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What One Young Adult's Addiction Says About Tennessee's Opioid Crisis

Joy Fanguy was so afraid of overdosing on pain pills that she kept a running log of how many she'd taken on her nightstand. Some nights, she scrawled a note in the event she didn't wake to let her loved ones know her death was not a suicide.

"I was always afraid I would take too much so I wrote it all down," Fanguy said.

Fanguy got her first taste of prescription painkillers around age 14, when she was given Percocet for migraines. She was addicted by the time she could legally drink, and it would be almost eight years before she recognized she needed help.

Now 31, she's left the log behind and is moving into adulthood. She is sober, having escaped the grip of a drug that killed more than 1,400 Tennesseans in 2015 as the state — and much of the nation — struggles to counter an opioid-abuse epidemic.

"I'm not the status quo: I didn't get married. I didn't have kids. I didn't get my s--t together until I was 30," Fanguy said. "I didn't 'keep up with the Joneses.' I lost a decade. My 20s were there — they happened — but I didn't accomplish anything."

For some, the introduction to pain pills — Tramadol, hydrocodone, oxycodone, among others — happens during formative high school years: through an oral surgery prescription or a well-meaning parent hoping to relieve some pain. It can happen in a high school locker room before a football game, to dull the pain. Or before a party, to loosen up.

Addiction specialists are increasingly worried about the high school gateway to opioid abuse as they find themselves treating more addicts in their 20s who got started earlier in life. It can begin innocently enough: Just 2 percent of youths between the ages of 12 and 17 misused a psychotherapeutic drug (a pain reliever, stimulant, tranquilizer and sedatives) in 2015, according to the National Survey on Drug Use and Health. But that number rises dramatically to 5.1 percent for the group between 18 and 25. Several people in various stages of recovery interviewed for this story started using painkillers before they received a diploma — setting the stage for a downward spiral in the years that followed.

In Tennessee there is some reason for optimism. State analysis indicates the number of youths in the state who used a painkiller fell from 9 percent to 5 percent between 2004 and 2014. The commissioner of the Tennessee Department of Mental Health and Substance Abuse Services can't point to specific campaigns that influenced the drop, but the decrease gave Dr. Stephen Loyd, medical director, some hope.Lack of life skillsNot everyone who takes a prescription opioid will be an addict.Dr. Meg Benningfield, child and adolescent psychiatrist at Vanderbilt University Medical Center, said more research is needed to understand what differentiates those who become addicted.Limiting exposure to painkillers, unless it's medically necessary, is a priority, physicians say. Nearly three-quarters of teens get a pill from a parent, friend or relative — meaning extra pills in medicine cabinets are a problem.But when it comes to misusing pills for fun, parents and public awareness campaigns should be clear: Opioids are as dangerous as alcohol or illicit drugs."Kids perceive prescription pain medications to be far less dangerous than heroin, when in fact the way they work in the brain is similar," Benningfield said.

Drug court 'probably the worst best thing that's happened to me'

Even as the state has made inroads in curbing the number of opioids being prescribed, the state still ranks second in prescriptions per person. At the same time, doctors say the number of young adults seeking rehab for opioid addiction is growing.

A heroin addict at Cumberland Heights was a novelty when Dr. Chappy Sledge, chief medical officer, joined about seven years ago. Now "it's more and more and more" as pills are harder to get.

It's so common for 20-somethings who haven't mastered the basics of life to come into Cumberland Heights that the facility is introducing special programming on how to maneuver daily situations.

Misuse spiraling into abuse and addiction at a young age will impact generations.

The number of young pregnant women, aged 18 to early 20s, who come to VUMC with an opiate addiction reflects a huge increase from what Dr. Reid Finlayson, an addiction specialist, saw when he joined the hospital about 16 years ago.

Regaining dreams

Fanguy wishes, though, she’d known the risks — that it would have been a topic at school, in the doctor’s office or at home. She said she wouldn't have taken them.

"Really the hallmark of crossing over into addiction from controlled use is the loss of control. The idea that 'I'm using more than I intended. I'm giving up other things because I'm using,'" Benningfield said.

Fanguy, who balances a quick wit with introspective commentary, gave up a lot.

But she's regained her dreams and ambitions. She is thinking of finishing college, and she wants to be a writer. Her book would be called "Room 112" after the room with plastic office desk rocking chairs where she attended her first outpatient meeting. She loves that room because it gave her her life.

"I finally get the opportunity to remember I had dreams I never got to follow," Fanguy said. "I didn't care about making it through the day. Sometimes I didn't want to wake up the next day."

One of the dreams is to help someone who might be like her: an addict living in plain sight.

"People don't see the average person as being a possible opiate addict. I thought I'd be in a room with really scary looking people. I wasn't," Fanguy said. "I was in a room with people who looked like me. We're your child's teacher. Your banker. Your nurse. Your restaurant manager. We're not bad people. There are people out there who are waiting for someone to say these things out loud so they can say, 'yeah, me too.' "

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