More people die in America every year from prescription drug abuse than die from heroin and cocaine combined. That stunning finding comes in a new report Tuesday from the Centers for Disease Control and Prevention.

The CDC found a fourfold increase in deaths from prescription narcotics over the past decade. Not surprisingly, it coincides with a fourfold increase in the number of prescriptions written for the powerful painkillers.

In 2008, the most recent year for which there are statistics, there were 20,044 overdose deaths from prescription drugs. Of those, 14,800 were from narcotic painkillers.

“Prescription overdoses are epidemic in the U.S.”, says Dr. Thomas Frieden, director of the CDC. Most people who die from prescription drug overdose are taking someone else’s medicines, he says. “Medicines that were left in the medicine cabinet. Medicines that were given to a friend or a relative. Maybe innocently, maybe maliciously.”

Prescription narcotics are being handed out almost like candy by doctors – some of whom are genuinely interested in patient care – others who run so-called “pill mills”, where narcotic prescriptions are traded for cash to feed addictions. The CDC study found that enough narcotics are prescribed every year to medicate each and every adult in America every day for a month.

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“It’s astonishing”, says Frieden. He adds that many addictions begin innocently, when patients are given narcotics for a minor injury that could be treated with less addictive medication. “When I went to medical school, we were incorrectly assured – don’t worry – if patients have short-term pain, they won’t get hooked. That was completely wrong, and a generation of doctors, patients and families have learned that’s a tragic mistake.”

Death and abuse rates vary widely across the country and don’t necessarily correlate. New Mexico has the highest death rate, followed by West Virginia, Nevada, Utah and Alaska. The highest abuse rate is in Oklahoma, followed by Oregon, Washington state, Rhode Island and Kentucky. The CDC report also found the highest death rates tend to be in either rural or impoverished counties.

The prescription drug epidemic has created a monumental law enforcement problem. The incoming Sheriff in Florida’s Pinellas County calls it “The most serious public safety issue we face.” Bob Gualtieri admits that despite intensive efforts at enforcement – targeting pill mills and users, they haven’t made a dent in the problem. And he says – unlike the crack cocaine epidemic of the 1990s, which was mostly an inner-city problem, prescription drug abuse is far more widespread. “This problem crosses all walks of life, crosses all socio-economic classes. Crosses all races and gender, national origin, age.”

In fact, the CDC report found the death rate among non-Hispanic whites and American Indians/Alaska Natives was three times higher than among Blacks and Hispanic whites.

Many states have passed new laws to monitor the prescribing of narcotic painkillers. Dr. Frieden says some laws have made a difference. Washington state, for example, has lowered its death rate, though it remains high.

Despite modest inroads, CDC researchers say the epidemic of prescription narcotic overdoses has continued to worsen. In today’s report, they caution doctors to only use narcotic painkillers in patients who are carefully screened and monitored, and for whom non-narcotic medications are insufficient.

That recommendation may help to reduce the number of new patients who inadvertently get hooked. The intentional abuse of prescription drugs among people who may prefer them to illicit substances like cocaine and heroin is another problem altogether, and one experts say can only be attacked through education and law enforcement.