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SAN DIEGO – Ninety-one Americans die every day from an opioid overdose. It’s a problem that’s becoming so prevalent, the U.S. Surgeon General labeled the issue a national health crisis.

Just 15 years ago, most prescription drugs were not even on the radar of doctors, parents and addicts as a possible source of getting high. Today, they have become the main “gateway drug” to heroin.

To understand how America got to the point of abusing painkillers it’s important to have some context about what was happening in the medical community in the late 1990s.

In 1996, OxyContin, now one of the most abused painkillers, hit the market after getting FDA approval. Its maker Purdue Pharma also spent tens of millions of dollars to incentivize doctors to prescribe it. It was one of the first pharma companies to send sales representatives to individual doctor’s offices to promote their drug.

Read more: The faces of opioid addiction

In 1996, sales of Oxy were $45 million. By the year 2000, sales jumped 2,000 percent to more than $1 billion.

A 2002, an LA Times investigation found hundreds of doctors recklessly prescribing Oxy, sometimes over the phone, knowing patients were getting addicted.

Dr. Roneet Lev runs the emergency department at Scripps Mercy Hospital. She is also the Chair of the RX Drug Abuse Medical Task Force.

“There was a whole focus on pain in the late 1990s. California passed several legislative measures including the Patient Pain Bill of Rights. We changed our prescription pads to allow and accommodate for stronger prescriptions overnight,” she explained. “We changed from Tylenol with Codeine to Vicodin and Percocet that we weren`t allowed to do before. And we were told only 1 percent of people were getting addicted and if you don`t prescribe then you`re not compassionate. It wasn’t until years later we learned 100% of users get addicted.”

The CDC recently found, prescription opioid painkillers shouldn`t be used for more than three days and provide no benefit for chronic pain.

San Diego County has since stepped up its awareness with the RX Drug Task Force, more public event to collect unwanted medication and school presentations about opioid overdoses.

There`s also a patient database aimed at eliminating “doctor shopping.” Dr. Lev said with a few clicks a physician can tell if their patient has been trying to hoard pills by visiting multiple offices.

“I`ve been threatened to be sued or fired, we`ve had physicians who say patients have said if you don`t give me my drugs I`m going to accuse you of rape,” she explained. “That`s still going on, but since we`ve instituted those guideline, we are seeing way less of that type of demanding abhorrent behavior to getting their opioid medication because we set a unified standard.”