There were 31 fewer prescription-drug deaths than murders in 2005, the most recent year for which statistics are available, based on the newspaper's review of state medical examiner records.
Prescription drugs were linked to the deaths of at least 67 people in Davidson County in 2005 while statewide there were 401 such deaths. From 2002 to 2005, at least 1,240 Tennessee deaths were linked to prescription drugs.
The numbers, however, are likely higher because the medical examiner tracks drug deaths through autopsies, which are not always performed in some counties.
"Prescription-drug abuse and accidental overdose is clearly a huge and escalating problem," said State Medical Examiner Bruce Levy. "The cases are coming from all across the state."
A recent report by the Substance and Mental Health Services Administration showed the number of emergency room visits nationwide for prescription-drug overdose - 598,542 in 2005 - has almost caught up with those for illicit drugs.
James Inciardi, director of the Center for Drug and Alcohol Studies at the University of Delaware in Coral Gables, Fla., said prescription drugs are obtained from a range of sources, which include doctors and pharmacists, parents and relatives and direct sales on the street and in nightclubs.
Powerful prescription painkillers such as methadone, oxycodone and hydrocodone play a great role in overdose deaths in Tennessee, autopsy records show.
Methadone, once primarily used to help heroin addicts kick the habit, is now often prescribed for chronic pain but has become a popular street drug linked to 231 deaths statewide from 2002 to 2005.
More than half of Tennessee drug deaths resulted from a toxic combination of two or more prescription drugs - typically powerful painkillers, tranquilizers or stimulants. In addition, prescription drugs were increasingly mixed with illegal narcotics to create more deadly narcotic cocktails.
The majority of prescription deaths were from accidental overdoses and less than 11 percent were suicides.
The newspaper's report follows the arrest of Williamson County Sheriff Ricky Headley, who was charged in January along with a Nashville pharmacist on charges related to illegal dispensing of prescription drugs.
He faces one felony and one misdemeanor drug charge for allegedly obtaining at least 1,900 Lortab pills between October 2006 and January 2007 from Brooks Drugs pharmacy in Nashville.
In Tennessee, the newspaper found the state board that polices pharmacies lacks enough inspectors to thoroughly investigate most cases. Tennessee Board of Pharmacy, whose job is to keep prescription drugs from being illegally sold, can only conduct brief inspections every two years because it has five investigators for 2,000 pharmacies and nearly 8,000 pharmacists. Federal Drug Enforcement Administration officials, charged with enforcing the nation's drug laws, and other law-enforcement agencies say combating prescription drug abuse can be complicated. "One of the major problems with investigating prescription-drug cases is the commingling of legal and illegal activity," said Assistant Special Agent Harry Sommers, head of the DEA's Nashville district office. "The pharmacist who might be selling drugs without prescriptions is also selling drugs legally. This makes it harder to discern illegal activity." (AP) Information from: The Tennessean, www.tennessean.com AP-CS-04-01-07 1703EDT