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 www http://www.cdc.gov/vitalsigns

Prescription Painkiller 

Overdoses in the US

Deaths from prescription painkillers* have 

reached epidemic levels in the past decade. 

The number of overdose deaths is now greater 

than those of deaths from heroin and cocaine 

combined. A big part of the problem is 

nonmedical use of prescription painkillers—

using drugs without a prescription, or using 

drugs just for the “high” they cause. In 2010, 

about 12 million Americans (age 12 or older) 

reported nonmedical use of prescription 

painkillers in the past year.

Enough prescription painkillers were 

prescribed in 2010 to medicate every 

American adult around-the-clock for a month. 

Although most of these pills were prescribed 

for a medical purpose, many ended up in the 

hands of people who misused or abused them. 

Improving the way prescription painkillers are 

prescribed can reduce the number of people 

who misuse, abuse or overdose from these 

powerful drugs, while making sure patients 

have access to safe, effective treatment.

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Enough prescription painkillers 

were prescribed in 2010 to 

medicate every American adult 

around-the-clock for a month. 

In 2010, 1 in 20 people in the 

US (age 12 or older) reported 

using prescription painkillers 

for nonmedical reasons in

the past year. 

15,000

Nearly 15,000 people die every 

year of overdoses involving 

prescription painkillers.

1 Month

1 in 20

* “Prescription painkillers” refers to opioid or narcotic pain 

relievers, including drugs such as Vicodin (hydrocodone), 

OxyContin (oxycodone), Opana (oxymorphone), and methadone. 

November 2011

National Center for Injury Prevention and Control 

Division of Unintentional Injury Prevention
Problem

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Overdose deaths from prescription 

painkillers have skyrocketed 

during the past decade.

Prescription painkiller overdoses are a 

public health epidemic. 

◊ Prescription painkiller overdoses killed nearly 

15,000 people in the US in 2008. This is more 

than 3 times the 4,000 people killed by these 

drugs in 1999. 

◊ In 2010, about 12 million Americans (age 12 or 

older) reported nonmedical use of prescription 

painkillers in the past year.

◊ Nearly half a million emergency department 

visits in 2009 were due to people misusing or 

abusing prescription painkillers. 

◊ Nonmedical use of prescription painkillers costs 

health insurers up to $72.5 billion annually in 

direct health care costs. 

Certain groups are more likely to abuse or 

overdose on prescription painkillers.

◊ Many more men than women die of overdoses 

from prescription painkillers.

◊ Middle-aged adults have the highest 

prescription painkiller overdose rates.

◊ People in rural counties are about two 

times as likely to overdose on prescription 

painkillers as people in big cities.

◊ Whites and American Indian or Alaska 

Natives are more likely to overdose on 

prescription painkillers.

◊ About 1 in 10 American Indian or Alaska 

Natives age 12 or older used prescription 

painkillers for nonmedical reasons in the past 

year, compared to 1 in 20 whites and

1 in 30 blacks.

The supply of prescription painkillers is 

larger than ever.

◊ The quantity of prescription painkillers sold 

to pharmacies, hospitals, and doctors’ offices 

was 4 times larger in 2010 than in 1999. 

◊ Many states report problems with “pill mills” 

where doctors prescribe large quantities 

of painkillers to people who don’t need 

them medically. Some people also obtain 

prescriptions from multiple prescribers by 

“doctor shopping.”

Some states have a bigger problem with 

prescription painkillers than others.

◊ Prescription painkiller sales per person were 

more than 3 times higher in Florida, which 

has the highest rate, than in Illinois, which 

has the lowest. 

◊ In 2008/2009, nonmedical use of painkillers 

in the past year ranged from 1 in 12 people 

(age 12 or older) in Oklahoma to 1 in 30 in 

Nebraska.

◊ States with higher sales per person and

more nonmedical use of prescription 

painkillers tend to have more deaths from 

drug overdoses. Real Life Stories of the Epidemic

A West Virginia father, age 26, struggling for years with 

pain and addiction after shattering his elbow in a car crash, 

died from a prescription painkiller one week after telling 

his mother he wanted to go to rehab. In New Hampshire, 

a 20-year-old man overdosed on a prescription painkiller 

bought from a friend, becoming the 9th person that year 

to die from drug overdose in his community of 17,000. 

Stories such as these are all too common.
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Rates of prescription painkiller sales, deaths and substance 

abuse treatment admissions (1999-2010)

SOURCE: Automation of Reports and Consolidated Orders System (ARCOS) of the Drug Enforcement Administration (DEA), 2010

SOURCE: National Vital Statistics System, 2008

SOURCES: National Vital Statistics System, 1999-2008; Automation of Reports and Consolidated Orders System 

(ARCOS) of the Drug Enforcement Administration (DEA), 1999-2010; Treatment Episode Data Set, 1999-2009

Kilograms of prescription

painkillers per 10,000 people

Rate per 100,000 people

(adjusted for age)

3.7 - 5.9

6.0 - 7.2

7.3 - 8.4

8.5 - 12.6

5.5 - 9.4

9.5 - 12.3

12.4 - 14.8

14.9 - 27.0

Drug overdose death rates by state per 100,000 people (2008)

Amount of prescription painkillers sold by state per 10,000 people (2010) 

HI

FL

AL

AZ

AR

CA CO

GA

IL

IA

KS KY

LA

ME

MI

MN

MS

MO

NE

NY

NC

ND

OH

OK

OR

PA

SC

SD

TN

TX

UT

VT

VA

WA

WV

WI ID

MT

NV

NM

WY

AK

CT

D.C.

NJ

DE

MD

NH

RI

MA

IN

HI

FL

AL

AZ

AR

CA CO

GA

KS KY

LA

ME

MI

MS

MO

NC

OH

OK

OR

PA

SC

TN

UT

VT

WA

WV

WI ID

MT

NV

NM

WY

AK

CT

D.C.

NJ

DE

MD

NH

RI

MA

IL IN

IA

MN

NE

NY

ND

SD

TX

VA

Rate

199920002001200220032004200520062007200820092010

Deaths per 100,000 people

Treatment admissions per 10,000 people

Sales per kilograms per 10,000 people

Deaths

Treatment

Sales

8

7

6

5

4

3

2

1

0
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 www http://www.cdc.gov/mmwr

For more information, please contact 

Telephone: 1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348

E-mail: cdcinfo@cdc.gov

Web: www.cdc.gov

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Publication date: 11/01/2011

What Can Be Done

The US government is

◊ Tracking prescription drug overdose trends to 

better understand the epidemic.

◊ Educating health care providers and the public 

about prescription drug abuse and overdose.

◊ Developing, evaluating and promoting 

programs and policies shown to prevent and 

treat prescription drug abuse and overdose, 

while making sure patients have access to safe, 

effective pain treatment. 

States can

◊ Start or improve prescription drug monitoring 

programs (PDMPs), which are electronic 

databases that track all prescriptions for 

painkillers in the state.

◊ Use PDMP, Medicaid, and workers’ 

compensation data to identify improper 

prescribing of painkillers.

◊ Set up programs for Medicaid, workers’ 

compensation programs, and state-run health 

plans that identify and address improper 

patient use of painkillers. 

◊ Pass, enforce and evaluate pill mill, doctor 

shopping and other laws to reduce prescription 

painkiller abuse. 

◊ Encourage professional licensing boards to 

take action against inappropriate prescribing.

◊ Increase access to substance abuse treatment.

Individuals can

◊ Use prescription painkillers only as directed by 

a health care provider.

◊ Make sure they are the only one to use their 

prescription painkillers. Not selling or sharing 

them with others helps prevent misuse and 

abuse.

◊ Store prescription painkillers in a secure place 

and dispose of them properly.*

◊ Get help for substance abuse problems if 

needed (1-800-662-HELP).

Health insurers can

◊ Set up prescription claims review programs to 

identify and address improper prescribing and 

use of painkillers. 

◊ Increase coverage for other treatments to 

reduce pain, such as physical therapy, and for 

substance abuse treatment.

Health care providers can

◊ Follow guidelines for responsible painkiller 

prescribing, including

• Screening and monitoring for substance 

abuse and mental health problems. 

• Prescribing painkillers only when other 

treatments have not been effective for pain.

• Prescribing only the quantity of painkillers 

needed based on the expected length

of pain. 

• Using patient-provider agreements 

combined with urine drug tests for people 

using prescription painkillers long term.

• Talking with patients about safely using, 

storing and disposing of prescription 

painkillers.*

◊ Use PDMPs to identify patients who are 

improperly using prescription painkillers. 

CS227796-B

* Information on the proper storage and disposal of medications 

can be found at www.cdc.gov/HomeandRecreationalSafety/

Poisoning/preventiontips.htm.