Since 1990, there has been a tenfold increase in prescriptions for opioids in the U.S., according to the Centers for Disease Control and Prevention (CDC). In 2007, 3.7 million people filled 21 million legal prescriptions for opioid painkillers, and 5.2 million people over the age of 12 reported using prescription painkillers nonmedically in the previous month, according to a survey by the Substance Abuse and Mental Health Services Administration (SAMHSA). From 2004 to ’08, emergency-room visits for opioid misuse doubled. At the same time, the drugs have become the stuff of pop culture, gaining cachet in the process. The fictitious Dr. House and Nurse Jackie gobble them like gumdrops, as did the decidedly nonfictional Rush Limbaugh and Heath Ledger. And, like Ledger, some users don’t make it out alive.
In 1990 there were barely 6,000 deaths from accidental drug poisoning in the U.S. By 2007 that number had nearly quintupled, to 27,658. In 15 states and the District of Columbia, unintentional overdoses have, for the first time in modern memory, replaced motor-vehicle incidents as the leading cause of accidental death; and in three more states it’s close to a tie.