There’s a painkiller addiction epidemic—and almost anyone is vulnerable. You are vulnerable.

Don’t believe it? Prescription painkillers—which don’t work very well in the first place when used long-term—kill 46 Americans daily.

And you can get addicted from a hospital stay.

The primary drivers of this plague? Doctors, according to a New York Times piece by Richard A. Friedman, MD, director of the psychopharmacology clinic at Weill Cornell Medical College in New York. Twenty years ago, opioids were primarily used to treat acute pain such as cancer pain or post-surgery recovery, but now they are widely prescribed for chronic conditions such as low-back pain and sciatica. Opioid addiction is driving the new heroin plague, too. Many people who find it hard to get, or afford, prescription narcotics are turning to heroin, which is illegal but often cheaper.

For many Americans, the issue hits close to home—39% of us know someone personally who has been addicted to painkillers, according to the latest poll.

Here’s what you need to know to protect yourself—and those you love. Be sure to follow the links to the Bottom Line articles below.

THE RISKEST ADDICTION MOMENT—HOSPITAL DISCHARGE

Here’s the scenario: You’re not currently taking opioid medications at all. You need to have a procedure at a hospital. When you get discharged, you are given a prescription for an opioid painkiller for the pain. It might be hydrocodone (Vicodin, Zohydro), oxycodone (Oxycontin, Percocet) or hydromorphine (Dilaudid).

Here’s why it’s risky: Compared with someone given a different kind of painkiller prescription or no prescription at all, you are five times more likely to be a chronic opioid user over the following year. So report researchers at the University of Colorado Anschutz Medical Campus in the Journal of General Internal Medicine. One reason, the researchers speculate—the drugs work for pain but also provide euphoria, and it’s easy to get addicted even after original post-surgical pain is gone.

BETTER SOLUTIONS FOR CHRONIC PAIN

Chronic pain affects about 100 million Americans, but relying on opioid prescriptions, especially for long-term relief (more than 90 days), greatly increases the risk for adverse side effects—constipation, drowsiness, concentration problems, driving accidents, vision impairment, reduced immunity and, for men, reduced testosterone levels.

Taking opioid medications for chronic pain is a dangerous, and sometimes deadly, slippery slope. To take a different path, start by exploring drug-free ways to handle pain in these Bottom Line articles about pain in your back, feet, hands, joints and head.

And read about the painkiller trap.

INTERACTIVE MAP: DO DOCTORS IN YOUR STATE OVER-PRESCRIBE OPIOIDS?

Where you live can be a risk factor, too. The states with the highest prescription opioid addiction rates, according to the Centers for Disease Control and Prevention, are Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee and West Virginia. Similar geographical differences also show up in Medicare claims. The map below, used with permission from the Centers for Medicare & Medicaid Services, lets you see how your state stacks up against the national average in prescription opioid Medicare claims.

There are many reasons why some states have more opioid prescriptions (and addiction) than others, but one factor may be the prescription patterns of area doctors. So if you live in a high-use state, you may need to be extra-vigilant to avoid falling into a prescription addiction for chronic pain. Ask your doctor if there are better solutions for you.

Centers for Medicare & Medicaid Services.