U. S. government researchers said fatal overdoses of prescription painkillers in West Virginia and overdoses of legal drugs across the United States are on the rise. Dr. Aron J. Hall, an epidemic intelligence service officer of U. S. Centers for Disease Control and Prevention said, "Now in the United States, drug overdoses are the second-leading cause of unintended deaths behind motor vehicle deaths. This epidemic is most pronounced in rural areas. Use and abuse of prescription and particularly narcotic pain medications have increased dramatically in the last 10 to 15 years." The report in the Journal of the American Medical Association said that two-thirds of the people who died from overdoses of legal pills had no prescription for the drugs that killed them leading to a belief that many legal drugs are being diverted for non medical uses.

The researchers studied drug abuse patterns in West Virginia where overdose rates have increased by 550 % between 1999 and 2004 in the hope to find a way to understand and fight the problem. They found in 2006 out of the 295 people who had died of drug overdose, 63 % had used drugs without a prescription while 21 % had obtained their drugs from five or more doctors which indicated that they had been "doctor shopping" to get the drugs particularly opioids like methadone, hydrocodone and oxycodone, Hall said. Methadone, used in substance abuse treatment and increasingly for pain relief, was involved in 40 % of all deaths. Women were more likely at 30.9 % to doctor shop than men at 16.7% and younger people were more likely to use painkillers for non medical purposes than the older ones. Several medications had been used in 79.3 % of the deaths while Opiods were the most common drug used accounting for 93.2 % of the deaths.

"This epidemic of prescription drug overdose involves a substantial amount of substance abuse, and it affects not just West Virginia, but particularly rural areas of the country," Hall said. "It's been a problem throughout the country. Our study focused on West Virginia as the tip of the iceberg. We were aware that prescription drugs were the primary culprits in many of these deaths, but we did not know whether individuals had prescriptions for the drugs that ultimately killed them," Hall said.

The researchers feel doctors and pharmacists have a critical role in preventing the misuse of these drugs and need to strictly follow set guidelines for managing narcotics. "It is essential that they counsel patients not only about the risk of overdose to themselves, but about the risks to those with whom they might share their drugs," he said.

Dr. Adam Bisaga, an associate professor of clinical psychiatry in the division on substance abuse at Columbia University College of Physicians and Surgeons in New York City said, "This finding is not surprising. Opiates are generally very safe if used appropriately, but opiate abuse/dependence is an illness with high mortality rates. So the issue is not with the medication, but rather the detection and treatment of those who abuse and become addicted to opiates. I strongly believe that present results could be directly used to justify implementing changes in practice and treatment to promptly reverse this worrisome trend that is likely to be occurring throughout the country, not just in one state," Bisaga said.

Leonard Paulozzi of the CDC said, "Taken as directed, the drugs are safe. But they are powerful drugs and they are not something to be taken recreationally at parties and that sort of thing."