On September 21, 2015, my life forever changed.
At 4:00 a.m. I was awakened by the police at my door informing me that my son Sean was dead. He died of an opioid overdose. I waited until 6:00 a.m. to call my mother, not wanting to wake her with this news. She hurriedly got ready and came to my house to be with me. Two hours after arriving at my home, she collapsed in my kitchen and died. They think that she had a heart attack due to stress. In the blink of an eye, a good part of my family was gone. I have patients who have lost children, and I have noticed that it seems that they either move ahead with purpose or drop into an abyss. I made a conscious decision to not do the latter.
My son became addicted to opioids in his junior year of college. He had called me during a finals week to let me know that he was going to ride dirt bikes with one of his friends. I told him not to do it because if he fell and hurt himself he wouldn’t be able to take his finals. Being a boy, he didn’t listen to me and did it anyway. Of course, he fell and hurt himself. Not wanting me to know he didn’t go the ER or Urgent Care. His neighbor handed him four pills, saying that they would get him through the finals. Apparently they did, and apparently, he liked them because he went back for more. Thus started his five-year odyssey. At first, he seemed to be about half a beat behind. When asked, he would say that he was tired. But it just got worse. He would deny everything when asked about it.
One of the symptoms of the disease of addiction is lying, and they become masters at it. When he got really bad, I got him to admit what he had been doing. He had become addicted to Oxycontin, the same thing handed to him by his neighbor. We got him into rehab, and I was hopeful that he was “cured.” I knew absolutely nothing about the disease.
With the disease of addiction, there is relapse
In rehab, he learned that Oxycontin is the synthetic equivalent of heroin, and heroin is pennies on the dollar. Of course, with the disease of addiction, there is relapse; and he soon became addicted to heroin. After stealing from me several times, I kicked him out of my home. He moved into an apartment in Georgia with other addicted young men. After we thought that he had hit rock bottom, his father brought him back to Ohio, let him move into his home and paid for him to finish the work for his college degree. When closely monitored, Sean could manage to stay fairly clean. He had been attending NA meetings.
During an NA white water rafting trip that he broke his ankle and needed surgery. Despite the warnings that he was a recovering addict, the surgeon prescribed opioids. Not long after, he relapsed and moved in with his girlfriend. She, too, soon became addicted to opioids. Their relationship eventually became toxic. Sean was working to get clean. He had managed to pull himself together to get a decent job and was leaving the relationship. I had agreed to let him move back in with me. He had moved part of his things in on a Sunday and was bringing the rest the following day. We talked about the future, and he was upbeat. He went back for one last night with his girlfriend. Then I got the knock at the door…
My life is forever changed.
If I could go back in time and change anything to make the outcome different, I would do it in a heartbeat. But of course, I can’t. The disease of addiction makes a loved one turn into an unrecognizable monster. Once in a while you see glimpses of the person you love. I moved on in my life half in a daze. I had a practice to run and another son who had just started dental school and needed my love and support. And being the Secretary of the Ohio Dental Association and President of my local society, I did not want to drop the ball on either.
While at an Executive Committee Retreat, I overheard one of my close colleagues discussing the opioid crisis. One said, “Why are we spending all of this money? Just let the addicts kill themselves.” I quickly went to the ladies room and cried my eyes out. I was devastated. How could they say that? I considered leaving the retreat and leaving organized dentistry but decided to stick both out, at least for a while. It took a few days for me to calm down, but it slowly dawned on me that the horrible things being said came from a place of ignorance, not hate. These were educated people… worse yet, they were prescribers. I spoke to the Executive Director of the Ohio Dental Association and told him that while very upset, I intended to stay and that it was my intention to try to educate dentists about this. I had absolutely no idea how I would do this, just that it was my intention.
That is when things just took off.
One of my friends in the ODA is an oral surgeon. He had not heard about my son’s death until later. He called me very upset and asked what he could do for me. Without thinking, the words that flew out of my mouth were, “Stop prescribing so many opioids.” I didn’t give it another thought until I saw him at a meeting about a month later. He stopped me and told me that he had taken what I said to heart. He looked at his practice and cut his prescribing back drastically, dreading it because he thought that he would spend his weekends dealing with people in pain.
“You won’t believe it — the opposite happened! I get no calls for pain, and the parents are thrilled. This has changed my practice and my life!” he told me. The Executive Director of the ODA heard him say this. Not long thereafter he asked the oral surgeon and me to say a few words about opioids at the Ohio Dental Association Leadership Institute. The “few words” happened to be a course that we gave. I do not really like to speak in public and was scared to death. I had to sit on a stool behind the podium, my legs were shaking so badly. But it was received very well, and soon we were asked to speak at Component Dental Societies.
FIVE TIMES MORE LIKELY
To date, I have spoken to several groups, most of the dentists, about opioids and addiction and have been interviewed on local television and CBS Sunday Morning. Since many of us never learned about addiction in dental school, most dentists do not understand their role in the whole crisis. Between the age of 13 and 26, the prefrontal cortex is still forming. If someone in this age group is exposed to an opioid, they are five times more likely to become addicted. THAT IS HUGE!! FIVE TIMES MORE LIKELY. That is middle school, high school, and college sports. And, that is wisdom teeth.
I have had many dentists tell me that they have been practicing the same way for years and that they have never gotten anyone addicted. My answer to that is, “How do you know?” The person is NOT going to come back to you and ask for more. They are way too smart for that. They will get it elsewhere. You could be where they got that first taste and decided to get more.
Remember, my son went back after just four pills. Another big component of why someone becomes addicted is genetics. I don’t think anyone is good enough to know by looking at someone who is at risk and who is not. So, why chance it? Studies have shown that alternating ibuprofen and acetaminophen is more effective at relieving pain than opioids. Another option is the long-lasting local anesthetic Exparel.
The perfect storm had occurred in my home state and washed my son away with it.
As with many things in my life, I did not plan to be an activist. However, the deeper I looked into this problem of opioids, the more upset I became. If you have never read the book Dreamland by Sam Quinones, I would highly recommend it. The perfect storm had occurred in my home state and washed my son away with it. I was helpless to save him, as the only person who can save someone addicted is the addict himself.
Something good needed to come from this terrible tragedy. I did not feel qualified to help those already addicted, but I was in a position to try to help create fewer future addicts. We, as dentists, were unwitting participants in this whole crisis. We believed what we had been told about pain relief and our responsibility to abolish pain. Pain became the fifth vital sign, muddying the waters even more. I believe that we, as a profession, have come a long way.
The American Dental Association, as well as the Ohio Dental Association, developed an Opioid Policy that supports prescribing limits and mandatory continuing education about addiction and opioids. I helped to get both of these passed and was elated when it finally happened. There is more work to be done, but the progress made gives me hope. I want to save other families from the heartache of losing a child.