You probably know someone who has chronic pain, or perhaps you suffer from it yourself. If you think it is a huge health problem, you are right. According to the Institute of Medicine at the National Academy of Sciences, in 2011 over 100 million Americans suffered from chronic pain at a national economic cost of $560-635 billion, exceeding the costs of cardiovascular disease, diabetes and cancer combined—not to mention the incalculable personal cost of suffering and indignity.

You also most probably know, or know of, someone who has died from an unintentional overdose of painkillers and think it is a huge health problem as well. What you may not know is that by the time you finish reading this article, another American will have died from an opioid (painkiller) overdose. According to the Centers for Disease Control and Prevention (CDC), the amount of prescription painkillers dispensed in the US has quadrupled since 1999, despite there being no overall change in the amount of pain that Americans report. This dramatic increase is due to changes in how doctors prescribe opioids.  Furthermore, there is wide variation in painkiller prescribing among the states, which cannot be explained by differences in health issues from state to state.

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Dr. Alex Cahana is Director of Medical Affairs at the Center for Lawful Access and Abuse Deterrence and theme developer for ARK Investment Management. He has over 15 years of experience in policy and healthcare redesign and serve as a consultant for the Department of Defense and the Veterans Health Administration.