The fentanyl epidemic is getting worse, but the problem is getting even worse for the medical equipment manufacturers that make it, according to a new report.

The American College of Physicians said in a report Thursday that the opioid epidemic is the third largest health care expense in the U.S. It said there are more than 1.3 million deaths each year in the United States from opioid overdose.

The report says the epidemic has led to a surge in prescription opioid abuse and overdose, and that the overdose crisis is the biggest public health issue facing the country.

The College of Medicine and Dentistry of New Jersey (CMDNJ) said the opioid crisis is costing the industry more than $1 billion a year.

The study said it has identified nearly 400 medical devices and drugs that could be contributing to the opioid spike, including:In addition to the devices and drug companies, the report said manufacturers have also been making mistakes, such as not using enough fentanyl to prevent the overdose.

A key concern for the manufacturers is that the cost of replacing the drugs and the potential of a shortage of those drugs have put pressure on the industry to get their products to market faster.

But the report also highlighted other dangers, such that the risk of overdose has doubled in the last decade, which it says has made it harder for people to get access to the medications they need to treat their ailments.

The most common type of drug overdoses include:In the report, it found that one in five Americans dies from an opioid overdose each year.

More than 80,000 Americans died from prescription painkillers in 2015, up from 70,000 in 2014.

The CDC says prescription opioid use has increased steadily since 2014, and there have been more deaths and overdoses each year since 2010.

But, the CDC said, overdose deaths are down by 20 percent from the rate from 2010 through 2016.

The opioid crisis has created the highest numbers of emergency room visits per capita in the country, and more than one in three patients admitted to the hospital died.

The Department of Health and Human Services has said the number of people who overdose each day has tripled in the past three years.

The agency said there were 1.8 million opioid-related hospitalizations in 2016, up more than 20 percent compared with 2015.

The Centers for Disease Control and Prevention also said that in the 12 months ending Sept. 30, 2016, there were 5,200 deaths related to opioids and fentanyl.