A striking rise in drug poisonings in Utah between 1991 and 2003 was largely attributable to medications that can be prescribed legally, the Centers for Disease Control and Prevention said.

Methadone and other prescription narcotics accounted for most of the tripling of the rate of "nonillicit" drug-poisoning deaths that were unintentional or of undetermined intent, from 1.5/100,000 population in 1991-1998 to 4.4/100,000 in 1999-2003.

During the 12-year period, the number of Utah residents dying from all drug poisonings increased nearly fivefold, from 79 (4.4/100,000) in 1991 to 391 (16.6/100,000) in 2003, the CDC said (MMWR 2005;54:33-6).

During 1991-2003, a total of 2,396 drug-poisoning deaths were identified in Utah's centralized medical examiner database.

Of those deaths, 947 were caused by illicit drugs only, 1,277 by nonillicit drugs, and 172 by a combination of the two. Alcohol was not considered a drug in this analysis.) The largest increase in annual drug-poisoning deaths--from 55 in 1991 to 237 in 2003--was attributed to nonillicit drugs, the CDC reported.

Among the deaths attributed to nonillicit drugs during 1991-2003, a total of 733 were classified as unintentional or of undetermined intent. Of these, the highest death rate was among adults aged 25-54 years.

The rate was higher for men than for women, although the percentage increase from 1991-1998 to 1999-2003 was greater among women.

Similarly, more deaths occurred in urban than in rural areas during both periods, but the increase was greater in rural areas And, although death rates rose substantially for people in all body mass index categories, rates were substantially higher during 1999-2003 among overweight (5.26/100,000) and obese individuals (14.25), compared with normal-weight people (3.61).

Comparing the two time periods, the average number of deaths attributable to Methadone increased from 2 to 33 per year, while deaths attributable to other prescription narcotics--principally oxycodone and hydrocodone--increased from 10 to 48 per year.

From 1991-1998 to 1999-2003, the proportions of those deaths that involved Alcohol decreased from 33% to 20%, while deaths due to antidepressants dropped from 15% to 7%.

During 1997-2002. Utah had an increase in the distribution of many of the prescription drugs implicated in these deaths, including Methadone, but that rate of increase was surpassed by the rate of increase in poisoning deaths attributed to them.