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When you think of a drug overdose victim, chances are you think of someone inexperienced with drug use who takes more than they can handle, or a person who unknowingly takes a purer strain of drug than they’re used to. Those assumptions, however, aren’t reflected in current U.S. statistics. So what is an accurate profile of a drug overdose victim?

WHO: Statistics show that the people most at risk of drug overdose are people you wouldn’t necessarily think of as drug addicts — suburban, middle-aged white men, according to a 2014 study. Although many people picture the young being hardest hit, the Centers for Disease Control and Prevention (CDC) reports that in 2015 alone, the highest death rate from drug overdose occurred in people aged 45 to 54.

WHAT: What drugs are people in the highest risk groups taking? In a word, painkillers. Prescription opioids like hydrocodone (Vicodin, Lortab) and oxycodone (OxyContin) were responsible for 24% of drug-related deaths in 2015. According to the Office of the Surgeon General, 44% of Americans say they personally know someone who is or was addicted to prescription painkillers, and 78 Americans die every day from an opioid overdose. Prescriptions for opioid medications have quadrupled since 1999.

But the problem doesn’t stop with prescription painkillers. Heroin is another drug contributing to the alarming rise in overdose deaths. In 2015, heroin was responsible for 25% of drug-related deaths. Heroin overdose deaths tripled between 2010 and 2015. The highest recorded death rate from drug overdose in the U.S. occurred in 2014, when there were 47,055 drug overdose deaths, including 28,647 people who died from an overdose involving either a prescription painkiller or heroin.

Trailing close behind heroin and pain pills, at an 18% overdose death rate, are semisynthetic opioids such as fentanyl. Typically used for sedation during medical procedures and to treat cancer pain when other painkillers have failed to provide relief, fentanyl is 50 times stronger than heroin. For illicit use, fentanyl is regularly mixed into other drugs such as heroin and cocaine, often without the user’s knowledge, making it even more dangerous.

WHEN: Many users don’t realize that once they achieve a period of abstinence, either through a drug rehab program or on their own, they are at greatest risk for drug overdose. When they haven’t been using the drug regularly their tolerance drops. If they relapse (as about half of addicts do) and return to their usual dose of the drug, they are at grave risk of overdose.

There is also a risk of overdose when people mix drugs. For example, if a person takes one form of an opiate (such as a pain pill) and within 24 hours takes another type of opiate (such as heroin), they increase the opiate’s effect in their body and, thus, their risk of overdose.

WHERE: Studies also reveal surprising information about where drug overdoses are most likely to take place. A growing number of drug overdoses are occurring not in low-economy urban areas, but in suburban and non-urban settings, and often in affluent neighborhoods. Some of the states with the highest numbers of drug overdose deaths in recent years are New Hampshire, Ohio, West Virginia and Kentucky.

WHY: Addiction to opioid painkiller medications can develop even when people are using them for legitimate medical reasons. In fact, nearly one in four patients receiving long-term opioid pain therapy in a health care setting struggles with addiction. People who struggle with underlying depression, anxiety, trauma or other issues may find that the medication they take for physical pain also helps them cope with their emotional pain. This can contribute to addiction and lead to further problems. For example, since heroin is cheaper and easier to get than prescription opioids, many painkiller addicts turn to heroin when pain pills become difficult to acquire.

Stemming the Tide of Drug Overdose

In an effort to raise public awareness about opioid addiction, the Surgeon General has launched a “Turn the Tide” campaign advising concerned Americans to take active measures to help people in their communities who are struggling with addiction. Some of these include:

• Write to local health care providers encouraging them to treat their patients’ pain appropriately
• Talk to community leaders about the practices that are most effective and the challenges that remain
• Inform policy makers, educators, law enforcement officers and others to help change how they think about substance use disorders and addiction

These measures can help address the problem at the community level, but it is also important to take action at the individual level. If you are seeking medical assistance to manage your pain, ask your doctor questions before taking an opioid prescription. Also consider alternative pain management approaches as well as medications that carry a lower risk for addiction, such as gabapentin (Neurontin, Gralise) and pregabalin (Lyrica). These are FDA-approved for pain and can be combined with other therapies for long-term use.

Finally, if you or someone you know is struggling with opiate addiction, get treatment before you become a statistic, and learn about the powerful anti-overdose tools available to you. Naloxone, a medication that can rapidly reverse opioid overdose, is easy to administer and more readily available than ever. In many states, relatives and friends can obtain prescriptions for an automated injector or nasal spray in case their loved one overdoses and in some states no prescription is required. Drug overdose is a tragedy that can be prevented by knowing who is at greatest risk, and how and when to take action.