I wrote about a month ago of my growing concern about the increased use of marijuana in my young patients. I find that more and more I am having to address statements like these:

“They were gummi bears – I thought that meant they were safe for kids.”

“My friend said two grams a day was nothing.”

“It will have an effect on my brain…you mean, like a bad effect??”

Today, just when I am thinking that this increased use of marijuana is enough to worry about, I received two emergency room reports about my patients – for opioid overdoses. Marijuana and alcohol are common in my practice, but opioids have not been. I ask about them consistently and maybe one or two people have tried these in the past. The world has changed, however, and now there have been two overdoses in my practice.

Upon hearing this, I went immediately to the Word Health Organization’s Information Sheet on Opioid Overdoses and learned that overdose deaths account for between one third to one half of all drug-related deaths and most of these are attributable to opioids. I know opioid overdoses are dangerous and we keep information on how to get naloxone kits in our program. Naloxone can reverse the effects of opioid overdose and prevent death. We keep naloxone kits on or crash cart – the cart we bring out when a patient loses consciousness – but we have never had to use it. That may change, however, and I find myself reading up on this frightening topic.

Once I have fortified myself with that reading, I call one of the patients and immediately they say,” Don’t worry. It wasn’t a suicide attempt.”

“It’s too late,” I told my patient. “I am now worried. Can we get you help?”

“Well, I think I’m okay now.”

“Please let’s get you help.”

Much of being a psychiatrist for teens and youth is begging and convincing. Bossing people around never works. Occasionally, I forget that, although I’m also a Mom and there is no one better to remind you that bossing doesn’t work than your own children.

As I write this, I am thinking of parents. If you are a parent, and your child is using drugs, remember that your best skills will be begging and convincing. While you are doing this, do not worry if your emotions spill out. They should. You are, after all, worried that your child might get very sick – or even die. If your child accuses you of becoming dramatic, admit that you probably are. Admit that you love them too much for this risky behaviour not to upset you deeply.


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