Mental Health Supports: Irresponsibility And Indifference (Part. 4)

Written by Seth Gryffen

"how do i politely tell some prominent world leaders on here that their irresponsibility and indifference over climate change are causing young people to have panic attacks and suicidal thoughts?"

I've been engaging with youth climate activists for over fifteen years and I am very concerned about mental health issues generally, the key to stopping this intensifying crisis is climate action from world leaders.

I feel that I am scrupulously truthful in my messaging, both factually and emotionally. Without bold action now we are heading into a very scary future. Sugarcoating this has done tremendous damage by contributing to society's collective climate denial and inaction.

In addition, I am fighting as hard as I can — day in, day out to help society come out of this climate and extractive capitalist nightmare. I believe we can still save so much but we need to fight for every fraction of a degree. I’m not a "doomer," I’m a fighter.

Teen deaths from fentanyl overdose tripled from 2019 to 2021, "what's causing this?" — My thoughts as a teen addiction specialist working on the front lines.

Q's: "What's causing this rise in overdose deaths?" — Clearly fentanyl is a contributor, now involved in a majority of teen overdose deaths. Fentanyl is 50-100x more potent than heroin and everywhere in the US now but fentanyl isn't the whole story, addiction begins early in the life course.

Two in every three adults with opioid addiction first used opioids before age 25, if we want to have a long-term solution to the overdose crisis we need to look 10-20+ years ahead. Specifically, we need to tackle the child mental health crisis. In my experience, it is the rule and not the exception that teens with opioid addiction have underlying mental health problems: (untreated depression, anxiety, adhd and trauma)

People worry that just getting prescribed an opioid causes overdose, I did a study and found that in fact it's relatively uncommon (<1 in 300 youth prescribed an opioid go on to have a problem). Low individual risk (though still public health concern) but we found that youth with mood or anxiety disorders were >4x more likely to develop a problem with opioids.

Also three-quarters had already started to have problems with other substances, m. commonly nicotine, alcohol and cannabis. Plus worth noting that polysubstance use is important because, per recent as of 2017 it is more common among U.S. youth to die of an overdose involving an opioid plus another substance (rather than overdosing on an opioid alone) and once teens do develop addiction, access to treatment is abysmal also it always has been.

In a study from pre-Covid times, I found that 2 out of every 3 U.S. counties have no teen opioid addiction treatment programs, here's what we need to do:

✅ Increase the of teen addiction treatment progs: "teens cannot receive treatment alongside older adults."
✅ Ensure programs accept Medicaid: "must address disparities by ability to pay, as well as race, ethnicity and language."
✅ Increase of child psychiatrists and therapists, put them in places where teens are, not just in healthcare settings (e.g., schools, community orgs, churches, homeless shelters) maximize accessibility and approachability.
✅ Ramp up screening for substance use, pediatricians and family docs should screen at every annual visit using a standardized approach.
✅ Increase training for addiction in pediatricians, it’s a huge gap in our training.
✅ Invest $ to address social determinants: "teens and families need housing, income, food, education, employment. without these things, addiction follows."
✅ Reduce stigma. "your child has cancer?" People show up at your door with casseroles, "your child has addiction?" You don’t tell people because you’re afraid of what they’ll think. Families suffer in silence and this keeps them from getting high-quality care.
✅ Get rid of ineffective ot punitive treatment, wilderness 'boot-camp,' programs can worsen teens mental health and are not evidence-based. Worse, they drain families financial resources since they’re often paid for out of pocket.
✅ Give teens access to evidence-based interventions: "medications like buprenrophine (suboxone) which are effective."
✅ Give teens overdose prevention education and Narcan, they need this just like adults do but are often overlooked.
✅ Stop punishing teens who use substances, drug testing is ineffective and not recommended. Keeping teens from sports and other activities that actually help support health and well-being is counterproductive.

To summarize, we're in an overdose crisis that has largely focused on adults but which has its roots much earlier in the life course. There is much we can do but policymakers and public health experts need to look 10-20+ years into the future and implement a long-term plan.

Without a forward-looking strategy that is proactive (invest in kids mental health) rather than solely reactive (focusing solely on overdoses, rather than their underlying causes) we will be living with a worsening addiction crisis for decades to come.

Written by Seth Gryffen

Co-wrote by Andi Bazaar