Tips for Talking with Children about Addiction and Overdose Loss

Tips for Talking with Children about Addiction and Overdose

We’ve all read about it and heard about it in the news. In 2016 the number of opioid overdose deaths in the United States topped 63,000. Not only does this number surpass the total killed by car accidents and firearms, it also surpasses the number of Americans who were killed in the 19 years of the Vietnam War. This epidemic has impacted the entire fabric of American life. Many who have died are young people and adults with children. So how do we talk about overdose death with children? What words should we use? How do we address a topic that brings up complicated feelings of sadness, anger, guilt, blame, worry, isolation, and anguish, as well as the big “why” questions and the desire to protect those we love?

There are really two parts to these questions. First, how do we talk about drugs and addiction and second, how do we talk about death by overdose. Another point to consider is children’s exposure to the loved one’s substance use. Some children who have lost a family member to overdose already know that life had been a struggle or had been “different”, that the person had been experiencing ongoing trauma and change. Other children are not aware that their loved one struggled with drug-related issues, so both the drugs and death are foreign experiences. Either way, the death of a loved one is a difficult and often overwhelming experience for children.

Explaining Addiction to Children: Points to Consider

Not everyone who dies a drug-related death has struggled with addiction (also known as substance use disorder (SUD)), but many have. If this is the case, it is important to acknowledge the addiction and how it may have already impacted the child’s life.

  • Addiction has multiple causes and is unique to each individual, but factors of genetics, personality, environment, exposure, and past trauma all play a role. In adult terms, it is a chronic relapsing condition, and in children’s terms it is an illness that impacts the brain and behavior—an illness that can be treated.
  • One helpful approach is to use the “gum” analogy with young children– that treating addiction is like getting sticky gum out of their hair—very difficult to do and requiring a lot of time and effort. Another helpful image is that of a fish stuck on a hook—wanting to get “unhooked” can be a frustrating and difficult task.
  • With children, offer as much clarity as possible around drugs of abuse versus medicine that the doctor prescribes for medical needs. For example, with a prescription drug overdose, one might say, “Joe used more of the medication than the doctor prescribed or was safe to use.” An addiction is an “invisible disease that causes a person to use more (alcohol or other drugs) than is safe and can be treated but sometimes can end in death.” The words “drug,” “medicine,” and even “substance” can be unclear. Clarify that not all medicine is addictive or bad for us, and that it is important to never take someone else’s prescribed medication. Teenagers can often understand the different meanings of the words, but you must keep it clear.
  • Addiction “highjacks” or controls the brain and can make people do or say hurtful things that they don’t really mean. In other words, try to separate the person from the disease. In addition, it is important to clearly state that the child did not cause the addiction, so as to separate the child from the cause.  
  • Children growing up in homes with a family member who struggles with addiction can experience a confusing array of emotions. They can both be very protective and loyal to their family member, but also resentful and hurt. Often, they are reluctant to open up due to the fear of sharing a long-held family secret or of feeling shame and embarrassment. It can be helpful to acknowledge this conflict, and that multiple feelings can be experienced at the same time.

The following “Seven Cs of Addiction”, from the National Association for Children of Alcoholics, is a helpful tool for your discussion of addiction with your child:

  • I didn’t Cause it.
  • I can’t Cure it.
  • I can’t Control it.
  • I can Care for myself
  • By Communicating my feelings,
  • Making healthy Choices, and
  • By Celebrating myself.

Explaining Overdose Loss to Children

Now we address the challenge of explaining overdose death to children. There is no exact script, but there are some talking points that may help. The initial conversation is not the time to share all of the available information about the death. Instead, the beginning conversation lays the groundwork, allowing the child to react and ask questions while allowing the adult to support and draw out what the child is thinking and feeling. Some children may have heard the terms “overdose” or “drug-related death”, but many have not. Well-meaning adults are sometimes tempted to “protect” children and to avoid the truth when talking about overdose death. Children will inevitably discover the true cause of death of close family members and friends, and it is best to first hear this information from the adults they trust. Adults can reassure children in these moments and talk about their concerns.

 Below are guidelines we can use to address this sensitive topic:

  • Take care of yourself first:  Consider the airplane analogy — put on your own “oxygen” mask before placing one on your child.  Take a couple of deep breaths and give yourself time to collect your thoughts.
  • Think about the conversation in terms of building blocks:  Telling “the truth” does not mean sharing all the information at once. This foundation of truth can be built upon during future conversations.
  • Name your feelings but try to keep them in check: When we are processing difficult news, we will experience waves of feelings; after all, we are human. Name your feeling, e.g. “I am feeling very sad right now,” but stay as calm as possible and take breaks when needed.
  • Keep language clear: Try to use language that is appropriate to your child’s age, level of understanding, and previous knowledge of the situation.
  • Younger children need a concrete explanation of death and overdose: “Death means the body has stopped working” and “An overdose is when someone takes too much of a drug or the wrong drug, and it makes their body stop working.”
  • Talk about the person who died in a caring and respectful way: “Your Grandma died by an overdose, but this does not define who she was.”  Just as a period does not define a sentence, the cause of death does not define a person.  He or she is not “an overdose” but a person who died by an overdose.
  • Avoid assigning fault and blame: Underline that it is not anyone’s fault that this person died—and that the death is certainly not the child’s fault. Remember that in the course of normal development, children can experience “magical thinking” which sometimes leads them to see a death as their fault. 
  • Guide children in learning to share information appropriately: Children may need assistance in sharing with others what has happened. Let them know that sharing does not mean telling everything—it is not a lie to keep some things private. They may need guidance in answering questions from peers or community.

Children and teens need to make sense of the death and embrace their feelings as much as adults do. Be sure to remind the child that if they themselves ever struggle with their feelings, there is always help available. Avoid comments like, “Your loved one wouldn’t want you to be sad.”  These will only serve to shut down conversation. Instead, reassure them that it is okay to feel any emotion and share with you if they choose. Avoid trying to make sense of the loss for your child or teen with blanket statements like, “They are in a better place now.”  Instead, invite curiosity and questioning.  Even when we do not have the answers, it is reasonable to share that you do not know and ask, “What do you think?”

Help them identify the people around them who are available to talk with during tough times. Help them to identify what safe activities bring them a sense of comfort and control when they are distressed, such as drawing pictures of their feelings, petting their cat, or listening to favorite music.

Substance abuse and overdose losses are complicated topics, difficult even for sensitive and thoughtful parents. Please reach out to a mental health provider if you need additional support or if you have on-going concerns.  Remember, it is a sign of health to ask for guidance in times of need.


About the Authors: 

Sarah Montgomery LCSW-C is the Coordinator of Children and Family Programs at the Chesapeake Life Center at the Hospice of the Chesapeake. She has over 20 years clinical experience providing individual, family, and group counselling in a variety of settings including school-based, outpatient psychiatry and community-based organizations. She holds a BA from Williams College and an MSW from University of Maryland School of Social Work. Sarah has also co-written three books Helping Your Depressed Teenager (1994) and the Clinical Uses of Drawings (1996) and recently Supporting Children After a Suicide Loss: A Guide for Parents and Caregivers (2015) with Susan Coale LCSW-C.

 

 

Joy McCrady, MS, LGPC, NCC, is a bereavement counselor with the Chesapeake Life Center of Hospice of the Chesapeake. She offers family-centered grief support and works with clients throughout the lifespan who have experienced traumatic loss. She co-facilitates a support group for those who have lost a loved one to substance abuse as well as a group for grieving teens.

Leave a Reply

Your email address will not be published. Required fields are marked *

Follow Hey Sigmund on Instagram

When they are at that line, deciding whether to retreat to safety or move forward into brave, there will be a part of them that will know they have what it takes to be brave. It might be pale, or quiet, or a little tumbled by the noise from anxiety, but it will be there. And it will be magical. Our job as their flight crew is to clear the way for this magical part of them to rise. ‘I can see this feels scary for you - and I know you can do this.’ 
⠀⠀

⠀⠀

 #mindfulparenting #neuronurtured #parentingteens #neurodevelopment #braindevelopment #positiveparenting #parenting #parenthood #childdevelopment #parentingtip #adolescence #positiveparentingtips #anxietyawareness #anxietyinchildren #childanxiety #parentingadvice #anxiety #parentingtips #motherhoodcommunity #anxietysupport #mentalhealth #heyawesome #heysigmund #heywarrior
When our kids or teens are struggling, it can be hard to know what they need. It can also be hard for them to say. It can be this way for all of us - we don't always know what we need from the people around us. It might be space, or distraction, or silence, or maybe acknowledging and being there is enough. Sometimes we might need to know that the people we love aren't taking our need for space, or our confusion or anger or sadness personally, and that they are still there within reach.
⠀⠀
What can be easier is thinking about what other people might need. Asking this when they are calm can invite a different perspective and can give you some insight into what they need to hear when they are going through similar. Don't worry if you just get a shrug, or a disheartened, 'I don't know'. They don't need to know, and neither do we. The question in itself might be enough to open a new way through any sense of 'stuckness' or helplessness they might be feeling.
⠀⠀

⠀⠀
#parenthood #parenting #positiveparenting #parentingtips #childdevelopment #parentingadvice #parentingtip #mindfulparenting #positiveparentingtips #neurodevelopment #parentingteens
Give them space to talk but you don’t need to fix anything. You’ll want to, but the answers are in them, not us. Sometimes the answer will be to feel it out, or push for change, or feel the futility of it all so the feeling can let go, knowing it’s done it’s job - it’s recruited support, or raised awareness that something isn’t right.

Sometimes the feelings might be seismic but the words might be gone for a while. That’s okay too. Do they want to start with whatever words are there? Or talk about something else? Or go for a walk with you? Watch a movie with you? Or do a spontaneous, unnecessary drive thru with you just because you can - no words, no need to explain - just you and them and car music for the next 20 minutes. 

The more you can validate what they’re feeling (maybe, ‘Today was big for you wasn’t it’) and give them space to feel, the more they can feel the feeling, understand the need that’s fuelling it, and experiment with ways to deal with it. Sometimes, ‘dealing with it’ might mean acknowledging that there is something that feels big or important and a little out of reach right now, and feeling the fullness and futility of that. 

Part of building resilience is recognising that some days are rubbish, and that sometimes those days last for longer than they should, but we get through. First we feel floored, then we feel stuck, then we shift because the only choices we have we have are to stay down or move, even when moving hurts. Then, eventually we adjust - either ourselves, the problem, or to a new ‘is’. But the learning comes from experience.

I wish our kids never felt pain, but we don’t get to decide that. We don’t get to decide how our children grow, but we do get to decide how much space and support we give them for this growth. We can love them through it but we can’t love them out of it. I wish we could but we can’t.

So instead of feeling the need to silence their pain, make space for it. In the end we have no choice. Sometimes all the love in the world won’t be enough to put the wrong things right, but it can help them feel held while they move through the pain enough to find their out breath, and the strength that comes with that.♥️
Speaking to the courage that is coming to life inside them helps to bring it close enough for them to touch, and to imagine, and to step into, even if doesn’t feel real for them yet. It will become them soon enough but until then, we can help them see what we see - a brave, strong, flight-ready child who just might not realise it yet. ‘I know how brave you are.’ ‘I love that you make hard decisions sometimes, even when it would be easier to do the other thing.’ ‘You might not feel brave, but I know what it means to you to be doing this. Trust me – you are one of the bravest people I know.’
⠀⠀

⠀⠀
 #neurodevelopment #positiveparenting #parenting #parenthood #neuronurtured #parentingtip #childdevelopment #braindevelopment #mindfulparenting #parentingtips #parentingadvice
So often, our children will look to us for signs of whether they are brave enough, strong enough, good enough. Let your belief in them be so big, that it spills out of you and over to them and forms the path between them and their mountain. And then, let them know that the outcome doesn't matter. What matters is that they believe in themselves enough to try. 

Their belief in themselves might take time to grow, and that's okay. In the meantime, let them know you believe in them enough for both of you. Try, ‘I know this feels big and I know you can do it. What is one small step you can take? I’m right here with you.’♥️
⠀⠀

⠀⠀

 #neurodevelopment #positiveparenting #parenting #parenthood #neuronurtured #parentingtip #childdevelopment #braindevelopment #mindfulparenting

Pin It on Pinterest