Seeing The Opioid Crisis Up Close

Having lost a child to cancer, if I had to choose to have a child die of cancer or a child die of a drug overdose, I don’t know which one I would choose.

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Photo by Rhodi Alers de Lopez on Unsplash

I have lost a child to cancer. It was ten years ago, and there is not a day that goes by that my heart does not ache in agony for her loss. Even before she got cancer (lymphoma), she suffered from a crippling, incurable disease that ravaged her immune system, robbed her of the ability to walk by age 8, and left her in a wheelchair by the age of 10. Cancer took her life at age 12.

And so, when I have taken care of young people in my ICU who later die from heroin overdose, I know all too well the suffocating agony of their parents. I know the pain they feel inside; I know the indescribable nightmare in which they are forced to live; I know the unspeakable horror through which they are going.

The statistics of the heroin epidemic are staggering. According to the Centers for Disease Control, 130 Americans die every day from an opioid overdose.

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Yet, these statistics are stale and dry; they do not tell the story of how horrible a death from opioid overdose is. Usually, when a person overdoses on opioids, it causes them to stop breathing, robbing their brain of precious oxygen. It only takes a few minutes to cause permanent damage, and if the lack of oxygen to the brain is long enough, the brain becomes damaged beyond any hope of repair.

This damage may leave the patient brain dead, which is formal, legal death in many states. Worse, however, is when the brain suffers damage that is severe enough to preclude any chance of meaningful recovery, but not severe enough to cause brain death. Here is where I see firsthand how horrible a toll this takes on the family.

Many of the people who overdose on opioids are young and otherwise healthy, and so when they suffer such severe brain damage, the rest of the organ systems are just fine. Thus, it becomes exceedingly difficult to understand how it can be when a doctor — like me, many times — tells them that their son or daughter will never wake up again.

I try to counsel them as much as I can, sharing with them my story of how my own child died of cancer and letting them know that I truly understand from which their pain comes. It does usually help the parents, but it does not take away from the horror through which they are going.

And then I think to myself: if I had a choice; if I could choose — and what a horrible choice it would be — to have a child die of cancer or a child die of a drug overdose, I don’t know which one would be easier to bear.

Thus, it is so important for those afflicted with drug addiction to get help, so they can prevent themselves dying from an overdose and putting their parents and other family members through the terrible agony of having to live through such a scenario. In addition, we need to think about what our children and other loved ones would want if — God forbid, God forbid — they would be forced to live the rest of their lives on machines.

It is not natural to have such conversations — called “Advanced Care Planning” — about young patients. Typically, we have such conversations about what to do at the end of life for people who have lived long lives. The opioid crisis has changed all that.

I remember having to give the terrible news to the parents of a young man who overdosed on heroin that he would never wake up again. He was not brain dead, but he would need to be on a breathing machine, fed through a tube, and live in a long term care facility for the rest of his life. His parents were adamant: their son would never want to live like that. And so, as unspeakably horrific this decision was, they decided to let their son pass away without aggressive life support. It was terrible.

And I admired their courage in making this decision. No parent should ever, ever have to make such a decision. Sadly, the opioid crisis has forced hundreds of thousands of families to make such decisions. The statistics of the opioid crisis are staggering. At the same time, they do not tell the story of how truly horrible it is.

The views expressed here are my own and do not reflect the views of my employer or of those institutions with which I am affiliated.

NY Times featured Pulmonary and Critical Care Specialist | Physician Leader | Author and Blogger | His latest book is “Code Blue,” a medical thriller.

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