April 20, 2011 -- It is unclear if Americans are suffering from more pain than ever, but they are definitely getting more prescriptions for it. The use of Vicodin, the most popular pain relief drug in the country, has grown dramatically from 112 million doses prescribed in 2006, to 131 million in the U.S. today, according to a national survey done by the consulting firm IMS Health.
Experts say most of those prescriptions are unnecessary. The United States makes up only 4.6 percent of the world's population, but consumes 80 percent of its opioids -- and 99 percent of the world's hydrocodone, the opiate that is in Vicodin.
"Vicodin is the most prescribed opioid mainly because it's been incorrectly scheduled as a class III rather than a II," says Andrew Kolodny, Chair of Psychiatry at Maimonides Medical Center in New York. "Many states have prescribing regulations linked to DEA scheduling. But it is no less abusable or addictive than Oxycodone or heroin."
Who is prescribing all that Vicodin? More than 600,000 doctors, from surgeons to podiatrists, are licensed by the Durg Enforcement Agency to prescribe the drug. At the top of the list of pain relief prescribers are primary care doctors, followed by internists and then dentists. According to many critics, doctors often prescribe Vicodin because it is not as tightly regulated as other narcotic pain relievers are, although it is just as dangerous.
"Opioids are essentially legal heroine," says Lewis Nelson, who served on an FDA panel to revise the Risk Evaluation and Mitigation Strategy (REMS) associated with the prescription drugs.
Although it is used by many doctors and patients for legitimate reasons, accidental overdoses from Vicodin and other narcotic pain relievers kill more people than car accidents in 17 states now, according to Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention. Public health and law enforcement officials in the Obama administration also said in a press conference that painkillers are now responsible for more deaths than crack in the 1980s and black tar heroin in the 1970s combined.
Carolyn Alfieri, 41, from New York, suffered from chronic shoulder pain caused by years of playing the violin. When she was 26, she went to see a doctor who prescribed Vicodin. Over the years, she was given progressively more powerful pain relievers. She said she became so addicted that she was taking up to 75 pills a day. She said she eventually lost her teeth because of drug use. She said she she sold her violins and began forging prescriptions to feed her addiction.
"The progression happened very quickly," said Alferi. "It went from Tylenol with Codeine, to Vicodin, to Percocet, to the Oxycontin."
Gil Kerlikowske, the national drug czar, says the current culture of writing narcotic prescriptions for moderate pain, which began about a decade ago, needs to be changed and doctors need to be retrained.
"In the amount of education and training that doctors get, there was very little time, if any, in medical schools and other places to be devoted to understanding this," he told ABC News.
Many pain specialists say narcotic pain relievers should only be used by patients with terminal illnesses, when addiction is not a concern.