The lead article in the January 25, 2005, Morbidity and Mortality Weekly Report published by the Centers for Disease Control and Prevention of the U.S. Public Health Service exposed the tip of a massive iceberg that has now dominated the health news media for over half a decade. The lead article in that issue was entitled "Increase in Poisoning Deaths Caused by Non-Illicit Drugs—Utah, 1991-2003."1 That landmark article described a dramatic increase in deaths from legitimate opioids, primarily methadone and controlled-release oxycodone, that had occurred in the previous decade according to records of the Utah Poison Control Center and the Office of Chief Medical Examiner of the State of Utah. This was perhaps the first of what rapidly became a flood of reports of deaths form accidental use or illicit use of licit opioid medications.
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