B.C. has one of the highest rates of prescription painkiller use in the country, according to new a new study led by Simon Fraser University.

The study looked at retail pharmacies across Canada, and found there's been a 50-per-cent hike over the past decade in the number of prescriptions filled for powerful painkillers called opioids.

The classification includes drugs such as codeine, oxycodone, morphine, dilaudid and methadone.

"I am very worried about it because it needs a lot of attention," said SFU health sciences professor Benedikt Fischer, who headed up the study research team. "This is -- after alcohol and tobacco -- our third biggest drug problem in this country so we've got to act."

Fischer said B.C and Ontario are second only to Alberta in the number of opioid prescriptions.

Ontario has been tracking the health impact and has seen overdose deaths in the province doubling since 2005.

In the U.S., opioids are now the second leading cause of death for men aged 35 to 54, and total more than deaths from heroin and cocaine combined.

Prescribing dilemma

The challenge for manufacturers and the pharmacy industry is knowing who's really in need of the drugs, and who's abusing them,

"There's no question people with terminal cancer or [in the] final stages of AIDS urgently need those drugs," Fischer said. "What are the guidelines and especially are we over-prescribing to people who may not have severe or chronic pain?"

Fischer said it's not the same kind of drug problem evident on vancouver's Downtown Eastside, but is as much a middle-class phenomenon.

"The vast extent of misuse of prescription opioids happens in the general Canadian population, in other words people like you and i, or friends we know," said Fischer. "So let's not be misconceiving the issue as if this is a crazy drug problem on the street."

He said a national strategy is needed to crack down on opioid abuse.

With files from the CBC's Priya Ramu and Eric Rankin