When I was a young mother with friends and family members having babies, I would often send a hand-lettered card with a poignant message by Elizabeth Stone:

“Making he decision to have a child — it is momentous. It is to decide forever to have your heart go walking around outside your body.”

So when I read the headline a few weeks ago from a Chesterfield County, Virginia newspaper about six overdose deaths in the last 72 hours, I felt like I’d been socked in the gut. How many more people are left to grieve, mourn, try to understand…wonder if there was anything they could have done. How many more parents are burying their children?

Fentanyl and Heroin Use is Growing

When I started working here many years ago, most of our patients came to the Coleman Institute for Addiction Medicine for an outpatient Accelerated Opioid Detox seeking help getting off Oxycontin®, variations of oxycodone and hydrocodone (like Roxicet®, Percocet®, Vicodin®, Vicoprofen®), tramadol, and heroin. We certainly saw overdoses, but the drugs that are out there now — especially fentanyl, which is a synthetic opioid manufactured easily and cheaply —is wiping people out with more ferocity than the other substances.



According to the Drug Enforcement Agency, fentanyl is approximately 100 times more potent than morphine and 50 times more potent than heroin. Two milligrams of fentanyl (equivalent to a few grains of table salt) can cause breathing to stop in more than 95 percent of the American public. Source

6 Things You Can Do If Your Child Is Using Heroin & Fentanyl

1. Do your homework.

Figure out what options are available. Make some calls. Insurance and cost of programs will be part of what guides you, so the first call may be to your child’s insurance company to find out what mental and behavioral health conditions they cover.

2. Understand that different Substance Use Disorders require different kinds of treatment.

A person who needs help to stop drinking or to get off benzodiazepines may potentially need medical help to do so safely. A person who has become physically dependent on opioids will become extremely ill with flu-like symptoms: runny nose, nausea, vomiting, diarrhea, severe muscle aches and cramping if they stop cold turkey. The dangerous thing about opioids is not the withdrawal, however, it is the possibility of overdose. As bad as a person feels with opioid withdrawal, it is not as dangerous as potentially stopping alcohol or benzos. The problem is, most people can’t do it without help.

3. If you suspect your child is addicted to opioid medication, please be sure to have emergency naloxone available!

Naloxone is an opioid blocking agent. If someone has overdosed on an opioid such as pain medication like oxycodone, heroin, or fentanyl, this medication can be easily administered by spraying it in the unconscious person’s nose. You cannot hurt them by using this medicine. Having naloxone on hand can be critical.

4. Be aware of your loved ones' prescription medications.

Many patients are supplementing legitimate pain or anxiety prescription medication with pressed pills bought off the street. Many of our patients adamantly deny they are using fentanyl; they swear their dealer is trustworthy and would never sell them tainted pills. I just saw my first illegal pills earlier this month when a patient’s spouse turned them over to me. They were little turquoise pills. When I searched online for other images, I found they are produced in a rainbow of colors: orange, pink, various shades of blue, grayish-purple. They look so legit. How simple it must be to add a substance the size of a few grains of salt to these tablets.

5. Expect resistance when you ask your loved one about the possibility he/she is using illegal drugs.

I remember someone describing what it’s like to take away addictive substances from someone who has become physically dependent. They said it’s like cutting off their air supply. On the other hand, for many of my patients over the years, it has been a huge relief to finally be able to let someone know how desperately they need help. A guy who completed his accelerated opioid detox earlier this week told me he was a total slave to his drug. “This sh-t owned me. Every day, no matter what I had to do for work or my family, I first had to figure out how to find $200 to get stuff so I wouldn’t be sick. I would steal and deal every day.” He couldn’t wait to just be able to live a normal life again.

6. Wrap your mind around the idea that a person with a Substance Use Disorder has a chronic illness and will likely need to be treated for a long time.

In addition to counseling, therapy, and group support, there are three Medication-Assisted Treatments (MATs) for Opioid Use Disorder: Methadone, Buprenorphine (often called Suboxone), and Naltrexone. Each one of these treatments are dispensed by trained medical professionals and will require some planning and understanding of the processes to get booked.

It’s helpful to know that just because your loved one may not instantly be grateful for or excited about taking advantage of your offer to help get off his addictive substance, you can still move forward. I used to believe a person had to be motivated and ready to ‘do it for himself’ to successfully stop using opioids, but evidence would tell us otherwise. People often stop using addictive substances even when they are brought to treatment as reluctant consumers. At a recent meeting, one of our doctors quoted the old adage: You can lead a horse to water, but you can’t make him drink… our job is to make them thirsty.

Detox Off Fentanyl and Heroin at the Coleman Institute

Treating Substance Use Disorders is not a cookie-cutter, one-size-fits-all situation. Each person has their own unique personalities, strengths, and challenges. What works for one person at one time may not work after a relapse, or multiple relapses. What works for one person may not be the best treatment for another person.

The Coleman Institute for Addiction Medicine in Richmond, Virginia uses both long-acting naltrexone and Suboxone for patients with Opioid Use Disorder. If you are concerned about your loved one, please don’t wait to learn more about what options are available.