9 year/old to the Rescue!

Last night I took care of a 50 year-old male who was brought to the ER by paramedics after he lost consciousness at home. Apparently this patient was at home alone with his 9 year-old grandson when he fainted. The quick-thinking 9 year-old helped his grandfather to the ground and then called 911 to get medical support. He also called his mother and grandmother who split up to take care of the child and go to the ER to check on the patient respectively. As I was assessing the patient whose mental status was altered on arrival to the ER I suspected, among other things,that a drug overdose was the cause of sluured speech and slowed responses. I gave him a medicine called narcan which is an antidote for opioid overdoses and he showed mild improvement in his mental status. I stabilized the patient and initiated the normal labs and imaging needed to evaluate an altered patient which included a urine toxicology screen and alcohol level. After leaving the patient’s bedside I took a few minutes to review his old records on the computer and, sure enough, he had had a similar ER visit less than a year ago after overdosing on soma and vicodin. The patient’s work-up revealed nothing remarkable other than a tox screen confirming exposure to opiates as well as benzodiazepines (valium, xanax, etc). the patient’s clinical status remained stable with continued improvement in his mental status and when his wife arrived in the ER she confirmed that the patient did take vicodin, soma, and xanax daily for his chronic back pain. After I finished conversing with the patient’s wife, my nurse pulled me aside to inform me that she recognized the patient and the wife who had both arrived on the same day of the patient’s last admission after they both overdosed on the same medications. The remarkable thing is that, once again, it was the same grandchild who had called 911 to alert medics about his grandparents’ condition.
In a perfect world no child would be exposed to such poor examples and suffer such responsibility, but in reality it occurs every day. Children are suffering while being raised by families in which substance abuse is passed down through the generations. Often this form of child abuse is not even recognized because these pill-popping addicts feel legitimatized because their drugs-of-choice are “medications prescribed by a doctor”. As I attempt to educate these patients about the dangers of this form of drug abuse, I can tell my advice is falling on deaf ears. Even though there have been numerous programs aired on television outlining the growing epidemic of prescription drug abuse, people remain in denial of their problem and fail to see their obvious similarities to street-drug users such as heroin junkies. Instead they insist they have a medical condition that warrants these dangerous medications, and they swear they would be unable to function without their medications. Sounds like the definition of a junkie to me. Meanwhile their children and grandchildren are growing up in a world where they are responsible for calling 911 when their guardian, the person who is supposed to be responsible for the child, passes out after overdosing on the pain medications they should never have been prescribed for long-term treatment in the first place. So much for teaching our children well to let them lead the way in the future.