The US death toll from overdoses of prescription painkillers has more than tripled in the past decade, and over 40 people die every day from overdoses involving narcotic pain relievers, the Centers for Disease Control and Prevention (CDC) has reported.

"Overdoses involving prescription painkillers are at epidemic levels and now kill more Americans than heroin and cocaine combined," said the CDC's director, Thomas Frieden.

"States, health insurers, health care providers and individuals have critical roles to play in the national effort to stop this epidemic of overdoses while we protect patients who need prescriptions to control pain," he added.

Increased use of prescription painkillers for "nonmedical" reasons - without a prescription for the high they cause - along with growing sales, has contributed to the large number of overdoses and deaths, says the CDC. Last year, one in every 20 people in the US aged 12 and older - a total of 12 million people - reported using prescription painkillers nonmedically, according to the National Survey on Drug Use and Health, and almost 5,500 people start to misuse the drugs every day.

Based on data from the Drug Enforcement Administration (DEA), sales of these drugs to pharmacies and health care providers have increased by more than 300% since 1999.

Earlier this year, the Obama Administration released an action plan aimed at addressing the national prescription drug abuse epidemic to reduce the public health burden. The plan includes support for the expansion of state-based prescription drug monitoring programmes, more convenient and environmentally-responsible disposal methods of removing unused medications from the home, education for patients and healthcare providers, and support for law enforcement efforts that reduce the prevalence of "pill mills" and "doctor shopping."

While national strategies are being strengthened, the CDC advises US states - as regulators of health care practice and large public insurers - to take the following steps to help prevent prescription painkiller overdoses and reduce the public health burden:
- start or improve prescription drug monitoring programmes, which track all prescriptions for painkillers in the state;
- use these programmes, plus public insurance programmes and workers' compensations data to identify improper prescribing of painkillers;
- set up programmes for public insurance programmes, workers' compensation programmes and state-run health plans that identify and address improper patient use of painkillers;
- pass, enforce and evaluate pill mill, doctor shopping and other state laws to reduce prescription drug abuse; 
- encourage professional state licensing boards to take action against inappropriate prescribing; and
- increase access to substance abuse treatment.