The 10 Most Dangerous Meds Driving America's Pill Crisis

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For the first time in nearly a century, automobile accidents are no longer the nation’s leading cause of accidental deaths, according to a major report released Tuesday by the National Center for Health Statistics. The new number one killer is drugs—not smack, crystal meth or any other stepped-on menace sold in urban alleyways or trailer parks, but bright, shiny pills prescribed by doctors, approved by the government, manufactured by pharmaceutical companies and sold to the consumer as “medicine.” Yet of the billions of legit pills Americans pop every year for medical conditions serious and otherwise, the vast majority of lives are claimed by only a select few classes—painkillers, sedatives and stimulants—that all share a common characteristic: they promote abuse, dependence and addiction.

“This is just the tip of the iceberg of the prescription drug abuse problem,” says Dr. Margaret Warner, the federal report’s lead author. “The take-home here is, this should be a wake-up call.” Some 41,000 Americans died from what the report refers to as “poisonings” in 2008, compared with 38,000 traffic deaths. That tally marks a 90 percent increase in poisonings and a 15 percent decrease in car accidents since 1999.

Nearly nine out of ten of those poisonings were caused by prescription drug overdoses, with the chief culprit being opiate-based pain relievers such as Vicodin (hydrocodone), OxyContin and Percocet (oxycodone), codeine, morphine—and let’s not forget Actiq (fentanyl), the infamous berry-flavored lollipop that is 100 times stronger than morphine and—like most opiate analgesics—so overprescribed that only about 10% of its sales come from its original indication to treat cancer pain.

These legal opiates accounted for 40 percent, or 15,000, of the fatalities, up from 25 percent, or 4,000, in 1999. Deaths by painkiller now outpace the combined nationwide number of deaths by cocaine (5,100) and heroin (3,000); these fatal overdoses often involve mixing painkillers with other prescription drugs—for example, Klonopin, Xanax, Valium or another benzodiazepines, which are the second most lethal class.

Other report findings: Three quarters of the poisoning are unintentional—likely the result of overdoses rather than drug interactions or allergic reactions—and some 13 percent are suicides. The five states with the highest oxy-type drug death rates (per 100,000 of the population) were New Mexico (30.8), West Virginia (27.6), Alaska (24.2), Nevada (21.0), and Utah (20.8).The most likely to die: white men, American Indians and Native Alaskans, usually between the ages of 45 to 54.

Warner’s death report is but the latest in a disturbing accumulation of evidence, ranging from scientific surveys to celebrity deaths, that underscore what we already know about our painkiller nation: pill mills and doctor shoppers are not just creating a land of bathroom-cabinet addicts—their bodies are packing morgues.

With our surging “oxy addiction” showing no signs of letting up, the Centers for Disease Control and Prevention this year officially named it an “epidemic.” President Obama has repeatedly invoked prescription drug abuse as the nation’s leading drug problem responsible not only for a rising number of overdoses and deaths but also ratcheting up the incidence of break-ins and burglaries of pharmacies.

Warner and her colleagues at the agency, which is overseen by the CDC, are at pains to draw comparisons between oxy-type drug deaths and those from auto accidents, because they hope that the same comprehensive approach that helped cut traffic deaths in half during the previous decade can save just as many lives on the drug front. Auto fatalities fell following a concerted government focus on national highway safety, resulting in car safety improvements as well as a wide range of regulatory, legal, and public health measures. Seat belt laws were enforced; drunk driving laws became stricter. The fact that alcohol—yet another legal intoxicant—is responsible for close to 40% of all traffic fatalities indicates how difficult it is to apply policy to substance abuse and get significant results. Still, drunk driving is playing a smaller and smaller role in automobile fatalities, falling by close to 40% since 1982.