Why it's so hard to win the war against US oxycodone epidemic

Crime appears to be a close companion of oxy abuse. In West Virginia, which has the highest rate of opioid-related deaths, adult children of elderly parents with prescriptions have installed safes to lock up their medications, convinced that otherwise their parents would be robbed. In May, authorities charged a former New York police detective with robbing several pharmacies. The detective had retired because of an injury, which in turn led to a prescription-pill addiction.

It's "the most dangerous, most addictive, and most deadly drug problem of our lifetimes," says Jim Hall of the Center for the Study and Prevention of Substance Abuse, in Fort Lauderdale, Fla.

Mike Agar, an ethnographer and long-time drug culture researcher, says that as with other epidemics, including opium and heroin, the rise in oxycodone abuse corresponds with economic travails and "political change."

In all previous epidemics he has studied, "they were populations that [were thrown] a sudden and unpleasant curve, an undelivered promise of doing better or just fine, and then someone pulled the rug out," writes Mr. Agar, in an e-mail. "Moral of the story: Narcotics, especially initial uses, are a 'give me peace' drug, a relief from anger and depression. We might well now be seeing a chapter from the same book," he adds, given "economic collapse, jobs, housing, education for the kids, health care, a kid in Iraq or Afghanistan."

Partly in response to opioid abuse, 38 states now have prescription-monitoring programs to try to crack down on "doctor shopping" by users who supply the black market. This fall, Florida begins implementing a new prescription-monitoring program and new licensing requirements for pain clinics in a bid to curb the ready supply, even as the state is considering 500 new pharmacy applications.

One sign of a political shift: After opposing a prescription-monitoring program as government overreach, Florida Gov. Rick Scott (R) relented once it became clear that even small-government tea partyers saw the problem as serious enough to require more government oversight. The Obama administration has also kicked in some extra money for drug-abuse prevention and treatment. Whether new policy and enforcement measures will actually curb abuse remains a question.

"It's going to be an expensive proposition in terms of lives and the cost and the critical need for more treatment opportunities," says Mr. Hall. But without a more concerted national effort, he adds, "we're going to have increasing crime rates and more tragic consequences."

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