The number of people who have died of drug overdoses in Massachusetts from 2002 through 2007 is nearly 41 times as many as the number of servicemen and women from the state who died in Afghanistan and Iraq over the same span, according to just-released report on drug use in the commonwealth.

"If more than 3,200 people from the commonwealth died overseas [in that time span], there would be outrage," Berkshire County District Attorney David Capeless said Friday. "People would be screaming for action."

Capeless was one of 13 state and local officials and professionals who were a part of the Massachusetts OxyContin and Heroin Commission. The commission, which held hearings on drug addiction throughout the state, released a 71-page final report this week.

Capeless said prescription opiates such as OxyContin, Fentanyl, Percocet and Percodan pose a much deadlier problem than heroin in the Berkshires. Other counties in Massachusetts face a similar problem, he said.

"We just had a very tragic example of this issue," said Capeless, referring to the sentencing of Dawn Cote of North Adams on Thursday. Cote received three to six years in state prison for providing Fentanyl, a prescription painkiller described as 100 times more powerful than heroin to 32-year-old Carlen Robinson, who was taking painkillers for a painful medical condition.

The number of nonfatal overdoses was more than 18,000 in Massachusetts, up more than 200 percent since 1996, the report stated.

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"Because of the stigma surrounding substance abuse," said the report, "this epidemic is left in the shadows."

The commission urged the state to begin a multi-faceted effort to deal with the problem. The focus was monitoring prescription opiates, making it harder to obtain them, and providing treatment for those who become addicted.

The recommendations included strengthening the existing prescription-monitoring programs so that public health officials learn more quickly about patients collecting multiple prescriptions for the same drug.

The commission recommended that all prescriptions for controlled substances be written on special, tamper-resistant pads that would make it impossible to alter dosages.

Other recommendations would increase the level of drug treatment programs in the criminal justice system. Top among those are "jail diversion" programs that give low-level drug offenders the option of going into a 90-day in-patient treatment system program followed by a year of case management instead of jail.

"We push very strongly for treatment, but not as an alternative to prosecution," said Capeless. "Just locking someone up isn't going to solve the problem, because as soon as they get out, they'll go back to using.

"By the same token, offering treatment options alone isn't going to work, either, because they won't go."