Once championed as the answer to chronic pain, opioid medications and painkillers have become a large and costly problem in the United States. Fatal overdoses have quadrupled in the last 15 years, and opioids now cause more deaths than any other drug, over 16,000 in 2010. Prescription opioid abuse is also costly, sapping productivity and increasing health care and criminal justice costs to the tune of $55.7 billion in 2007, for example.

Addressing this problem would cost money, too, but evidence suggests it would pay for itself.

Much of the problematic use of opioids like Vicodin and OxyContin originates with a prescription to treat pain. Prescriptions can be of tremendous help to certain patients. But doctors write a lot more of them for opioids in the United States than they should, enough for every American adult to have a bottle of opiate painkillers each year, according to the U.S. Centers for Disease Control and Prevention.

One approach to the problem, therefore, is to attempt to reduce the number of prescriptions written by targeting use to patients for whom the medications are most appropriate. In July 2012, for example, Blue Cross Blue Shield of Massachusetts began requiring prior authorization for more than a 30-day supply of opioid medication within a two-month period. After 18 months, the insurer estimates that it cut prescriptions by 6.6 million pills.