Opioid-related deaths are rare even for patients who take narcotics every day for years. The CDC cites "a recent study of patients aged 15–64 years receiving opioids for chronic noncancer pain" who were followed for up to 13 years. The researchers found that "one in 550 patients died from opioid-related overdose," which is a risk of less than 0.2 percent.
The risk of addiction also has been exaggerated. According to NSDUH, those 259 million painkiller prescriptions in 2012 resulted in about 2 million cases of "dependence or abuse," or one for every 130 prescriptions. A recent study by Castlight Health estimated that 4.5 percent of people who have received opioid prescriptions qualify as "abusers," and its definition, based on the amount prescribed and the number of prescribers, probably captures some legitimate patients as well.
The rarity of addiction to opioids should come as no surprise to the vast majority of Americans who have taken Vicodin or Percocet for pain. Maybe they enjoyed the buzz, but they did not continue taking opioids every day once their pain was gone.
The truth is that using such drugs regularly for their psychoactive effects appeals to only a small minority of people, which is one reason heroin has never been very popular even among illegal drug users. "We lose sight of the fact that the prescription opioids are just as addictive as heroin," says CDC Director Thomas Frieden. In other words, not very.
Some of the legislative responses to the increase in opioid-related deaths, such as shielding people who report overdoses from criminal charges and making the opioid antagonist naloxone more widely available, are sensible. But the crackdown on painkiller prescriptions is bound to hurt bona fide patients while driving opioid users to black-market heroin, which is more dangerous because its potency is unpredictable—a hazard created by an earlier round of antidrug legislation.