A pill problem: prescription drug abuse is the fastest growing form of substance abuse.

• Author: Hanson, Karmen

The figure is startling: A 96.6 percent increase in drug-related deaths in a five-year period.

What's most shocking is that the drugs involved are not cocaine or heroin or even methamphetamine. They are prescription drugs--medication prescribed every day by doctors, mostly for pain.

"The prescription drug problem is a crisis that is steadily worsening," says Dr. Len Paulozzi, a medical epidemiologist with the Centers for Disease Control and Prevention. "The vast majority of unintentional drug overdose deaths are not the result of toddlers getting into medicines or the elderly mixing up their pills. Our scientific evidence suggests that these deaths are related to the increasing use of prescription drugs, especially opioid painkillers, among people during the working years of life."

Opioid analgesia painkillers, one of the largest growing segments of prescription drugs, are medications such as OxyContin, Darvon and Vicodin. They include ingredients such as oxycodone, hydrocodone, fentanyl and propoxyphene. More than 201 million prescriptions were written in 2007 for products that have a potential for abuse opioid analgesics, methylphenidates and amphetamines--according to Verispan, a prescription information database.

It was a CDC study that found the 96.6 percent increase in prescription opioid analgesic-related deaths in 28 metropolitan areas from 1997 to 2002. During the same period, deaths from cocaine overdoses increased 12.9 percent, and deaths from heroin or morphine decreased 2.7 percent.

The problem is growing faster than previously estimated. Some 4.7 million people used various prescription drugs--pain relievers, sedatives and stimulants--nonmedically for the first time in 2008, according to the National Survey on Drug Use and Health.

As Paulozzi points out, "drug overdoses are now the second leading cause of unintentional injury death in the United States, exceeded only by motor vehicle fatalities.

People who initially take prescriptions for legitimate pain relief may go on to abuse these drugs for a recreational high. Others are abusing prescription drugs from the beginning as an alternative to illegal drugs.

State legislators are hoping to reverse this growing trend. In 2009, at least 11 state legislatures enacted Drug Abuse Awareness months, regulated pain clinics, and created prescription drug monitoring programs and unused prescription drug disposal programs to help prevent fraud and abuse and to rehabilitate current abusers.

GOING AFTER THE SUPPLY

The problem is widespread across the country, hitting every type of community. It began to increase after doctors started treating chronic pain with new, stronger medications in the 1990s. While thousands of people use these products legitimately every day, they may become addicted if the drugs are not used as prescribed.

More than half the nonmedical users of prescription pain relievers get them from a friend or relative for free, according to the national drug survey. The majority of those people had obtained the drugs from one doctor. Fewer than 10...