The devastation began for Steve Rummler when he got a prescription for nerve pain radiating through his leg and back. It started when he was 28. For the next nine years, the Minneapolis man endured the pain.
It was not until 2005, when Rummler was 37, that a doctor prescribed hydrocodone to address his pain, along with clonazepam, a benzodiazepine and anti-anxiety medication, to relieve his injury-related anxiety.
Family members said it was the first time in nearly a decade Rummler felt relief from the life-altering pain he endured.
But that relief was short-lived. In a journal entry, Rummler said of the drugs, "At first they were a lifeline. Now they are a noose around my neck."
It is a common sentiment, and a common scenario, according to Meyers, who says Rummler's case is far too common -- a person genuinely needs opioids but becomes addicted to the relief they provide.
"The person that is on them for legitimate reasons and the kid who experiments with them seem very different, but the outcome is the same," said Meyers. "And they are very difficult to get off of. I think we probably need to do a better job of pain management in this country."
By 2009, Rummler had sunk into dependence and, eventually, into addiction. At the advice of his family, he enrolled in two addiction treatment programs and seemingly had a handle on his addiction.
But in July of 2011, just 45 days after completing the final stage of his rehabilitation, Rummler relapsed and died at 43.
Rummler still had outstanding prescriptions for hydrocodone and clonazepam at the time of his death, and empty prescription bottles were in his house when the police arrived. His official cause of death was mixed drug toxicity caused by opiates and benzodiazepines. A medical investigator said there was no way to tell what Rummler ingested immediately before his death.
Like Emily Jackson, Rummler stopped breathing in his sleep.
Experts: Better communication needed
Accidental prescription drug overdoses is "the only epidemic that I know that has been recognized by the DEA, FDA, CDC and the White House Office of Drug Control," McLellan said.
Meyers and McLellan believe the key to combating accidental deaths related to prescription drugs is creating a better dialogue among doctors, patients and pharmacies.
"When someone is given prednisone, a steroid commonly used to treat inflammatory diseases, they are given very specific instructions," said Meyers. "They are very direct about what will happen if the patient misuses it. You don't see that with pain medication.
"Maybe if we did a better job with how we communicate the effects of prescription medications when you don't take them the way they are prescribed or if you mix other substances with them, maybe we wouldn't have the number of people who are in crisis," she added.
After co-founding the Treatment Research Institute, McLellan worked as the deputy director of the White House Office of National Drug Control Policy for the Obama administration. One of his main tasks was combating the epidemic of prescription drug abuse.
McLellan says he believes everyone throughout the supply chain of opioids needs to take greater responsibility.
This means pharmaceutical companies would carefully monitor and control the supply they produce, he said. Doctors would be more rigorous with patient screening -- including, possibly, urinalysis exams before issuing or extending a prescription.
Patients would be more careful about the storing and disposal of their medications along with how they take them. And, most importantly, pharmacies would keep a watchful eye on all of the substances each of their customers takes, he said.
"You don't want to stop the use of opioids, because that would be stupid, but you need better management," he said. "Information exchange is the main thing; pharmacies have to know what everyone is getting prescribed."

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