Drugs now kill more people than motor vehicle accidents in the U.S. -- a monumental shift that reflects gains in road safety amid a troubling rise in prescription drug abuse.
Drug overdoses and brain damage linked to long-term drug abuse killed an estimated 37,485 people in 2009, the latest year for which preliminary data are available, surpassing the toll of traffic accidents by 1,201. And the number is likely to rise as the U.S. Centers for Disease Control and Prevention prepares to release its official statistics in December.
Dr. Leonard Paulozzi, medical epidemiologist at the CDC's division of unintentional injury prevention, said prescription drugs were driving up the death toll.
"There has been a dramatic increase in use of prescription drugs as physicians have become more liberal in prescribing them," said Paulozzi, adding that the bulk of drug-related deaths stems from accidental opioid painkiller overdoses. "And with the decrease in the motor vehicle crash mortality rate, drug-induced deaths have now passed motor vehicle crash deaths."
This is first time that drugs have caused more deaths than motor vehicle accidents since the government started tracking drug-related deaths in 1979. Bob Anderson, chief of the CDC's mortality statistic branch, said the swing is bittersweet.
"On one hand the motor vehicle death rate has been going down, and I think that's important in and of itself," said Anderson, crediting the bulk of the drop to speed limits and seatbelt laws. "On other hand, we've seen a fairly steep rise in drug-related deaths, and the rise is mostly due to drug overdose."
Illegal drug use is on the rise, according to a recent report from the Substance Abuse and Mental Health Services Administration. In 2010, almost 9 percent of Americans 12 or older used illegal drugs such as marijuana. Prescription drug abuse, on the other hand, has stayed relatively steady, according to Dr. Peter Delany, director of Samsha's Center for Behavioral Health Statistics and Quality. But it is landing more people in emergency rooms or rehab clinics.
"The number of people starting to have significant consequences, or at least recognizing they need help, is on the rise," said Delany. "A lot of people think that because you need a prescription, it must be a pretty safe drug. But it's addictive. Even if you take them the way they're prescribed. You can build up a tolerance pretty quickly."
The tendency to wrongly assume prescription drugs are safe, Delany said, leads people to take too many pills or mix them with other drugs or alcohol -- both possibly fatal errors.
In 2008, prescription painkillers like oxycodone and hydrocodone, the main ingredients in Oxycontin and Vicodin, landed 305,885 Americans in emergency rooms -- more than double the 144,644 visits in 2004, according to a 2010 study by Samsha and the CDC.
Joel Saper, founder of the Michigan Headache and Neurological Institute in Ann Arbor, said the rise in drug-related deaths underscored the liberal "unleashed" prescription of opioid painkillers nationwide.
"Pain is not provable. It all comes down to trust," said Saper. "That puts a very high burden on the physician to carefully assess every person he or she feels is in pain. That's just not happening in this country, and now we have a monster."
In April 2011, the Obama administration revealed a plan to curtail the country's prescription drug abuse "epidemic."
"We are in the midst of a public health crisis driven by prescription drug abuses," Gil Kerlikowske, White House director of the Office of National Drug Control Policy said at the time. The plan supports state-based prescription drug monitoring programs, take-back programs that safely dispose of prescription narcotics and education programs for patients and health care providers. It's unclear when the bill will be introduced.
Saper said policies could help curb painkiller abuse, just as they helped improve road safety. But all the stakeholders, including the companies that make painkillers and the doctors who prescribe them, have to be on board.
"It's one thing to use these drugs for surgery, trauma or burns. But this stuff is given to teenagers for headaches," said Saper. "While there are people who deserve narcotics for pain, not all doctors are trained to understand how these drugs are used. They don't monitor patients carefully, and they don't look out for multisourcing" -- patients who seek drugs from multiple doctors. "Until that all can be controlled, we're not going to stave off the continued growth of drug-related deaths."