Drug overdose deaths have risen for 11 straight years according to a new report, with prescription opioids accounting for the majority of drug overdoses. Experts warn of signs of addiction like mood swings and changes in social behaviors. While prescription drugs are more accessible and freely prescribed, they carry high addiction risks similar to heroin. Effective treatment approaches require recognizing the problem and often involve medication, therapy, and social support over long periods of time.

1. With drug overdose deaths on rise, experts push to
recognize signs of addiction
Drug addiction can be a hard fact to face
and accept, but it's an ongoing problem
that needs dire attention.
A new report published in Tuesday's
Journal of the American Medical
Association shows that drug overdose
deaths were on the rise for the 11th straight year. There were a total of 38,329 drug overdose
deaths in 2010 according to the Centers of Disease Control and Prevention -- and 60 percent were
due to medications, the majority of which were prescription drugs.
Opiod drugs, which include OxyContin and Vicodin, were the most frequently involved, accounting
for three out of four medication overdose deaths. Only 17 percent of the deaths were suicides,
meaning the vast majority were unintentional overdoses.
"The big picture is that this is a big problem that has gotten much worse quickly," Dr. Thomas
Frieden, head of the Centers for Disease Control and Prevention, told the Associated Press.
The first step though is recognizing or helping others recognize that they need help. Some signs that
a loved one or a friend might need help include seeing behavioral changes that seem out of the
ordinary.
Family members may notice a person's mood swings, altered sleep habits, bizarre behavior including
lying and stealing, changes in friends or social groups and unexpected weight loss, Dr. Greg
Johnson, a staff physician at Origins Recovery Centers in South Padre Island, Texas, said to
CBSNews.com.
For co-workers, this could mean noticing they are becoming less reliable, coming later to work,
missing deadlines, isolating themselves in their offices and having more unexcused absences or
more absences attributed to illness, Dr. David Sack, CEO of Promises Treatment Centers, told
CBSNews.com. They may also have more financial problems like borrowing against their 401Ks or
taking money out of their savings. Frequent medical visits for panic attacks or chest palpitations can
also be a sign.
Both experts have noticed that younger addicts are seeking treatment -- and believe prescription
drugs may be to blame. More adults are on prescription drugs, giving a larger population of children
access to them, Johnson pointed out. While alcohol and marijuana still remain "gateway" drugs, he
said, young people have easier access to prescription pills from their parent's cabinets. Some start
while they are just in middle school.
"A parent may notice at the end of the month, but they may or may not get the idea that their kid is
stealing from them," Johnson said.
Sack believes that prescription drug abuse has increased recently because doctors have been

2. prescribing them more freely. While 40 years ago, many physicians held off from giving out pain
medication, in the 1970s many medical professionals saw how these pills could help treat pain in
people like cancer patients.
"There was a push for a better job of treating all forms of chronic pain," Sack said. "It was a very big
initiative around the U.S. and the world."
Frieden added to AP that many doctors and patients don't realize how addictive prescription
painkillers can be. He believes they are often given for conditions that could have been managed
with less addictive drugs.
But what people may not realize is that opioids are the same class of drugs as heroin, only in
prescription form. The doctors say that they both are seeing more and more people turning to heroin
use. Sack believes part of the reason is that after a while opioid drugs can become expensive, and
black tar heroin is much cheaper. At that point, many addicts are what Johnson likes to call
"polysubstance abusers."
"They'll do Xanax and 'xanibars' if they are here and available, and cocaine if they can get their
hands on it, and they'll do heroin if there's heroin," Johnson said.
Sack believes that part of what makes prescription drugs seem safe is that they come from
pharmacies and doctors. But, since many prescription narcotics are respiratory depressants, and
many people who abuse them use them in conjunction with other depressants like alcohol or
sedative hypnotics like Xanax or Ambien, it can lead to negative consequences -- possibly death,
Sack said. Johnson has heard of Vicodin, Soma and Xanax referred to as the "Holy Trinity," meaning
that drug addicts like to use all three at the same time.
"It's kind of the Heath Ledger phenomenon," Sack explained. "Even though any one of them are not
enough to cause an overdose, two or three of theme together is enough."
There are many ways to treat addiction, but all of them come with their risks and benefits. Promises
Treatment Centers uses a multifaceted approach of detox, traditional medicine and complimentary
treatment like yoga, meditation or acupuncture, and emphasizes community support. For Origins
Recovery Centers, they try to aid in drug addiction recovery with a 12-step program and use a
mixture of psychiatric, physical and clinical care lasting at least 90 days, with a 24-month follow up
period.
"We believe in the concept of if you're treating a disease like you are treating diabetes, you need to
have some ongoing care," Johnson explained about Origins' approach. "If you are a diabetic, you
wouldn't go to the doctor and be treated for 30 days and then be sent home."

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There's also additional medications that can help a patient wean themselves off an addiction. One
method uses Naltrexone, which blocks opioid receptors and stops people from getting high. It can
also decrease cravings.
A problem with Naltrexone is that it comes in a daily pill, and sometimes that can be a challenge for
addicts to continue with the regiment. Missing a few doses decreases the effectiveness, Sack pointed
out. Another version of Naltrexone called Vivitrol only involves a once a month shot, but it can be
quite costly, Johnson added. Whereas Sack believes that medications like Naltrexone can be
beneficial for people who've had even short term addictions and help them beat them, Johnson
thinks that putting addicts on another substance should only be reserved for people who have
relapsed many times.
Another form of therapy called medication-assisted or opiate-assisted therapy (also known as
maintenance therapy) replaces the drug of choice with other medications like methadone. Since
methadone has a longer half-life, people don't experience the euphoria with use like they do when
they abuse other drugs like heroin. Still, it can make people addicted to this new substance, so Sack
only recommends it for people who repeatedly relapse.
But, the most important part of recovery is recognizing there is a problem.
"The first step is an addict has to hit some type of a bottom or find something that convinces them
that they are powerless, that I can no longer do heroin so I have to find another way," Johnson
stated.
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