An estimated 27,500 people died in 2007 from unintentional drug overdoses, many of them involving prescription opioids, according to a report that recommends doctors try other pain control options before prescribing opioid medications.

The report, by doctors affiliated with the U.S. Centers for Disease Control and Prevention (CDC), the University of North Carolina at Chapel Hill School of Medicine and Duke University Medical Center, notes that in 2007 accidental deaths due to prescription opioid painkillers were involved in more overdose deaths than heroin and cocaine combined.

The report recommends that before prescribing opioids, physicians should first try non-narcotic medications, as well as non-drug treatments such as physical therapy, psychotherapy and exercise, according to the article in Medical News Today. The authors suggest that these methods be given an adequate trial before a physician decides to prescribe opioids.

In the Journal of Clinical Psychiatry, they note that doctors may not realize the extent of overlap between chronic pain, mental illness and substance abuse. They recommend that physicians screen patients with chronic pain for substance abuse and mental health problems, especially depression and other mood and anxiety disorders, and treat these problems. The report authors say that opioids, antidepressants, benzodiazepines and sleep aids are often prescribed in combination, even though they are potentially harmful if taken together and can result in fatal overdoses.

The federal government recently announced a new strategy that aims to cut the use of prescription painkillers by 15 percent in five years. The plan includes doctor training, promoting prescription databases in all states and increased focus on rooting out illegal ‘pill mill’ clinics.