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Many physicians do not heed these warnings, because “it’s all about money and the pharmaceutical companies at the top,” Dr. Kogan said. “There is huge pressure from the companies to get doctors to use their drugs.”

Painkillers are the most profitable drugs for American pharmacies.

The abuse of prescription medication extends far beyond the privileged precincts of the rich and famous. “It’s not just celebrities,” she said. “Our entire country has become overmedicated.”

More than 7 million Americans use nonmedicinal prescription drugs, including pain relievers, tranquilizers, stimulants and sedatives, according to the National Institute on Drug Abuse, NIDA.

“Prescription-drug abuse comes to the forefront when it’s associated with the death of celebrities like Anna Nicole Smith, Michael Jackson and Elvis,” said Dr. Erika Schwartz, Cinergy Health Medical Director in New York City. “But every day million of Americans are taking these drugs - and not for aches and pains.”

They are particularly popular among adolescents, according to NIDA, which reports that in 2008, among the nation’s 12th-graders almost 10 percent reported nonmedicinal use of Vicodin, while close to 5 percent reported use of OxyContin, both powerful opioid painkillers.

Many youngsters report they think these drugs are safe because they’re prescribed by a doctor.

“It’s a false perception,” said Dr. Wilson Compton, director of the division of epidemiology, services and prevention research for NIDA.

Deaths caused by overdosing on prescription drugs have doubled, and now account for more than 20,000 annually since 1999. “It’s now the second-leading cause of unintended death after traffic accidents,” Dr. Compton said.

Still, in young adults 18 to 25, the nonmedicinal use of prescription pain relievers rose 12 percent between 2002 and 2007, according to the Substance Abuse and Mental Health Services Administration.

Dr. H. Westley Clark, director for Substance Abuse Treatment, a division of SAMHSA, said, “It has to do with accessibility - more than 50 percent of young people are getting them from friends and family for free.”

The American Pain Foundation, though, cautioned that there are many legitimate uses for prescription pain medication.

“When prescribed appropriately by knowledgeable health care providers and taken as directed, prescription pain medication can make a tremendous difference for people suffering from pain,” said Will Rowe, CEO of the American Pain Foundation in a statement released in response to speculation about the role of pain medication in Mr. Jackson’s death.

That raises the question, if prescription pain pills are popped by an increasing number of Americans, are we as a nation in more pain than ever or are we just hunting for another high?

“I don’t know. If we’re in more pain, then why? If we’re all just becoming a nation of drug addicts, then why?” said Dr. Schwartz. “Let’s examine it. Let’s make this unfortunate death a wake-up call to take responsibility, to create a more positive outcome.”