The rate of misuse of prescription pain medications jumped 40 percent in New York City from 2002 to 2009, according to the city’s Health Department.

The department found that 4 percent of New Yorkers age 12 and older said they had misused prescription pain medicines in 2008 and 2009, The New York Times reports. One out of 10 students in grades 7 through 12 said they had used a prescription opioid for non-medicinal use at least once.

According to the report, opioids were involved in 25 percent of the city’s accidental drug overdose deaths in 2009. The rate of opioid-related emergency room visits doubled between 2004 and 2009 in New York City, from 4,466 to 9,254.

Daliah Heller, Assistant Commissioner for the Bureau of Alcohol and Drug Use Prevention, told the newspaper that the city is urging doctors to avoid prescribing more opioids than patients need for short-term uses, such as after dental or knee surgery. She also said that more coordination is needed between doctors to avoid potentially fatal interactions between opioids and prescription drugs for mild anxiety and sleep disorders.