Why a Mother Bravely Shares Daughter’s Final Words

[J.Adderton, BSN, MSN]

On April 6, 2019, Fox News published an article bravely written by Dawn Harding. Harding’s daughter, Taylor, died at the age of 23 of a fentanyl overdose. Taylor suffered from both addiction and bipolar disease, like many others with substance abuse problems. Harding describes how her daughter’s disease would lead to jail time, periods of sobriety and then back into active addiction. After her death, Harding discovered a letter written by Taylor on the back of an arrest report detailing her deepest agonies. Taylor, like many addicts, experienced trauma that would ultimately lead to self medication and addiction.. In hopes of helping another person, Harding shared her daughter’s written letter and words about the power of addiction.

“There’s something dark hanging over my head that we all try to ignore. It’ll cause me and everyone I love, a lot of pain in the future. But for now, we carry on. Even after my dad disappears and the memory of him softens, his abuse lightens my mind and though I long for him, we all learn to live without him”.

"As deafening, quiet calm storm rush, breathing only when absolutely necessary. I nod into a bright, soft, warm ocean. I’m not sad, I am not happy, I just am. My mind isn’t screaming with worry, regret or shame. I can breathe if I want, I can stop and be gone. There is power in my pain now. I found wholeness my aching mind, heart and soul so badly craved.”

Up until age 18, Taylor was taking medication for her bipolar disease and her condition was well managed. At age 18, she was dropped from her mother’s insurance, was unable to find programs for uninsured individuals and eventually began to self-medicate. Taylor’s story is like many suffering from mental health issues but without insurance or financial resources to access care.

This article is written to continue Harding’s efforts to help even one family by raising awareness. In 2016, synthetic opioids (primarily illegal fentanyl) passed prescription opioids as the most common drugs involved in U.S. overdose deaths. In 2016, nearly 50% (19,413) of opioid-related deaths were attributed to synthetic opioids. The amount of deaths were up from 14% (3,007) in 2010.

What is Fentanyl?

Fentanyl is a synthetic opioid similar to morphine but 50 to 100 times more potent. It is a prescribed drug that is used to treat severe pain, as with surgery or cancer. Fentanyl is also used to treat chronic pain in individuals who have built a tolerance to other opioids. Prescription fentanyl is most commonly known as the Duragesic patch. It can also be given as an injection or lozenges.

Illegal Fentanyl

Fentanyl is often smuggled into the U.S. from China and Mexico and used to cut cocaine and heroin. Drug dealers are also mixing fentanyl with methamphetamine and ecstasy. This is especially dangerous since people taking drugs may not realize they contain highly potent fentanyl increasing the risk for overdose. Illegally manufactured fentanyl, made in labs, is associated with the spike in overdose deaths. This synthetic fentanyl is sold in several forms, including as a powder, in eye droppers or nasal sprays and as a pill.

Effect on the Brain

Fentanyl works like other opioids by binding to the body’s opioid receptors. The receptors are found in the area of the brain that controls brain and emotions. Sensitivity to the drug decreases when opioids are taken many times and it becomes difficult to feel pleasure from anything other than the drug. The effects of fentanyl include:

• Extreme happiness
• Drowsiness
• Confusion
• Nausea
• Sedation
• Breathing problems
• Unconsciousness

Fentanyl overdose cause respirations to slow or stop. The brain does not receive adequate oxygenation and may lead to coma, permanent brain damage and possibly death. Overdose is treated with Naloxone which blocks the effects of the opioid drug.

Barriers to Treatment

Taylor’s story is like many facing addition- a need for treatment but significant barriers make accessing services difficult. A wide range of treatment programs exist but they only serve a limited number of patients. This is due to lack of bed availability and financial issues such as lack of insurance and ability to pay. The Substance Abuse and Mental Health Services Administration (SAMHSA) surveyed 14,399 facilities in 2016 and found these facilities served a little more than 1.1 million patients. This is far short of the 21 million people age 12 and older who needed treatment during the same year. Other barriers include:

• Lack of mental health professionals available for individual therapy
• Geographical barriers including lack of inpatient and partial hospitalization programs in rural areas
• Lack of insurance or financial resources.
• Differences in socioeconomic status (higher unemployment rates and unstable housing among certain groups)
• Cost of rehab
• Cost of medication-assisted treatment for addiction (i.e. naltrexone)
• Stigma associated with addiction
• Women specific barriers such as pregnancy and childcare
• Co-occuring mental health disorders

In sharing her daughter’s story, Dawn Harding inspires hope that those struggling with addiction can find a way to overcome obstacles to treatment. The barriers are challenging because they occur on structural, systemic, personal and socioeconomic levels. However, there is progressing being made in identifying potential solutions for helping others, like Taylor, to heal and begin to live life fully.

References:

Read Dawn Harding’s full article

Access the Substance Abuse and Mental Health Service Administration’s 2016 National Survey on Drug Use and Health here

Center for Disease Control Information on Fentanyl