illegal narcotics, such as heroin, with most deaths in big cities. Prescription painkillers have now surpassed heroin and cocaine, however, as the leading cause of fatal overdoses, Paulozzi says. And the rate of fatal overdoses is now about as high in rural areas — 7.8 deaths per 100,000 people — as in cities, where the rate is 7.9 deaths per 100,000 people, according to a paper he published last year in Pharmacoepidemiology and Drug Safety.
“The biggest and fastest-growing part of America’s drug problem is prescription drug abuse,” says Robert DuPont, a former White House drug czar and a former director of the National Institute on Drug Abuse. “The statistics are unmistakable.”
About 120,000 Americans a year go to the emergency room after overdosing on opioid painkillers, says Laxmaiah Manchikanti, chief executive officer and board chairman for the American Society of Interventional Pain Physicians. Experts say it’s easy to see why so many Americans are abusing painkillers. There are lots of the drugs around, and they’re relatively easy to get, says David Zvara, chair of anesthesiology at University of North Carolina Hospitals.
As Americans age and carry extra pounds, more are asking for pain relief to cope with joint problems, back pain and other ailments, Zvara says. He says he has seen a huge increase in the number of patients seeking care for chronic pain. Paulozzi notes that the rise in fatal overdoses almost exactly parallels a corresponding rise in prescription painkiller sales. In surveys, about 5% of Americans say they have used a prescription narcotic in the past month. Doctors today are also more apt to prescribe pain pills in an effort to relieve real suffering, says James Garbutt, a UNC addiction specialist.