For the first time in U.S. history, the number of people who died from narcotic drugs is greater than the number who died in car crashes. A new study found that in 2009, the most recent year for such statistics, 37,485 died from opioid drug complications, and 36,284 were automobile fatalities. In 1999, 13,800 died from opioids.
The narcotics involved in these deaths are not necessarily illegal ones like heroin. Abuse of prescription opiate painkillers increased by 111% between 2004 and 2008, according to figures from the Substance Abuse and Mental Health Services Administration. Over two million Americans abuse them, and deaths involving OxyContin, Valium and Xanax doubled between the years 2001 and 2011. Vicodin, a prescription painkiller, is now the second most abused drug after marijuana among high school students, according to a 2010 study from the University of Michigan.
Some of these changes may be linked to the economic recession. The price of cocaine has risen so fast that people may be turning to prescription drugs that are cheaper.
The U.S. Drug Enforcement Administration (DEA) and local prosecutors are increasingly investigating and pursuing criminal charges against physicians who dispense prescription painkillers. More families are filing malpractice suits after the deaths of loved ones from opiate overdoses. Two high profile cases involving celebrity overdoses are examples of the trend.
Prosecutors in California charged Michael Jackson’s physician, Dr. Conrad Murray, with involuntary manslaughter, which carries a penalty of four years in prison. They alleged that Dr. Murray breached standard care practices when he administered Propofol to Jackson. Propofol is an anesthetic used in surgery and rarely abused as a narcotic drug, but it is not a controlled substance. The Jackson family has also filed a wrongful death suit against Dr. Murray. Prosecutors will have to prove that Dr. Murray and not Jackson himself administered the drug.
The second celebrity case involved Anna Nicole Smith, whose doctor was accused and acquitted of violating the controlled substance law after she died from taking a variety of prescription drugs.
More physicians, especially in states like Florida where prescription drugs are widely available from "pain clinics," are facing malpractice and criminal charges. Most of these cases involve opiate painkillers. The DEA arrested and convicted 15 physicians in 2003, compared to 43 just five years later. Prosecutors are aggressively closing down pain clinics that dispense opiates.
"Our marching orders are that we will not turn down a pill case coming into the office," said Florida state prosecutor Nick Cox. "It is more efficient to pursue the source of the pills – the prescribing doctors – than the patients who abuse the drugs."
Doctors are defending themselves by saying that the treatment of pain is based upon subjective reporting from patients, and there is no way of knowing which of them are addicted or drug-seeking.
As one law professor put it, "Doctors are not supposed to be law enforcement agents. They are supposed to believe their patients."