As a kid, Mark Fuscia was a strong student who was passionate about baseball and nicknamed “the politician” by his family for his ease with adults. When his parents found out he had tried marijuana at age 14, they hoped it was merely a teenage phase.
“Within a five-year period he moved on to cocaine, mushrooms, various pills and then heroin,” recalls his mother, Sue D’Ambrosio, from Voorhees, NJ. Like many addicts, for much of that time Mark was highly functioning, even getting two academic scholarships to college. “We never thought we had to learn about drug addiction because he was never that type of kid,” D’Ambrosio says.
Once Mark’s parents discovered he was using drugs — and selling them to support his habit — they worked tirelessly to help him break the addiction cycle. Despite individual and family counseling and both in- and out-patient rehab, “The disease just kept getting worse,” D’Ambrosio says.
The family’s worst fears were realized in February 2010 when Mark died from a heroin and ecstasy overdose at just 19 years old. His 11-year-old sister found him in his bedroom, needles lying on the rug.
Who's using and why?
Tragically, Mark’s story is not uncommon. Drug overdose is the leading cause of accidental death in the U.S., with more than 47,000 lethal drug overdoses in 2014, according to the American Society of Addiction Medicine. Opioid addiction is driving this epidemic, and young people are getting caught in the fray. In 2014, an estimated 28,000 adolescents ages 12-17 had used heroin in the past year, and an estimated 16,000 were current heroin users.
Although many parents have visions of inner-city kids shooting up in seedy back alleys, the face of an addict is far different today. Suburban kids might sneak their parents’ and grandparents’ leftover painkillers for a quick high, for example. Since 2000, painkillers have become the entryway into heroin, says Elana Dobrowolski, program director at Meridian Counseling Services in Cherry Hill, NJ.
“It’s over the last decade that it’s become an epidemic because it’s so accessible,” she says. “Young people start at home, finding it in their medicine cabinets or having painkillers prescribed after a sports injury or wisdom teeth removal.”
“For a lot of people, it’s an attempt at coping,” adds Dobrowolski. “They may have underlying anxiety, depression or trauma, and the first time they take a pill they may notice a sense of calm. They may not have the other tools to be able to cope. People don’t understand that opiate pills — the pain medications — are heroin in pill form.”
How opioid addiction happens
Becoming addicted can happen quickly, in just a couple of months for some people. “It’s difficult to predict who will become addicted or how long it’s going to take,” says Kate Cronan, pediatric emergency medicine physician at Nemours/Alfred I. DuPont Hospital for Children in Wilmington, DE, although a history of depression or other mental health issues may make someone more susceptible to addiction.
“Addiction becomes a brain disease where the communication inside your brain changes,” says Dr. Cronan. The brain chemical dopamine naturally gives people pleasure. If a person takes opioids to achieve feelings of pleasure, the brain realizes it doesn’t need to make as much dopamine. “So your body feels it needs to take the meds again because your messenger system isn’t working like it used to,” Dr. Cronan explains.
From pills to street drugs
The jump to heroin comes once the pills run out because getting more is expensive — $20-$30 a pill, says Dobrowolski. “Heroin is $5 or $10 a bag. When they start, they typically use it recreationally, and in time, their brain starts to adapt to it and they need more and more of the drug. At that point they’re not able to support the habit financially.”
The cost leads many teens to crime — shoplifting items they can resell or pawn- ing stolen valuables from families and friends. “Usually they’ll start where the money is most accessible and the people — often family members — aren’t going to get them in trouble,” says Dobrowolski. “We’ve even seen people get to the point of selling their bodies.”
Law enforcement response to opioid use
Finding heroin is surprisingly easy. In Philadelphia, Camden, NJ, and Wilmington, DE, the drug can readily be found on street corners. But it’s also infiltrated suburbia.
“I’d estimate about 40 percent of the people we encounter on the street are from various suburbs outside the city,” says Daniel MacDonald, chief of the narcotics bureau for the Philadelphia Police Department. “They started taking pills, then transitioned to heroin — first powder that they snort. As the effects diminish, they step up to injecting the heroin, and it spirals downward from there.”
In 60 to 70 percent of the cases, the parents were already aware of their child’s addiction, MacDonald says, although they typically are shocked that their children have bottomed out to heroin.
The Philadelphia Police Department now recognizes that addiction is a medical problem. “Arrest is not the solution,” says MacDonald. “It truly is a public health crisis.”
Warning signs of opioid use
Physical and behavioral signs parents can look for include:
- changes in their child’s mood or grades
- outbursts of anger
- trouble sleeping
- irrational behavior
- bloodshot eyes
- enlarged or shrunken pupils
- unusual odors on the breath
- showing up late without explanation
- exhibiting a lack of respect for others
- selling previously treasured belongings
D’Ambrosio urges parents to be honest about their kids and not be embarrassed to ask questions or seek help. She urges other parents, “Learn about the signs, and search their rooms for drugs, paraphernalia or extra cash. We didn’t see the signs in the beginning, and I wish we would have known more.”
In Part 2 we will explore prevention and treatment, offering additional resources to families who may need help for a child battling addiction.
Terri Akman is a contributing writer to MetroKids.