Drug Overdose Deaths Are Going Through the Roof -- Is Anybody Watching?

According to a little noticed January report from the Centers for Disease Control (CDC), drug overdoses killed more than 33,000 people in 2005, the last year for which firm data are available. That makes drug overdose the second leading cause of accidental death, behind only motor vehicle accidents (43,667) and ahead of firearms deaths (30,694).

What's more disturbing is that the 2005 figures are only the latest in such a seemingly inexorable increase in overdose deaths that the eras of the 1970s heroin epidemic and the 1980s crack wave pale in comparison. According to the CDC, some 10,000 died of overdoses in 1990; by 1999, that number had hit 20,000; and in the six years between then and 2005, it increased by more than 60%.

naloxone, the opiate overdose antidote
"The death toll is equivalent to a hundred 757s crashing and killing everybody on board every year, but this doesn't make the news," said Dan Bigg of the Chicago Recovery Alliance, a harm reduction organization providing needle exchange and other services to drug users. "So many people have died, and we just don't care."

Fortunately, some people care. Harm reductionists like Bigg, some public health officials, and a handful of epidemiologists, including those at the CDC, have been watching the up-trend with increasing concern, and some drug policy reform organizations are devoting some energy to measures that could bring those numbers down.

But as youth sociologist and long-time critic of the drug policy establishment's overweening fascination with teen drug use Mike Males noted back in February, the official and press response to the CDC report has been "utter silence." That's because the wrong people are dying, Males argued: "Erupting drug abuse centered in middle-aged America is killing tens of thousands and hospitalizing hundreds of thousands every year, destroying families and communities, subjecting hundreds of thousands of children to abuse and neglect and packing foster care systems to unmanageable peaks, fostering gun violence among inner-city drug dealers, inciting an epidemic of middle-aged crime and imprisonment costing Americans tens of billions of dollars annually, and now creating a spin-off drug abuse epidemic among teens and young adults. Yet, because today's drug epidemic is mainly white middle-aged adults -- a powerful population that is "not supposed to abuse drugs" -- the media and officials can't talk about it. The rigid media and official rule: Drugs can ONLY be discussed as crises of youth and minorities."

The numbers are there to back up Males' point. Not only are Americans dying of drug overdoses in numbers never seen before, it is the middle-aged -- not the young -- who are doing most of the dying. And they are not, for the most part, overdosing on heroin or cocaine, but on Oxycontin, Lorcet, and other opioids created for pain control but often diverted into the lucrative black market created by prohibition.

Back in October, CDC epidemiologist Leonard Paulozzi gave Congress a foretaste of what the January report held. Drug death "rates are currently more than twice what they were during the peak years of crack cocaine mortality in the early 1990s, and four to five times higher than the rates during the year of heroin mortality peak in 1975," he said in testimony before the House Oversight and Investigations Committee.

"Mortality statistics suggest that these deaths are largely due to the misuse and abuse of prescription drugs," Paulozzi continued. "Such statistics are backed up by studies of the records of state medical examiners. Such studies consistently report that a high percentage of people who die of prescription drug overdoses have a history of substance abuse."

But there is more to it than a mere correlation between increases in the prescribing and abuse of opioid pain relievers and a rising death rate, said Dr. Alex Kral, director of the Urban Health Program for RTI International, a large nonprofit health organization. Kral, who has been doing epidemiological research on opioid overdoses for 15 years, said there are a variety of factors at work.

"There hasn't been a big increase in heroin use," he said. "What's changed has been prescription opiate drug use. Oxycontin is probably a big part of the answer. The pharmaceutical companies have come up with good and highly useful versions of opioids, but they have also been diverted and used in illicit ways in epidemic fashion for the past 15 years."

But Kral also pointed the finger at the resort to mass imprisonment and forced treatment of drug offenders as a contributing factor. "What happens is that people who are opiate users go into prison or jail and they get off the drug, but when they come out and start using again, they use at the same levels as before, and they don't have the same kind of tolerance. We know that recent release from jail or prison is a big risk factor for overdose," he said.

"The last piece of the puzzle is drug treatment," Kral said. "Besides the tolerance problems for people who have been abstaining in treatment, there has been an increase in the use of methadone and buprenorphine, which is a good thing, but people are managing to overdose on those as well."

There are means of reducing the death toll, said a variety of harm reductionists, and the opioid antagonist naloxone (Narcan) was mentioned by all of them. Naloxone is a big part of the answer, said the Chicago Recovery Alliance's Bigg. "It's been around for 40 years, it's a pure antidote, and it has no side effects. It consistently reverses overdoses via intramuscular injection; it's very simple to administer. If people have naloxone, it becomes much, much easier to avoid overdose deaths."

"Naloxone should be made available over the counter without a prescription," said Bigg. "In the meantime, every time a physician prescribes opioids, he should also prescribe naloxone."

"For a couple of years now, we've been talking about trying to get naloxone reclassified so it's available over the counter or maybe prescribed by a pharmacist," said Hilary McQuie, Western director for the Harm Reduction Coalition. "The problem is that you don't just need congressional activity, you also need to deal with the FDA process, and it's hard to find anyone in the activist community who understands that process."

Harm reductionists also have to grapple with the changing face of drug overdoses. "We're used to dealing with injection drug users," McQuie admitted, "and nobody really has a good initiative for dealing with prescription drug users. In our lobbying meetings about the federal needle exchange funding ban, we've started to talk about this, specifically about getting naloxone out there."

But while the overdose epidemic weighs heavily on the movement, no one wants to spend money to bring the numbers down. "This is a very big issue, it's very present for harm reduction workers," said McQuie. "But we haven't done a lot of press on it because there is no funding for overdose prevention. We have a very good program in San Francisco to train residential hotel managers and drug users at needle exchanges. It's very cheap; it only cost $70,000, including naloxone. But we can't get funders interested in this. We write grants to do this sort of work around the state, and we never get any money."

Perversely, the Office of National Drug Control Policy also opposes making naloxone widely available -- on the grounds that it is a moral hazard. "First of all, I don't agree with giving an opioid antidote to non-medical professionals. That's No. 1," ONDCP's Deputy Director of Demand Reduction Bertha Madras said in January. "I just don't think that's good public health policy."

But even worse, Madras argued that availability of naloxone could encourage drug users to keep using because they would be less afraid of overdoses. And besides, Madras, continued, overdosing may be just what the doctor ordered for drug users. "Sometimes having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation and snap into having someone give them services," Madras said.

"The drug czar's office argues that if you take away the potential consequences, in this case, a fatal overdose, you facilitate the use, but betting someone's life on that is just cruel and bizarre," snorted Bigg.

RTI's Kral noted that there are now 44 naloxone programs run by community groups across the country. "It would be wonderful if there were more of them, because they are staving off a lot of deaths, but they are controversial. The ONDCP says they condone drug use, but you can't rehabilitate a dead drug user."

While battles over naloxone access continue, said Bigg, there are other things that can be done. "We need to engage people, and that means overcoming shame," said Bigg. "Every couple of months, I get a call from a family that has lost a member to drugs and I ask them if they're willing to come forward and talk to reporters to stop it from happening again, and they say 'let me think about it,' and I never hear from them again.

Another means of reducing the death toll would be to start local organizations of people whose friends or family members have died or are still using and at risk. "We could call them 'First Things First,' as in first, let's keep our folks alive," he suggested.

"When people found out naloxone is out there, that it's this medicine that has no ill effects -- it has no effect at all unless you're using opioids -- and that it can't be abused, and that their family member could have had it and still be alive, that's a hard thing to realize," said Bigg. "Everyone who has lost a loved one wants him back, and to think he could still be alive today if there were naloxone is a bitter, bitter pill to swallow."

Despite the apparent low profile of drug policy reform groups, they, too, have been fighting on the overdose front. "We worked to pass groundbreaking overdose prevention bills in California and New Mexico," said Bill Piper, national affairs director for the Drug Policy Alliance. "We're working to advance overdose prevention bills in Maryland and New Jersey. We had a bill in 2006 in Congress that would have created a federal grant program for overdose prevention," he said, pointedly adding that not a single federal dollar goes to overdose prevention. "We've tried to introduce that in the new Congress but can't find someone to take a lead. To be frank, few politicians care about this issue. Their staff care even less."

A massive public education campaign is needed, said Piper, adding that DPA is working on a report on this very topic that should appear in a few weeks.

In the meantime, while politicians and drug war bureaucrats avert their gaze and deep-pocketed potential donors keep their purses tightly closed, while the nation worries about baseball players on steroids and teenagers smoking pot, the bodies pile up like cordwood.



What's with the comment that people are overdosing on buprenorphine? My understanding is that due to its ceiling effect, the risk is pretty minuscule unless bupe is combined with benzodiazapenes or other tranquilizers.

Of course, this small detail does not change the ridiculousness of the ONDCP's "It served 'em right to OD" stance.

Legalize, decontrol cannabis; decriminalize "hard drugs"

In the interest of Harm Reduction, the first step is to eliminate the harmful law enforcement against smoking, because that will enable smoking method reforms to proceed.

The hot-burning-overdose cigaret, with 5.4 million deaths per year (WHO, Feb. 2008) is the No. 1 drug overdose emergency on the planet. Laws against cannabis represent a well-financed political protection for the tobacco industry in the face of this genocide.

1. If cannabis were legalized and decontrolled, equipment reformers would quickly proceed to promote availability of VAPORIZERS for all users of both tobacco and cannabis, and, failing the money for that, widespread instruction in how to make a semi-vaporizer utensil-- mini-toke, one-hitters, kiseru, midwakh-- permitting 25 mg. servings in contrast to a 700-mg. cigaret or 500-mg. joint, easily produced for pennies in anyone's garage anywhere in the planet. Semi-vaporizer-- because by sucking slowly on such a utensil and maintaining a low burning temperature, users can assure that a high percentage of the cannabinol-- or nicotine-- in each herb particle vaporizes from the heat of adjoining particles already burning, such a utensil realizes at lower initial cost much of what is offered by vaporizers costing hundreds of dollars.

2. However, here is something for U.S. taxpayers to think about: in 1998 the Clinton-Gore administration reached a settlement with Big Tobackgo to pay over $200 billion which was supposed to be used for smoking cessation programs (in most states, the money is getting hi-jacked for everyday budget items like schools and roads). If each of 45 million nicotine cigaret addicts received a $600 Volcano Vaporizer (the top of the line brand endorsed by NORML Executive Director Allen F. St. Pierre) it would represent only a one-time $27 bil. cost. Now throw in a smaller number of persons encouraged to step forward and identify themselves as cannabis users, and you have a Harm Reduction Marshall Plan at quite reasonable cost, considering that tobacco overdose medical consequences alone cost the USA nearly a hundred billion a year.

3. Why decontrol? I had a look at the Illinois Medical Marijuana Act-- a maze of bureaucratic locked doors that a patient would need a lawyer to negotiate, plus all those bureaucrat watchdog jobs for the taxpayer to fund. Let's give the citizen a paperfree path for a change.

4. By overtly differentiating between cannabis and the "hard drugs" I think you can expect a massive drop in the demand for the latter substances, which are popular because they are easier to smuggle and easier to hide in use than cannabis. Let's urge the next administration to change foreign policy, allowing Columbia to grow "bo" instead of cocaine, Afghanistan to grow hashish instead of poppies, and Americans to substitute "grow-houses" for meth labs.

5. This will NOT lead to a big increase in marijuana smoking because the hot-burning overdose bongs and joints will disappear into museums, replaced by one-hitters. The chauvinism of those who defy the law by smoking a hot-burning joint or tobacco-contaminated blunt under someone's nose will be replaced by a Qur'an-compliant regimen of 10 tokes every two days. Respect for the creative imagination and gift of Miracle-Wonder (sp.?) prophecy will spread everywhere on the planet after the USA eases its threats and coercions against other nations such as Jamaica.

6. If the public were better informed I think we would see a spread of the vaporizer/one-hitter idea to many presently legal and beneficent herbs, such as hops and camomile flowers, basil, marjoram, oregano, sage, savory, thyme, peppermint, spearmint, pennyroyal, ginseng, mate, eucalyptus etc. It is even probably just as safe to toke a 25-mg. serving of poppy petal or coca leaf as any of the above. A truly CONSERVATIVE and democratic attitude toward herb use would thus prevail. But as mentioned, the first step is cannabis legalization and decontrol, combined with controlled decriminalization of the hard drugs.

What's The Answer?

Most know the answer to that question. End Prohibition as we know it. Yet, how does that occur?

The biggest obstacle we encounter is NOT the law itself. No, it's those who write and vote into existance, the laws. They're afraid! Plain and simple. Afraid of what will be said about them and that they'll lose their jobs. Now, you can't really or realistically condemn them for that. You'd probably be the same way.

So, how do we, the reformers, give our elected officials a "channel" to voice their "real" position? Most, it has turned out, agree with us. Yet, it's "job security" that they fear. An appliance is not yet in place for these people to voice their true feelings without retribution. THAT, has to be found and implimented, QUICKLY. There has to be a "protective umbrella" constructed for them, soon.

They also know and need to be "shielded" by facts, which the prohibs conveniently side-step or "modify." They need to realize something I heard a couple days ago. "Prohibition dosen't control substances. Prohibition requires that you give up total control of substances!"

You can have your jails, your prisons, your Plans' Colombia and Mexico, your SWATTERS and your past-century idiologies. But everyone knows, that only by cutting off the $$ supply to the cartels will you move them out of this transaction. The Drug Czar and the cartels are on the same side of the fence. Bin Laudin and McCain are on the same side of this fence. The two US individuals mentioned WANT the two foreigns mentioned to remain in business. They must. They're doing everything they can to "make it so."

While we bicker and bitch amongst ourselves, we do ourselves and our world a disservice. Find and impliment that "protective shield"/applicance that lawmakers can use for protection. They're no different than our "boots on the ground" in any conflict. They, too, want "armor." They want to "be her tomorrow." And legislators are truly looking to the reform arena to find that appliance for them.

At any upcoming reform conventions within the next 18 months, action should be taken toward this goal. We've given them the facts. Now, it's time to provide them with a platform.

What are YOU doing to achieve that goal? Today?

Malkavian's picture

The Answer ;)

Yes indeed, people are afraid of the drugs and cannot imagine another world because they've grown up in one where Prohibition is the rule (and alcohol the exception). The drug warriors are offering two distinct benefits that are presently believed by the listeners: a fear of the drugs (that which people run from) and the hope for a brighter future (what they run towards). Nevermind if they don't provide the goods, it's less important. People just really, really would like their children NOT to die from an overdose. Mass incarcerations, forfeiture, seizures and accidental raids ending in the murder of innocents - if there are no alternatives people will find the excuses needed to excuse all those bad things.

Especially when WE don't offer very much in the way of hope. When it starts dawning on people that legalization offers the brightest of all hopes for a future with less death and damages from the drugs people will come round. When they vote those people in office they want to believe in their hearts that the resulting legalization will indeed do GOOD in our societies.

Most people, even those skeptical of the WoD, will have hearts filled with doubt if legalization really puts less drugs in the hands of their kids.

And I really think that the first part of the solution - fear of the WoD is materializing pretty nicely. But afraid as people may be they can't really see legalization doing the trick. Just as there are countless myths about cannabis and other drugs which have needed debunking, so there is about Legalization.

role of alcohol

My experience is that most overdoses occur when depressant drugs are combined with alcohol. Has anyone studied this synergistic depressant effect on overdose deaths? As the partner of a chronic pain patient who has been granted a life because of Oxycontin I am wary of any demonization of pain killers but it used to be common knowledge not to drink and do downs of any kind (re; Karen Ann Quinlen) Dr DeLuca has written an excellent paper on the abuse of the Harrison Act to turn a tax and regulation regime into a prohibition regime. Prohibition has been proven not to work but the association of the drug sub-culture with cultural leftism, a relic of the 1960's, is a huge part of the reluctance to address the failure of drug prohibition. I believe that if we had alcohol prohibiton today it would be difficult to undo in the present climate.

The Increase In Overdoses

I fully believe and agree that we should have the right to possess and administer the antidote Naloxone to overdose victims and think that if the shoe was on the other foot and it was the loved ones of the people fighting so hard against this issue, they'd feel the same way. Let's see how they'd react to finding that their wife, son, or best friend was found dead of an overdose because they stopped someone from having the right to save their life. I can almost guarantee they'd ALL wish that someone had been there with the shot that could've saved them. There's NO way they'll ever convince me otherwise.

On the other hand, as an IV heroin user for the better part of my life, I started using in hopes death would shortly follow, and if it actually came for me one day, I would hope like hell that no one would interfere with it. I HAVE, in fact od'd a few times; and every time, someone has brought me out of it. Now, my habit is too large and I can't clean up long enough to lower my tolerance. So, I have to think that I am NOT the only one who feels this way. In this instance, I feel like our right to chose life should be up to us and NO ONE ELSE! And to myself, and others like me, from now on, if you want to die, then use alone. Problem solved!

Those who are in support of changing the current situation, Take A Stand and FIGHT for what you believe in. The more voices heard, the more attention and consideration we just might get. But, if you insist on keeping things the way they are then PLEASE, DO NOT COMPLAIN about all the overdoses, which could SO easily be prevented if you allowed it! And, PLEASE, PLEASE, PLEASE: QUIT BLAMING THE DRUGS!!! For some of us, like myself, they are NECESSARY!

Malkavian's picture

The Suicide Button

The BIG problem that Prohibition is causing here is that it's turning people away from the safer recreational drugs towards drugs that contain more dangers. It's fairly difficult to kill yourself using pure cannabis, MDMA (Ecstasy), Methylone, psilocybin mushrooms, 2C-B, LSD or even Ketamine. Especially when you start using Mom's OxyContin, or the doctor's Methadone..Lots of people would no doubt prefer pretty much anything to opiods (they're really not very interesting to someone without emotional distress - I know that first hand). What's also quite important is that a LOT of recreational drugs can be combined with alcohol without the tell-tale Instant Death from the alcohol + benzo/opiod combo. So they're a lot safer in a recreational, social arena.

But Methadone and OcyContin present another crazy problem. Both are slow release medicines if you just eat them as is. If used "as the doctor ordered" they're probably very, very safe. The problem is that no one wants to own up to the fact that there is and always will be people who will take the available drug in order to get to that precious opiod "I don't care about anything" state of mind (because if they care they get overwhelmed by the utter psychological pain their life is...).

That's why specifically OcyContin and Methadone have in-built "Suidide Buttons". Drug users are impatient. They want relief NOW, not in an hour or two. So what happens when they start piling slow-release opiods on top of each other until they finally get that precious effect? When the slow releasing compounds finally get a psychoactive level in the blood stream the user feels happy (or "I don't care-ish") and stops taking more drugs, but now he's got a Triple Death Dose in his stomach and without help there's really not much to do besides waiting for respiration to cease.

Same with addiction treatment. That's NOT so smart to offer to people who are in fact not motivated to stop. Yet many join the treatment programs because they get privileges and/or reduced sentences if they do. In my country, Denmark, they calculated the (two-week) risk of death among all clean heroin users just dismissed from prison to be 65 times greater than the same risk for the general population of non-drug user. And it's 4-5 times greater than the risk of dying for the worst off addicts living on the street in abject poverty, under dangerous hygienic conditions and with heavy heroin abuse.

drug overdose

My best friends brother died of an overdose yesterday 4/26/2008. I live on Long Island and most of the people who live here moved out of the city so their kids could have a better life in the less dangerous suburbs. Unfortunately in Lindenhurst the town we live in every year people we know die of an overdose. Something has to be done before more and more kids die every year. Drug addiction is a disease that we can prevent. If we make better efforts to keep heroin, cocaine and other drugs off our streets that could mean there will be one less mother burying their child. Billy you are forever in our hearts.

Prohibition is impossible

If you look at the history of substance abuse, you'll find that no one has ever managed to stop it by "taking the drugs off the street". That's the mess we're in today and you seem to favor blinding going on with what doesn't work.

The more harshly a drug is prohibited, the higher the price. The higher the price, the more likely that someone will want to get into the business of dealing. People who would never think of dealing marijuana if it cost them $10 an ounce and they could sell it for $12, get very interested when they that they can buy an ounce for $150 and sell quarter ounces for $75. Prohibition ==> higher prices ==> more people willing to take the risk.

Illicit drugs are outrageously expensive, leading people to impoverish themselves or steal. Illicit drugs are of uncertain quality, leading to overdoses and poisonings. The vast pools of illicit drug money corrupt our police. The amount of money to be made and no access to police protection leads to violent encounters between competing dealers.

If the goal is to reduce the amount of harm drugs do to individuals and society, prohibition is counterproductive. If the goal is to build criminal empires and put people at more risk, prohibition is doing fine.

Release all Marijuana Offenders from Prison and Jail

I realize this article is focused more on harder drugs that cause OD's but I would just like to say that I think its very unfair for someone to be doing 2, 5, 10, 15, 20 or more years in prison for buying, selling, growing pot. I do not smoke pot myself so I am not just looking out for a personal indulgence. I believe that our forefathers smoked it and grew it, its safer than alcohol and you can't die from an OD of pot. Everything else, including alcohol can kill you for taking too much.

Change the laws!!

Release all Marijuana Offenders from Prison and Jail


Change the laws!!

This is getting to be

This is getting to be ridiculous. My big brother started drugs at 14; now hes 19 and has been to several drug rehabilitation centers through-out his teenage years and is STILL struggling. Rehab isn't enough, we must find a better way to get drugs off of the streets, and keep them off.

Oxycontin zombies

We need to find a way to limit the accessibility of Oxycontin.I have lost an uncle and two childhood friends due to oxycontin.My two childhood friends I lost passed only a week apart.If i were to name the people I know who arent addicted to them I could only think of a few.I honestly feel everyone I went to high school with is on them.Oxycontin addiction is taking over pasco county and destroying several peoples lives, either from being addicted to them or by taking the addicted from the rest of us.Oxycontin should only be perscribed to cancer patients and other illnesses that can not be faked.

Education, Education, Education

My brother died last week from an od. It was simply because in middle america there is no education on the effects of opiates. I don't deny my brother was in a lot of pain and used drugs to escape but you will never convince me he knew what he was doing when he took that "death dose". We went to the same high school and never once do I remember learning about the dangers of prescription pain killers. I think alot would solved if urine testing was madatory for all who are prescribed these drugs. Levels would be tested to prove the person was taking them and not making a quick buck of my brother while at the same time assisting in his death.


I hate to break it to you but you are being taken in by government propaganda. The government blames all deaths where opioids are found to be in the body on drug overdose, which the science simply doesn't support. In other words, medical examiners all across the country call every middle aged heart attack a drug overdose if that person was taking pain medicine for chronic pain. It's that simple and that idiotic.
Pain patients are so severely UNDERTREATED for pain that many of them die in middle age from the co-morbidities associated with enforced immobility due to untreated pain.
The Schneider case in Kansas, where the government was trying to run this number on the public by asserting that the doc and his wife had killed 59 people is coming apart at the seams..in large part because the science upon which the government relies is simply junk. Absolute junk.
So I wonder if the harm reduction people are required to run this line of palaver out there in exchange for government funding...and if that's so they might want to reconsider what they are doing.
Ultimately, this whole thing is a government generated crisis. Remember Reefer Madness?
This time it isn't funny. It's costing huge numbers of ill Americans access to medicines they need to survive.
We at PRN wish that the drug reform community would check with us before going off half-cocked like this.
Pain Relief Network

First things first

In Europe,several countries have passed heroin maintenance programs even as they failed to do anything about marijuana.The answer is obvious,there are no deaths or addictions with pot.You don't see pot smokers doing strings of armed robberies or home invasions to support their habit.People that use heroin have long prison records and still fail to stop.Their lives are so miserable without heroin and can be quite normal if given it by prescription.The people that OD are usually the ones that try to dry out and fall off the wagon but forget to reduce the dosage enough.This is also because the strength is changing all the time.Methadone,while fine for withdrawal is a nightmare as a maintenance drug as users usually stray and it raises the need by 3x.Once prohibition is ended and a sane look can be taken at what to do with the drugs we have,the use of opiates will settle at it's traditional 1% of the population.The illegality of heroin and morphine has caused this need for drugs like oxycontin,vicodin and the like.Once people with severe pain are allowed to use the real thing,the poor seconds will fade from use like barbituates and qualudes.Naloxone should be available at needle exchanges so that dealers or the operators of shooting galleries can avail themselves of it to avoid deaths.No matter how fast an ambulance it can't be there as fast as is often needed.At the very least there should be no penalty for calling in medical help.Eliminating the need to call police in on an overdose call is a start.

drug deaths

Google "the Florida Medical Examiner's Commission Report on Drug Deaths for 2008". It's on the Florida state police website. (FDLE) It gives a very detailed account of the drugs present in dead people in Florida, and which drugs were the proximate cause of death. Interesting facts like, methadone, supposedly a cure for heroin addiction, killed FIVE TIMES as many people as heroin. Around 4000 killed by prescription pills, only about 30 killed by heroin, 900 killed by cocaine. Coke is WAY more lethal than heroin, according to the guys who do all the autopsies. Alcohol was present in the deaths of around 4200 people, and alcohol was the direct cause of death in almost 500, 18 times as many as heroin.
Marijuana deaths? Zero, as always.



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