Illegal drugs such as heroin, crack cocaine, "bath salts," etc. are serious problems in Ohio. But legal painkillers, though often abused and trafficked illegally, may be an even bigger threat in some ways.
Painkiller abuse and use of heroin and similar drugs are linked, experts point out. Some of those who become dependent on pain pills move on to heroin addiction.
Hundreds of accidental deaths each year are linked to drug abuse. In 2007, drug overdoses, with many of them involving prescription painkillers, killed more Ohioans than highway crashes.
A coordinated approach to attacking misuse of prescription painkillers seems to be bearing some fruit, but progress has been excruciatingly slow.
Last year - you may want to sit down for this - Buckeye State residents were prescribed 767,763,408 doses of painkillers. That works out to 67 pills for every resident of the state.
And that does not count the pain pills obtained illegally, sometimes through theft and sometimes through dealers who buy the drugs in other states, then bring them back to Ohio for sale.
Efforts to combat the epidemic cut the number of painkiller prescriptions by 6.7 million doses between 2010 and 2011. While that may seem to reflect progress, the reduction was less than 1 percent.
Clearly, the multi-front battle against painkiller abuse needs to be stepped up. State agencies and insurance companies are working to lessen addiction among those who, with the best of motives, needed relief from pain but became addicted. Law enforcement authorities are cracking down on pill mills - unscrupulous doctors and pharmacies that prescribe and sell painkillers to all comers. New efforts to identify and treat addicts are helping.
Ohio is far from alone in having to deal with the scourge of painkiller abuse. Many states, including West Virginia, have problems at least as severe. Right here in Wheeling earlier this year, a man was killed in an aborted robbery at a pharmacy where he tried to steal pain pills.
Clearly, existing initiatives are helping - but not enough. They need to be expanded and intensified and new ways to deal with the crisis need to be found. In terms of health care needs in Ohio, reversing the growth of painkiller abuse should be a top priority.