Abuse of prescription drugs does not seem to be a problem of epidemic proportions in Hawaii — yet — but there is evidence that it is growing, as is the trend nationwide. So it is good to see the state taking a firm and proactive role in setting up an online network to curb abuse and diversion of painkillers and other medications.

Just under way is a new online prescription drug monitoring system, accessible to every pharmacy and doctor with a license to dispense drugs here, set up by the state Department of Public Safety that expands and updates an earlier, closed version.

It will give doctors the tools to work with patients who need to be weaned off drugs — medications that, in an alarming and growing trend, can start off therapeutic but turn insidiously dangerous and harmful.

Eventually, this new system — set up by private vendor RelayHealth with $170,000 in federal funds and to be maintained by $35,000 yearly in federal money — will contain data back to 2009 on all people who picked up a prescription in Hawaii.

According to the Centers for Disease Control and Prevention, prescription drug overdose is now the top cause of accidental death in the nation, killing even more people than automobile accidents for the first time in 30 years.

The CDC reports an epidemic of prescription painkiller abuse, with nearly 15,000 people overdosing in 2008, more than triple that in 1999.

Hawaii ranked 40th in the nation for the rate of residents who died of a prescription painkiller overdose in 2008 — and it’s hoped that awareness and preventative measures such as this new physicians-and-pharmacies database can help keep the numbers in check.

"It’s a relatively new phenomenon, so that’s why we’re trying to collect all this data to intervene," said Heather Lusk, with the CHOW Project, a nonprofit that exchanges sterile needles for drug users to prevent spread of diseases. "What I think is happening now, it went from only affecting the population that I work with, to now it’s affecting grandma, grandpa, auntie, who’s getting prescribed legitimate pain medication, but maybe not getting the understanding of how addicting it is or how easy it is to build tolerance and how it might cause overdose."

In addition to the CDC, the Drug Enforcement Administration and the National Institute on Drug Abuse also are sounding the alarm about the rising crisis of painkiller abuse. What might start as useful doses of prescription medications can sometimes grow into problems of dependence and addiction, as well as risky combinations of contraindicated drugs.

Several high-profile cases, too, have shined a tragic but needed spotlight on the problem. Cocaine and heart disease contributed to singer Whitney Houston’s death and decline, but so did her use of prescription drugs including at least three benzodiazepines: Xanax, Ativan and Valium. The death of Michael Jackson was caused by "acute propofol intoxication" in combination with two anti-anxiety sedatives; his doctor was convicted of involuntary manslaughter for injecting the pop icon with a lethal amount of propofol. And the sudden death of actor Heath Ledger in 2008 was found to be due to an accidental, toxic combination of prescription drugs.

William Haning, a University of Hawaii psychiatry professor, shared some valuable information and sounded a needed warning in saying that the most lethal prescription drugs are primarily the opiates or painkillers. "If you haven’t developed a tolerance for them as a result of chronic administration, (you) can have a pretty narrow margin between what’s therapeutic and what will kill you."