At the other end of the scale, Missouri has  relatively high death rate (17, seventh highest among the states) but scored only a 3 of 10 on the prevention scale. (Maybe Missouri could Show Me why this is a good plan.)

Kentucky is trying to address its OD rate, third highest in the nation, by taking advantage of 9 of 10 strategies to fight the high death rate. California, like Vermont, is refusing to stand pat despite ranking near the bottom of states with drug OD (37). It scored an 8-out-of-10 grade on strategies to reduce deaths.

A trio of laggards — Arizona, Pennsylvania and Wyoming — is apparently turning a blind eye to an obvious problem. All three had high death rates but scored very poorly (4 out of 10) on the strategies ranking.

States like South Dakota don't have a problem (death rate the lowest save for its neighbor, North Dakota) and so the state isn't addressing it, having adopted just 2 of 10 strategies.

Other data from the study included:

• West Virginia had the highest number of drug overdose deaths, at 28.9 per every 100,000 people – a 605 percent increase from 1999, when the rate was only 4.1 per every 100,000.
• North Dakota had the lowest rate at 3.4 per every 100,000 people.
• Just over one-third of states (17 and Washington, D.C.) have a law in place to expand access to, and use of naloxone — a prescription drug that can be effective in counteracting an overdose — by lay administrators.
• Fewer than half of states (22) have laws that require or recommend education for doctors and other health care providers who prescribe prescription pain medication.
• 32 states have a law requiring or permitting a pharmacist to require an ID prior to dispensing a controlled substance.
• Only 16 states require medical providers to use Prescription Drug Monitoring Program to help identify "doctor shoppers," problem prescribers and individuals in need of treatment

The report noted that death by prescription drug overdoses now surpasses death from automobile accidents, and, in 29 states and the nation's capital, from heroin and cocaine overdoses combined. It estimated the cost to the nation of prescription drug deaths at $53.4 billion, and offered a series of recommendations states could take to address the issue.