There's no getting around the fact that the abuse of prescription painkillers is a huge problem in the U.S. Prescription drug overdoses now kill more people each year than car crashes.
But the overdose risks vary quite a bit depending on where in the country you live. One reason is that how often doctors prescribed the drugs, such as Percocet, Vicodin and generic opioids, varies widely by state.
The Centers for Disease Control and Prevention analyzed a commercial database of drug prescriptions looking for patterns. Nationwide, there were 82.5 prescriptions written for opioid painkillers for every 100 Americans in 2012.
But the rates were much higher in some southern states. In Alabama, which led the country, there were 143 painkiller prescriptions for every 100 people in 2012. There were 11 other states where each adult, on average, got a least one painkiller prescription that year, including Tennessee, West Virginia and Kentucky.
CDC Director Dr. Thomas Frieden told reporters that officials don't think the high rates of prescribing in some states are because people living there have more pain. "This is an epidemic that was largely caused by improper prescribing practices," he said during a media briefing.
Prescription opioid drugs can be an important tool for helping patients in pain, he said, "but they're not the answer every time someone has pain."
The findings were published online in CDC's Morbidity and Mortality Weekly Report.
Policy changes in some states can reduce problematic prescribing. State-run databases that monitor prescriptions and alert doctors can be useful. In Florida, regulations targeting pain clinics helped contribute to a decline in overdose deaths. So, too, did restrictions on doctors dispensing the drugs to patients from their offices.
Between 2010 and 2012, annual overdose deaths in Florida dropped 16.7 percent, from 3,201 to 2,666. And deaths from oxycodone, the generic name of the ingredient in many brand-name opioid painkillers, fell by more than half, according to an analysis published in MMWR.
"Florida," Frieden said, "shows that policy and enforcement matter."