This is the last in a four-part series on the growing problem of heroin addiciton in our communities.

Patients having wisdom teeth removed, being treated for sports injuries, or undergoing other surgeries and treatments commonly go home with prescriptions for a powerful opiod painkiller such as oxycodone in hand. Often, the prescription provides many more pills than the patient needs or will take.

The over-prescription of opiod painkillers, both in terms of giving more pills than necessary and prescribing powerful and addictive drugs for pain that could effectively be treated with less risky medications, has been called the upstream reason for the heroin use spike. Yet even with a well-documented connection between prescription painkillers and heroin, and as the state and country struggle to implement effective solutions to stem the personal, societal and financial cost of addiction, opiod over-prescription continues.

While these powerful analgesics have made life bearable for patients with debilitating pain from cancer and other serious diseases, pharmaceutical companies' aggressive marketing tactics combined with over-prescription, over-use and abuse of these drugs, has had catastrophic results.

The Centers for Disease Control in June reported that in 2012, doctors nationwide wrote 259 million painkiller prescriptions. In Connecticut, between 72 and 82 prescriptions per 100 people were written.

Those who become addicted risk illness, death, prosecution and incarceration for their actions, but physicians face few limits on how many opoid prescriptions they can write. Some lawsuits have targeted pharmaceutical companies' culpability in the addiction crisis. In 2007 the state of Kentucky sued Purdue Pharma because of the high rate of addiction in Appalachia. Recently, the city of Chicago and two California counties sued several pharmaceutical companies for similar reasons in their jurisdictions.

Lawsuits may solve some problems, but a more productive and broad-based approach would be to include pharmaceutical companies, physicians and pharmacies in collaborations with law enforcement, health care workers, drug treatment centers, mental health professionals and government officials in working to identify and implement solutions.

Connecticut could reduce heroin and opiod abuse, more effectively treat those addicted and possibly prevent at least some instances of addiction by:

• Encouraging more towns to install locked drug disposal boxes as advocated for by Ledge Light Health District. Usually installed in police department lobbies, the boxes allow residents to anonymously and safely dispose unused prescription drugs. Waterford, East Lyme, New London and the City and Town of Groton, are among the towns with such boxes and the state police recently conducted a successful drug collection program. More towns must follow suit.

• Providing physicians with incentives to prescribe buprenorphine, also known as Suboxone. This drug allows patients to wean themselves from opiate dependence. Only about a dozen physicians in southeastern Connecticut currently prescribe it. A bureaucratic oversight process exists for physicians who want to prescribe the drug. Plenty of evidence exists that medication-assisted therapies, including Suboxone and Methadone, can be effective, but fewer than half those addicted to opiods actually received such treatments, according to a May article in the New England Journal of Medicine. Incentives should be accompanied by oversight to prevent over-prescription of the drug that unfortunately has found its way to the black market.

• Promoting drug use prevention via straight-talking, no-nonsense school-based drug education programs. Begin educating children at a young age and repeat the lessons using age-appropriate language and techniques through elementary, middle and high school. Include information about prescription drugs. Admit and promote the fact that there is a difference between recreational dabbling and addiction. Programs that for many years have been urging kids to say no to drugs have failed to prevent drug abuse. They also have ignored the scientific evidence that addiction is a disease.

• Mandating that physicians and pharmacies reference a digital data base when prescribing or dispensing opiod painkillers. Such mandates in others states have reduced the practice of patient pill shopping and kept dangerous drugs off the street. Some Connecticut hospitals mandate the practice and some doctors and pharmacies voluntarily adhere to it, but there is no universal law governing it.

• Advocating for medical school training that promotes a medical specialty in addiction. Addiction is a complex problem typically encompassing emotional and mental health challenges as well as physical problems. Treating each symptom in isolation, as is the case in the current health care system, wastes time and money and is not effective.

• Working to change attitudes about addiction. The stereotype of who becomes addicted to heroin and why is largely inaccurate. Shunning and incarcerating addicted individuals does little to ensure they can return to being contributing members of society. Changing attitudes is a difficult task, but an appropriate education campaign can help to dramatically shift viewpoints.

The human, social and financial cost of increased heroin use is immense. The trail of failed drug policies is long. Yet successful and effective prevention, treatment and policy models exist. Connecticut needs to increase the sense of urgency to act.