Pills, policies, and predicaments: the unintended consequences of a health care system's policy toward opioids.

Prescription drug abuse has escalated to a crisis in the United States. According to the Office of National Drug Control Policy, young people abuse prescription drugs second only to marijuana, and one-third of people who start using illicit drugs begin with prescription drugs [1]. Moreover, prescription analgesics were associated with more than 16,000 deaths, with frequent contributions from other medications, including benzodiazepines (involved in 30% of opioid-related deaths), antidepressants (13%), anticonvulsants (close to 7%) and antipsychotics/ neuroleptics (almost 5%) [2]. In many cases, the problem is too outsized for the federal policies in place to be effective. To address the prescription drug crisis directly and effectively, five public health initiatives are imperatives.