store the medications in our homes?

Woodard: You can invest as little as $25 to get a medicine-safe lock box. That may very well save a child’s life. All prescription medications, cough syrup—anything that could be harmful if abused—should be locked up.

Wagaman: This is important for grandparents, too, as we tend to take more prescription medications as we get older. In addition to locking your medications, it’s important to count and track them, so that you’ll know if something is being used in an unauthorized way. You can download a medicine tracker at bit.ly/trackmeds.

Q: What’s the best way to dispose of old medications?

Wagaman: It’s important not to flush them or throw them in the trash. And don’t keep unused, expired or old medications in your home. The Rappahannock Health District and RACSB provide medication disposal kits, and there are also a number of safe disposal options around the Fredericksburg region.

Woodard: Law enforcement offices throughout our region have established medication collection bins that are available for safe disposal of medicine, with no questions asked. Find the one nearest to you:

Fredericksburg Police Department 2200 Cowan Blvd., Fredericksburg, VA 22401

Spotsylvania Sheriff’s Office 9119 Dean Ridings Lane, Spotsylvania Courthouse, VA 22553

Stafford County Sheriff’s Office 1225 Courthouse Rd., Stafford VA 22554

King George Sheriff’s Office 10445 Government Center Blvd., King George, VA 22485

Caroline County CVS Pharmacy at Ladysmith 8048 Jefferson Davis Highway, Ladysmith, VA 22546

Town of Orange Police Department 249 Blue Ridge Drive, Orange, VA 22960

Walgreens Pharmacy 50 White Oak Rd, Stafford, VA 22405

Walgreens Pharmacy 10600 Rollingwood Drive, Fredericksburg, VA 22407

Q: What warning signs can help parents spot a substance abuse problem?

Wagaman: Important warning signs to look for include:

• Isolation
• Change in sleep patterns
• Random outbursts
• Self-harm behaviors
• Red glossy and dilated eyes (for marijuana)
• Decrease of engagement in school or other activities
• Change of behaviors or social groups
• Not dressing appropriately for the weather

It’s normal for adolescents to change interests, but the concern is if they drop an interest and don’t replace it with anything. That can be a sign that something is wrong.

Woodard: I think too many parents say, “I have to respect their privacy.” If they live in your house, we still have to have their future in mind. Knowing what is in their rooms, their cars and scanning their phones for unrecognized numbers or code names for drugs—these aren’t things we should be afraid to do as parents. Know what is normal behavior for your child. If there is a dramatic change in a quick period of time, there’s a problem. It may not be drugs; it may be something else. Parents have to be involved. They can’t sit back and wait until it happens.

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Resources for talking to your children

Guides from the Partnership for Drug-Free Kids: bit.ly/talk2yourkids

“Talk. They hear you.” From the Substance Abuse and Mental Health Services Administration: bit.ly/theyhearyou

Helpful information for parents on prescription drug abuse: bit.ly/rxdrugfacts