The number of fatal drug overdoses has spiked in the past decade as sales and prescriptions of heavy painkiller medication have quadrupled. Today, drug overdoses account for more deaths than motor vehicles in 29 states and the District of Columbia, according to a new report.

The report from the Trust for America’s Health shows the incredible spike of prescription painkillers like OxyContin, Percocet and Vicodin over the last decade has coincided with a dramatic increase in the number of drug-related fatalities. In 2000, only five states — Arizona, Maryland, Nevada, New Mexico and Utah — plus the District of Columbia, suffered more than 10 deaths per 100,000 residents due to drug overdoses. By 2010, 38 states and D.C. reached that mark.

Drug overdose mortality in 2000, per 100,000 residents:

(Source: Trust for America’s Health)

And in West Virginia, New Mexico, Nevada and Kentucky, the mortality rate due to drug overdoses was higher than 20 per 100,000 residents, according to data collected by the Centers for Disease Control.

The Southwest and Appalachia are hardest-hit by drug overdoses. The mortality rate in West Virginia alone has spiked by more than 600 percent since 1999. The rate of drug-related deaths more than quadrupled between 1999 and 2010 in Kentucky, Indiana and Iowa, too.

Meanwhile, states in the Midwest tend to have the lowest number of overdoses, while West Coast and Northeastern states fall in the middle of the spectrum.

Drug overdose mortality in 2010, per 100,000 residents:

(Source: Trust for America’s Health)

Men between ages 25 and 54 have the highest number of overdose incidents, though the rates of overdose among women the same age is rising at a faster clip. Residents of rural counties abuse pain medication almost twice as much as residents of urban counties, the report found. And a quarter of all teenagers has misused a prescription drug at least once in their lifetime; about one in eight reported taking Ritalin or Adderall without a prescription at least once, while about one in 12 high school seniors have used Vicodin for nonmedical purposes.

The spike in drug deaths comes even as states are moving to restrict the availability of painkillers. Thirty-two states have passed laws requiring a patient to show a valid identification to a pharmacist before filling a prescription. Every state except Missouri has a prescription drug monitoring program, which helps identify patients who skip from doctor to doctor looking for a prescription and spotlights doctors who dole out lots of painkiller prescriptions.

“These drugs are phenomenally important for managing pain, but they are also misused,” said Jeff Levi, executive director at the Trust for America’s Health.

New Mexico and Vermont have the strictest rules aimed at prohibiting prescription drug abuse, the Trust found. New Mexico is one of 16 states that shares information about prescription drug abuse across state lines, while Vermont has implemented every one of the group’s recommendations. But in a sign of just how prevalent the use of prescription drugs are, death rates have spiked even in those two states.

Drug overdose mortality rate change, 2000-2010:

(Source: Trust for America’s Health)

South Dakota, Missouri and Nebraska have the fewest rules governing prescription drugs. South Dakota has a prescription drug monitoring program, but that program isn’t mandatory for pharmacists. Patients in South Dakota and Nebraska don’t need a physical exam before getting a painkiller prescription, either.

There may be a silver lining to the cloud: The National Survey on Drug Use and Health found a decrease in the number of Americans abusing prescription drugs from 2010 to 2011, though Levi cautioned against reading too much into a single data point.

“We may be seeing the payoff on some of this. We may not have seen the reduction in deaths yet, but we’re seeing a reduction in the number of people who have drug dependence,” he said.