After breaking his arm, the patient was in such severe pain that he begged his doctor for the most powerful pain reliever he could get. The doctor obliged, writing a prescription for an opioid painkiller so the man could go back to work.

When the prescription ran out, his doctor would not refill it, as these potent drugs can cause addiction. The man forged a prescription — and got caught. 

The story sounds like a daytime soap script, but it plays out in real life with alarming frequency. Prescription painkiller abuse is called ''the worst drug epidemic today" by the National Safety Council (NSC), which has launched an effort to increase awareness and stem the toll of opioid-related addiction and death. Accidental drugs overdoses — most involving opioids — now cause more deaths than car accidents in adults age 35 to 54. 

Opioids (once known as narcotics) come from the poppy plant, as does heroine. They work by attaching to opioid receptors in the brain. Opioid include oxycodone (Oxycontin, Percocet), oxymorphone (Opana), hydrocodone (Vicodin or Lortab), methadone and fentanyl. 

How bad is the toll?

Opioid use has risen by more than 600 percent in the last 20 years, says Don Teater, MD, medical advisor for NSC. Despite that rise, data show Americans still have as much disability from back and  neck pain as they did in 1990, he says. 

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More than 16,000 deaths in the United States in 2013 involved opioid pain relievers, according to the Centers for Disease Control and Prevention (CDC). That's 45 people a day. In 2011, about 420,000 ER visits in the United States were related to opioids, the CDC found. 

When the drugs rose in popularity in the mid to late 1990's,, they were promoted as powerful but non-addicting. Experts know now that the addiction potential is high, says Teater. People who take the drugs for as short a time as five days then go off them can experience withdrawal symptoms such as chills, sweats and muscle pain. (These symptoms don’t mean you’re addicted, Teater notes.) How long it takes to become addicted depends on many factors. Some people say their addiction began with the first prescription, he says. 

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Why most people don’t need opioids

''There are not many instances where the opioids should be used," Teater says. The best use is for pain from severe trauma involving emotional distress, he says. This might be for injuries after a very severe car accident, for instance. 

The drugs are also good for soldiers injured on the battlefield, he says. Taking them immediately after such an injury has been linked with a lower risk of developing post-traumatic stress disorder or PTSD.

Opioids also have a place in the treatment of incurable cancers, terminal lung disease and other situations involving end-of-life health problems, says Teater. 

Where else to get relief

Instead of trying to manage pain with an opioid prescription painkiller, talk to your doctor about pain medication alternatives, suggests Teater. In one review of what works best for post-surgery pain, the Cochrane Collaboration, an independent network of researchers and other health experts, found that combining 200 milligrams of ibuprofen with 500 milligrams of acetaminophen gave the best pain relief of all when compared with opioid painkillers and with naproxen. 

The downward spiral of painkiller addiction

Most people who take the painkillers have no idea how much they are starting to depend on the pills until it's too late, Teater says. "They try to come off, their pain gets worse, they feel depressed, so they call for more. And the doctor keeps giving them [a prescription]."

Taking pills that weren’t prescribed for you is even more dangerous. In some cases, a family or friend shares their pills with someone in pain, trying to be helpful. (Sharing pills prescribed for you is never appropriate.) Teens and others may raid someone else’s medicine cabinet looking for a painkiller high. More than 70 percent of people who abuse the drugs say they get them from family and friends.

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If you do take the prescription painkillers, be sure you know how to take them correctly and are taking only the prescribed dose. To avoid potentially dangerous drug interactions, be sure your doctor knows about all other medicines you take. Store the meds out of sight. If you’re concerned someone else might take them, lock them up.

Be alert for warning signs of an overdose. These include loud breathing, floppy and weak muscles, cold and clammy skin, tiny pupils and a slow heart rate. Get medical help immediately if you experience any of these.

How to stop the drugs

When it’s time to stop the drugs, ask your doctor the best way to discontinue them. Some people can simply stop cold turkey, Teater says, while others may need to wean themselves from the painkillers gradually.

Kathleen Doheny is a Los Angeles journalist specializing in health, behavior and fitness topics.