A shadow epidemic

Jeanette Angel Coleman of Woodbine, left, a certified alcohol and drug counselor, talks to a patient at Families Matter Behavioral Health in the Villas section of Lower Township.

Cheryl Reda suffered more in the aftermath of having surgery on a herniated disk in her back from a car accident than before the operation.

Reda, 45, of Lower Town-ship, found herself in excruciating pain and started seeing a pain management therapist. He prescribed that Reda take four OxyContins and six Percocets, each a powerful narcotic, daily.

Reda developed an addiction to this medication.

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"Around 10 years after I started taking it (Percocet and OyxContin), I woke up one day and realized it destroyed my marriage. I wasn't happy anymore," said Reda, who added the withdrawal from these drugs is so powerful some people don't want to live. "This was the point that broke everything, being on medication. I didn't have a life."

Reda was lucky. She was able to overcome her addiction through the help of Families Matter Behavioral Health Services, also in Lower Township.

Women have died from addiction to painkillers. In July, the Centers for Disease Control and Prevention said there was a 400 percent increase in these deaths among women due to painkillers from 1999 to 2010. There were four times more deaths among women from prescription painkiller overdoses than for cocaine and heroin deaths combined in 2010.

The reason why people become addicted to pain medication is different than why they become addicted to illegal drugs, said Pat Campbell, the owner of Families Matter Behavioral Health Services.

Unlike with illegal narcotics, it is not because of preexisting mental health conditions. These medications are very, very easy to get addicted to, Campbell said.

There are more medical issues women seek help for than men, including migraines, fibromyalgia and PMS, Campbell said. The common opioids, which are pain relievers made from opium that come from the poppy plant, are OxyContin, Vicodin, Gabaset, Percocet and heroin.

"The main reason for death is that it depresses your respiration. As the load of the opioid is in your system, it slows your breathing down until you stop breathing. They go into respiratory arrest and can't breathe because everything slows down where it's not able to pump at the natural rate," Campbell said. "Your heart slows down. Your pulse slows down, and they just die."

In the emergency department at Cape Regional Medical Center, the physicians often try to educate the patient as to the dangers of long-term use of prescription pain killers and offer them some alternatives, said Dr. Domenic Coletta, medical director of emergency medicine at Cape Regional Medical Center.

"We usually suspect a dependency on narcotic pain medication in the emergency department when the patient presents a chronic problem that has never responded to alternative treatments and she often insists on receiving specific pain killers. Signs of withdrawal are also indications that the patient has a possible addiction," Coletta said.

AtlantiCare Regional Medical Center's emergency teams at ARMC City and Mainland campuses and its Satellite Emergency Department in Hammonton limit the amount of pain medication they prescribe for painkillers and have a pain policy for chronic pain and refills.

Substance use disorders are chronic medical conditions that have relapses and remissions, not unlike diabetes or hypertension, said doctor Rose Julius, medical director at AtlantiCare Mission HealthCare/Community Health Services. Those affected require ongoing treatment, which must be individualized based on specific needs, Julius said.

When a women decides to enter treatment, she can experience significant positive changes in her life, Julius said.

"As a result of treatment, these women are able to have improved relationships with their families, function better as a mother, return to work and avoid any additional legal trouble they may have had as a result of their addiction," Julius said.

Campbell said with those addicted to opioids, her organization is starting to use a medication called Vivitrol, a once-a-month, extended release medication given by a shot in the behind. Jeanette "Angel" Coleman, a certified alcohol and drug counselor with Families Matter Behavioral Health, said clients can be motivated for treatment, but Vivitrol has helped them to be motivated for recovery by reducing their cravings and helping them stay focused.

"It gives women who have problems with prescription pain medication the opportunity to once and for all break the cycle of addiction," Coleman said.

As a means to minimize diversion of controlled substances, AtlantiCare encourages its physicians to register and utilize the New Jersey Prescription Monitoring program, which allows a physician to view all controlled substances that were filled at a pharmacy by a particular patient, Julius said.

"This would help identify any potential opioid use disorder and address it with the patient for appropriate treatment planning," Julius said.

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Recognizing a problem with prescription drugs

These signs might indicate a problem with prescription painkillers.

•Needing more of the medication to have the same effect.

•Experiencing significant withdrawal problems when not taking the drug.

•Because of the use of prescription opiates, failing to fulfill major obligations in their life. For example, having problems at work or with school, conflicts between themselves and their partner, having difficulty with their children out of proportion of the usual norm.

•Using prescription opiates in conditions where it's hazardous, such as, driving under the influence.

•Buying prescription pills, not from their doctor. Taking them from friends or getting them from multiple doctors, potentially putting themselves in illegal or physically harmful situations.

•Becoming powerless about their drug use, and having their life revolve around drug use. Everything they think about is how to get drugs.

•Continuing to use drugs despite knowing it is hurting them and their whole family.

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