A mother recently told me that the daughter she had nurtured with so much love and joy was no longer a part of their lives. According to the mother, their 18-year-old daughter was homeless but had recently stopped by their home for an hour before leaving again. She told me her daughter had said, "Look, I need money; I don’t want to talk to you about how awful my life is."
When the mother asked what happened, she replied, “Don't waste my time! Give me something I can sell or give me money!” The mother relayed to me from this experience that she knew their daughter was no longer the child they had so joyfully raised. Even though the mother's 18-year-old daughter had a home, she barely stayed beyond an hour or more before hurriedly leaving again.
I reassured the mother that her daughter's comments came from the addictive mind, and the sooner she got her daughter to enter treatment, the sooner her recovering mind would grow at the expense of her addicted mind.
Fentanyl-dependent teens or young adults who are homeless have chaotic and perplexing lives. Street-based fentanyl addiction creates, in no small way, a physically, emotionally, and mentally debilitating life that manifests as intense cravings, mood swings, melancholy, and irritability. As the parents of a child who is addicted to fentanyl and homeless, it's important to be aware of the ongoing dangers your child will face. Their unstable living situation can leave them vulnerable to abuse, exploitation, and infection, making it all the more critical to provide them with love, support, and guidance on their journey toward recovery.1
Correlating Addiction, Homelessness, and Behavioral Health
In January 2023, the United States saw the highest homelessness rate since data collection began in 2007, with an estimated 653,104 people, or about 20 out of every 10,000 individuals, experiencing homelessness. Of these, six in ten were staying in sheltered locations while the rest were unsheltered. The majority (71%) were part of adult-only households. In fact, adult-only households living in unsheltered locations made up the largest segment of the homeless population (36%), followed by those staying in sheltered locations (35%). Around 29% of the homeless population consisted of families with at least one adult and one child under 18 years old. Notably, less than one percent, or 3,240 individuals, were unaccompanied children, under 18 years old without a parent or guardian present. This data highlights the urgent need for comprehensive solutions and resources to tackle homelessness. 2
Physiology of Addiction and Behaviors
Research suggests that young girls often experience homelessness more frequently than teenage boys. I suspect this may be due to family-related issues that include abuse in the home. Sadly, many young girls find themselves living on the streets as their lives spiral out of control due to physical withdrawal symptoms, depression, and hopelessness.
As a provider, I have witnessed firsthand the devastating effects of street-based fentanyl on individuals struggling with addiction. Like a wrecking ball, this potent drug wreaks havoc on their physical and emotional health, weakening their immune system and straining their relationships with loved ones. The loss of nourishment due to addiction can further exacerbate these challenges, making it difficult for those impacted by fentanyl to relate to others and find their way toward recovery. This leaves them feeling alone and disconnected because they lack fundamental social skills. Furthermore, you should not be surprised when your son or daughter’s mental health is severely affected, making it challenging for them to concentrate or carry out regular tasks.
Homeless addicts work tirelessly to avoid becoming "Dope Sick." They’ll do whatever it takes to prevent withdrawal symptoms. The brain experiences fluctuations in neurotransmitter levels during opioid withdrawal to compensate for the absence of opioid receptor output. The receptors modify their sensitivity or activity level to these changes, causing the reward system in the brain to become unbalanced. This imbalance causes the physical and mental withdrawal symptoms from opiate receptors when they are not provided with a continuing supply of fentanyl.
Abuse and Exploitation
Young women and boys alike who are homeless and addicted to street-based fentanyl will face dangers like abuse and exploitation because they might be made to barter sex for drugs or cash. They will encounter exceptionally severe weather conditions and be cut off from essential resources like food and clean water. Due to their vulnerabilities, young girls will be particularly susceptible to suffering from major bodily, psychological, or sexual harm.
If possible, you should consider keeping your addicted child at home. By establishing clear rules of behavior and boundaries around drug use, you can provide a safe and supportive environment that encourages your child's recovery. This approach can also foster open communication and trust between you and your child, allowing for a more collaborative effort toward healing. Additionally, in my clinical experience with this patient population, I have seen that those patients who receive support from family members during their addiction treatment are more likely to successfully complete the program and maintain sobriety after leaving. While it may not be possible or recommended in all cases, keeping your child at home can be a valuable strategy for parents looking to support their child through the difficult journey of addiction and recovery.
As parents, you need to be aware that your child's possible behaviors are strongly related to the changes that are occurring within their brain and body. Adolescent opioid addicts, for instance, may behave in various ways toward you or other close family members. Your child or young adult could grow more aloof and reclusive, avoiding contact with you as parents or acting aggressively when questioned. Your child might also keep their whereabouts and activities a secret from you and lie to hide their drug use. Furthermore, you should not be surprised if your child acts irritable or hostile toward you or other family members.
You should be aware and sensitive to the fact that your child will be prone to stealing from you or other family members or demand money in order to maintain their addiction. I offered some comfort to the distressed mother mentioned earlier, assuring her that the harsh words and actions were not reflective of her daughter's true self, but rather the distorted manifestations of an addicted mind. This addiction, like an infection, had taken hold of her daughter's behavior making her almost unrecognizable even to those closest to her. But I emphasized the transformative power of recovery. The sooner we could usher her into a recovery program, the quicker her true self - the daughter she knew and loved - would begin to re-emerge.
Recommendation 1: Adapting the disease model of addiction will allow you to better adapt to and tolerate that which was once your loving child is no longer your child but the addictive mind that is speaking and acting through them. |
Considering addiction as a sickness will help you, as parents, to comprehend why your children behave in specific ways. According to the illness model, addiction is a persistent, relapsing brain problem that alters the brain's reward system as well as regions responsible for motivation, memory, and decision-making. You will be better able to understand your children and realize that treatment is better rather than punishment. As parents, you will more readily appreciate how difficult it is for someone with opioid use disorder to stop using drugs despite wanting to. This is because you will see addiction as a disease rather than a moral failing or character flaw.
References:
1. Garfield, R., & Culhane, D.P. (2018). The fentanyl crisis: Evidence from homeless and marginally housed young adults in Pittsburgh. Substance Abuse, 39(4), 473-479.
2. U.S. Department of Housing and Urban Development. (2023). The 2023 Annual Homelessness Assessment Report (AHAR) to Congress. Office of Community Planning and Development. Retrieved from https://www.huduser.gov/portal/sites/default/files/pdf/2023-AHAR-Part-1.pdf.
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