The triumph of public health policies that have improved traffic safety over the years through the use of seat belts, air bags and other measures stands in stark contrast to the nation's record on prescription drugs. Even though more people are driving more miles, traffic fatalities have dropped by more than a third since the early 1970s to 36,284 in 2009. Drug-induced deaths had equaled or surpassed traffic fatalities in California, 22 other states and the District of Columbia even before the 2009 figures revealed the shift at the national level, according to the Times analysis.
The Centers for Disease Control collects data on all causes of death each year and analyzes them to identify health problems. Drug-induced deaths are mostly accidental overdoses but also include suicides and fatal diseases caused by drugs.
The CDC's 2009 statistics are the agency's most current. They are considered preliminary because they reflect 96% of death certificates filed. The remaining are deaths for which the causes were not immediately clear.
Drug fatalities more than doubled among teens and young adults between 2000 and 2008, years for which more detailed data are available. Deaths more than tripled among people aged 50 to 69, the Times analysis found. In terms of sheer numbers, the death toll is highest among people in their 40s.
Overdose deaths involving prescription painkillers, including OxyContin and Vicodin, and anti-anxiety drugs such as Valium and Xanax more than tripled between 2000 and 2008.
The rise in deaths corresponds with doctors prescribing more painkillers and anti-anxiety medications. The number of prescriptions for the strongest pain pills filled at California pharmacies, for instance, increased more than 43% since 2007 — and the doses grew by even more, nearly 50%, according to a review of prescribing data collected by the state.
Those prescriptions provide relief to pain sufferers but also fuel a thriving black market. Prescription drugs are traded on Internet chat rooms that buzz with offers of "vikes," "percs" and "oxys" for $10 to $80 a pill. They are sold on street corners along with heroin, marijuana and crack. An addiction to prescription drugs can be costly; a heavy OxyContin habit can run twice as much as a heroin addiction, authorities say.
On a recent weekday morning, Los Angeles County undercover sheriff's deputies posing as drug buyers easily purchased enough pills to fill a medicine cabinet on a sidewalk a few blocks south of Los Angeles City Hall.
The most commonly abused prescription drug, hydrocodone, also is the most widely prescribed drug in America, according to the U.S. Drug Enforcement Agency. Better known as Vicodin, the pain reliever is prescribed more often than the top cholesterol drug and the top antibiotic.
"We have an insatiable appetite for this drug — insatiable," Joseph T. Rannazzisi, a top DEA administrator, told a group of pharmacists at a regulatory meeting in Sacramento.
In April, the White House Office of National Drug Control Policy announced initiatives aimed at stanching prescription drug abuse. The plans include a series of drug take-back days, modeled after similar programs involving weapons, in which consumers are encouraged to turn leftover prescription drugs in to authorities. Another initiative would develop voluntary courses to train physicians on how to safely prescribe pain drugs, a curriculum that is not widely taught in medical schools.
Initial attempts to reverse the trend in drug deaths — such as state-run prescription drug-monitoring programs aimed at thwarting "doctor-shopping" addicts — don't appear to be having much effect, experts say.
"What's really scary is we don't know a lot about how to reduce prescription deaths," said Amy S.B. Bohnert, a researcher at the University of Michigan Medical School who is studying ways to lower the risk of prescription drugs.
"It's a wonderful medical advancement that we can treat pain," Bohnert said. "But we haven't figured out the safety belt yet."