Drug deaths now outnumber traffic fatalities in U.S., data reveals.

Fueling the surge are prescription pain and anxiety drugs that are potent, highly

addictive and especially dangerous when combined with one another or with other

drugs or alcohol.

Propelled by an increase in prescription narcotic overdoses, drug deaths now

outnumber traffic fatalities in the United States, a Times analysis of government

data has found.

Drugs exceeded motor vehicle accidents as a cause of death in 2009, killing at least

37,485 people nationwide, according to preliminary data from the

U.S. Centers for Disease Control and Prevention.

While most major causes of preventable death are declining, drugs are an exception.

The death toll has doubled in the last decade, now claiming a life every 14 minutes. By contrast, traffic accidents have been dropping for decades because of huge investments

in auto safety.

Public health experts have used the comparison to draw attention to the nation's

growing prescription drug problem, which they characterize as an epidemic. This is

the first time that drugs have accounted for more fatalities than traffic accidents

since the government started tracking drug-induced deaths in 1979.

Fueling the surge in deaths are prescription pain and anxiety drugs that are potent,

highly addictive and especially dangerous when combined with one another or with

other drugs or alcohol. Among the most commonly abused are OxyContin, Vicodin,

Xanax and Soma. One relative newcomer to the scene is Fentanyl, a painkiller that

comes in the form of patches and lollipops and is 100 times more powerful than

morphine.

Such drugs now cause more deaths than heroin and cocaine combined.

"The problem is right here under our noses in our medicine cabinets," said

Laz Salinas, a sheriff's commander in Santa Barbara, which has seen a dramatic

rise in prescription drug deaths in recent years.

Overdose victims range in age and circumstance from teenagers who pop pills to

get a heroin-like high to middle-aged working men and women who take

medications prescribed for strained backs and bum knees and become addicted.

A review of hundreds of autopsy reports in Southern California reveals one tragic

demise after another: A 19-year-old Army recruit, who had just passed his military

physical, took a handful of Xanax and painkillers while partying with friends. A

groom, anxious over his upcoming wedding, overdosed on a cocktail of prescription

drugs. A teenage honors student overdosed on painkillers her father left in his

medicine cabinet from a surgery years earlier. A toddler was orphaned after both

parents overdosed on prescription drugs months apart. A grandmother suffering from

chronic back pain apparently forgot she'd already taken her daily regimen of pills and

ended up double dosing.

Many died after failed attempts at rehab — or after using one too many times while contemplating quitting. That's apparently what happened to a San Diego woman found

dead with a Fentanyl patch on her body, one of five she'd applied in the 24 hours before

her death. Next to her on the couch was a notebook with information about rehab.

The seeds of the problem were planted more than a decade ago by well-meaning

efforts by doctors to mitigate suffering, as well as aggressive sales campaigns by pharmaceutical manufacturers. In hindsight, the liberalized prescription of pain

drugs "may in fact be the cause of the epidemic we're now facing," said Linda

Rosenstock, dean of the UCLA School of Public Health.

In some ways, prescription drugs are more dangerous than illicit ones because users

don't have their guard up, said Los Angeles County Sheriff's Sgt. Steve Opferman,

head of a county task force on prescription drug-related crimes. "People feel they are

safer with prescription drugs because you get them from a pharmacy and they are

prescribed by a doctor," Opferman said. "Younger people believe they are safer

because they see their parents taking them. It doesn't have the same stigma as

using street narcotics."

Lori Smith said she believes that's what her son might have been thinking the night

he died six months shy of his 16th birthday. Nolan Smith, of Aliso Viejo, loved to surf,

sail and fish with his brother and father. He suffered from migraines and anxiety

but showed no signs of drug abuse, his mother said.

The night before he died in January 2009, Nolan called his mother at work, asking

for a ride to the girls basketball game at Aliso Niguel High School. Lori told him she

couldn't get away.

When Nolan didn't come home that evening, his parents called police and his friends.

His body was found the next morning on a stranger's front porch.

A toxicology test turned up Zoloft, which had been prescribed for anxiety, and a host

of other drugs that had not been prescribed, including two additional anti-anxiety

drugs, as well as morphine and marijuana.

All investigators could give the family were theories.

"They said they will have parties where the kids will throw a bunch of pills in a bowl

and the kids take them without knowing what they are," Lori said. "We called all of

his friends, but no one would say they were with him. But he must have been with

someone. You just don't do that by yourself."

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."