Chances are that you have opioids in your medicine cabinet right now, leftover painkillers from a legitimate prescription filled because of an injury, or chronic pain. Every day in America, 116 people die from overdosing on opioids from among the 250 million annual prescriptions written for the drug. Since 2004, the number of teens overdosing on opioids has doubled. So if you think you know who abuses drugs these days, close that medicine cabinet and look in the mirror. Then sit down with your kids for an important discussion.

Consider asking your children the following:

" What kinds of people become addicted to opioids?

" What do you think opioids do to us to make them so addicting?

" What's wrong with taking opioids and why is it considered an epidemic?

" What is a "Pharm Party?"

Questions your child might not ask:

" If I'm in a lot pain, what can I do other than taking opioids?

" How do I help a friend who shows signs of opioid addiction?

" What do I say to a friend if one of them offers me opioids?

Did you know?

Drug overdose is currently the leading cause of death among Americans under 50-and well over half of those are caused by opioids. To help understand how these numbers got so scary so fast, it helps to understand what these drugs do. In our brains we have opioid receptors that regulate our body's pain and pleasure systems; opioids quickly impact both of them, instantly creating a euphoric "high" and reducing pain-making them very addictive in the process.

A few basics:

Warning signs: diminished appetite and grades; mood swings; change in sleep patterns-too much or too little; neglecting chores, homework and relationships; depressive behavior; self-harm.

Opioids vs opiates: the latter come from certain kinds of poppy plants and include illegal narcotics like heroine as well as legal (but highly abused) medicines like morphine, Vicodin, Percocet and OxyContin. Synthetic versions of opiates were also created, such as methadone and fentanyl; the term that refers to all of these drugs is "opioid."

A growing trend: A scary recent development is that even as we're curbing the availability of the legal, prescribed opioids, deaths related to abuse of their illegal counterparts have spiked, doubling since 2009.

Reasons for abuse: Recreational use or self-harm is the most common reason cited for older kids who overdose on opioids, while accidental ingestion is the most common reason for the younger overdose victims.

Family action plan:

" This is a broad and daunting subject that deserves a measured, layered approach. As with other scary subjects we bring up, we try not to overwhelm our kids, especially when talking in a group setting with a range of ages present; consider having more private conversations with the older kids for tackling age-appropriate details and questions.

" When seeking pain treatment for our families, we could consider physical therapy, massage therapy, cognitive behavioral therapy, exercise, yoga and meditation. These are especially useful for chronic pain since the effectiveness of opioids weakens over time as the brain builds up tolerance; depending on the cause of the pain, some of these may not be options.

" We can consider alternative medications such as over-the-counter Acetaminophen (Bayer/Tylenol), Ibuprofin (Motrin/Advid), or interventional therapy injections.

" We have to be prepared for less-than-immediate gratification: the alternatives to opioids are more gradual, time-consuming and sometime more expensive, but none of them are addictive.

" We can talk our doctors about available options, and if opioids are the only reasonable choice, partner with them regarding the minimal time period and dosage as well as asking for sources of information to further educate your family.

" Using the buddy system ensures that there is no abuse of opioids: someone other than the patient-even when we're talking about an older teen or adult-can store and administer the drug.

" Communicate the consequences of sneaking drugs of any kind-ideally before it becomes something of interest to them; we can bring our spouse in on this so that consistent enforcement occurs. Enlist allies among teachers, coaches, mentors, therapists.

" Know the potential hiding places for drugs: backpacks, makeup cases, bookshelves, drawers, under the mattress.

" Let's combine strict rules with unconditional love and open conversation: both positive and negative reinforcement. When kids fear harshness or shaming they tend to shut down, so we can let them know they don't need to be perfect, but they do need to trust us enough to include us on the hard stuff. Acknowledge their right to be individuals and to make mistakes: they promise to be honest, and we promise to be understanding.

Family resources:

Center For Disease Control and Prevention Combating Drug Addiction & The Opioid Crisis
U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration

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