By Lia Juriansz
Christina Paschall, president of the Arizona Counselors Association, keeps a shovel in her office. It’s a symbol, a tool she uses to help teenagers who are overcoming addiction. She said she gives them a choice: Take the shovel and “keep digging” or take her hand and start the process of getting help.
Paschall is one of Arizona’s many mental health professionals committed to combating the teen prescription opioid epidemic. In 2014, the American Society of Addiction Medicine reported that 467,000 adolescents were non-medical users of pain relievers.
She has a background in crisis counseling and works with the Arizona Counselors Association to connect other counselors in the state and across the country.
She said that mental health professionals in the state are working to educate families about the dangers of opioid use through programs using psychoeducation, the process of educating patients and their families who are seeking mental health services. The goal is to help patients and families better understand and become accustomed to living with mental illness.
Here’s what Paschall said she and other counselors in Arizona have learned through their work:
- Counselors, in a collaborative effort and through trial and error, have come to the conclusion that in most cases, in order to treat a teen that is struggling with an opioid addiction, the current family dynamic needs to change.
- Some 50 percent of what leads to a teen struggling with substance abuse is genetics and the rest is their environment, Paschall said. She said that while the majority of the parents she sees are aware their child has a problem and needs help, they may be under the impression that it is only the child that needs to change and not family behavior. Paschall said she believes that this mindset can lead to enabling.
- Treating teenagers with addiction, including addiction to opioids, comes with the added hurdle of a brain that isn’t fully developed, she said. This leads to Arizona counselors having to challenge the way the teen brain works — the impulsivity, the increased fight or flee complex and a higher need for immediate gratification — in order to treat patients. It’s not an impossible task, she said, but a challenge.
- “When someone with an opioid addiction is recovering, the brain chemistry has to rebuild itself,” Paschall said. “Often times in the first two weeks after a teen has stopped taking opiates, day 10 is the peak of anxiety and depression.”
When asked about the rise of prescription drug addiction, Paschall said she believes the overmedication of America is one of the biggest contributing factors. She said she believes the rise of prescription drug use in teens was indirectly caused by the overdiagnosis of ADHD in the 1990s, as both parents and teens became accustomed and desensitized to teen prescription drug use.
A study done in 2013 by the Partnership Attitude Tracking Study (PATS) reported that in a sample size of 750 parents, 21 percent reported that they believe prescription medication like Ritalin or Adderall can “improve a teen’s academic performance, even if the teen does not have ADHD.”
Paschall also said she believes there is a perception among teens that prescription medication is safer than other illegal drugs because they are prescribed by doctors. In a 2012 PATS report, out of a sample size of 3,884 teens, 27 percent of the respondents reported that “misusing and abusing prescription drugs to get high is safer than using street drugs.”
Access to these prescription drugs is statistically an easy task for Arizona teens. According to the Governor’s Office of Youth, Faith and Family, 348 million pain relievers were dispensed in Arizona last year. That is enough, its website states, “to medicate every adult around-the-clock for two weeks.”
The Governor’s Office of Youth, Faith and Family’s Deborrah Miller said that in 2006, the state’s primary concern was methamphetamines and marijuana use. The state was not aware of how rapidly prescription opioid use was growing with teens until the Arizona Youth Survey in 2008 found 10.7 percent of Arizona students (in grades eight, 10 and 12) had used prescription drugs in the last 30 days for non-prescribed purposes, up from 6.3 percent in 2006.
In 2013, Arizona ranked 11th in the nation for drug overdose deaths, according to the Centers for Disease Control and Prevention. The state fell to 13th in the nation in 2014.
Recent efforts of the state include the Arizona Angel Initiative that encourages prescription drug addicts to turn over their pills to law enforcement without fear of prosecution. The program, which is currently being piloted at one location in Phoenix, also offers an opportunity to request treatment.
There are also more than 120 dropboxes across the state (typically police departments or fire departments) where people can hand over their opioids without retribution, and the state will destroy them.
And in October, Gov. Doug Ducey signed an executive order to prevent millions of Arizonans from filling initial prescriptions for more than seven days’ worth of drugs.
Paschall said she believes the steps the state is taking to help combat the opioid epidemic are positive, but there needs to be more public awareness about the programs. She said, often times, her patients do not know about the many resources that are available.
Time will tell if the measures the state is enacting will eradicate the teen opioid epidemic. But for now, Paschall has a shovel in her office and a heart to help those struggling with addiction.
The faces of individuals fighting to end teen addiction to prescription medication
We asked people at a Governor’s Office of Youth, Faith and Family event focused on fighting substance abuse, “What would you say to a teen that is currently struggling with an opioid addiction?”