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Annual Causes of Death in the United States

Related Chapter:
Overdose
For facts about specific drugs, here's a list of Controlled Substance sections.

  1. (Annual Causes of Death, By Cause)

    Cause of death (Data from 2010 unless otherwise noted) Number
    All Causes 2,468,435
    Diseases of Heart 780,213
    Malignant Neoplasms [Cancer] 574,743
    Chronic Lower Respiratory Diseases 138,080
    Cerebrovascular Diseases 129,476
    Accidents (Unintentional Injuries) [Total] 120,859
       Motor Vehicle Accidents [subset of Total Accidents]    35,332
    Alzheimer's Disease 83,494
    Diabetes Mellitus 69,071
    Nephritis, Nephrotic Syndrome and Nephrosis 50,476
    Influenza and Pneumonia 50,097
    Drug-Induced Deaths1 40,393
    Intentional Self-Harm (Suicide) 38,364
    Septicemia 34,812
    Chronic Liver Disease and Cirrhosis 31,903
    Firearm Injuries 31,672
    Essential Hypertension and Hypertensive Renal Disease 26,634
    Alcohol-Induced Deaths 25,692
    Parkinson's Disease 22,032
    Pneumonitis Due to Solids and Liquids 17,011
    Homicide 16,259
    Human Immunodeficiency Virus (HIV) 8,369
    Viral hepatitis 7,564
    All Illicit Drugs Combined (2000)2 17,0002
    Cannabis (Marijuana)3 0

    2010 Drug Overdose Mortality Data In Detail as Reported By Paulozzi et al.4
    Drug Overdose Total 38,329
    Pharmaceutical Drugs 22,134
    Pharmaceutical Opioid Analgesics 16,651

    1 "Drug" includes both legal and illegal drugs.
    2 Mokdad, Ali H., PhD, James S. Marks, MD, MPH, Donna F. Stroup, PhD, MSc, Julie L. Gerberding, MD, MPH, "Actual Causes of Death in the United States, 2000," Journal of the American Medical Association, (March 10, 2004), G225 Vol. 291, No. 10, 1242.
    3 No recorded cases of overdose deaths from cannabis have been found in extensive literature reviews, see for example Gable, Robert S., "The Toxicity of Recreational Drugs," American Scientist (Research Triangle Park, NC: Sigma Xi, The Scientific Research Society, May-June 2006) Vol. 94, No. 3, p. 207.
    4 Paulozzi et al analyzed mortality figures and found that of 38,329 drug overdose deaths then reported in 2010, pharmaceutical drugs accounted for 22,134 deaths, of which 16,651 were opiod analgesic overdoses. The data was apparently revised slightly between the time the research letter was published in JAMA (February 2013) and release of the CDC's Deaths: Final Data for 2010 publication report, officially dated May 8, 2013.

    Source: 
    Sherry L. Murphy, BS; Jiaquan Xu, MD; and Kenneth D. Kochanek, MA, Division of Vital Statistics, "Deaths: Final Data for 2010," (Atlanta, GA: Centers for Disease Control), Vol. 61, Number 4, May 8, 2013, Tables 9 and 10.
    http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf
    Christopher M. Jones, PharmD, Karin A. Mack, PhD, and Leonard J. Paulozzi, MD, "Pharmaceutical Overdose Deaths, United States, 2010," Journal of the American Medical Association, February 20, 2013, Vol 309, No. 7, p. 658.
    http://jama.jamanetwork.com/article.aspx?articleid=1653518

  2. (Alcohol-Induced Mortality 2010) "In 2010, a total of 25,692 persons died of alcohol induced causes in the United States (Tables 10, 12 and 13). This category includes deaths from dependent and nondependent use of alcohol, and also includes deaths from accidental poisoning by alcohol. It excludes unintentional injuries, homicides, and other causes indirectly related to alcohol use, as well as deaths due to fetal alcohol syndrome (for a list of alcohol-induced causes, see 'Technical Notes').
    "The age-adjusted death rate for alcohol-induced causes for the total population increased 2.7 percent from 7.4 in 2009 to 7.6 in 2010 (Internet Tables I-5 and I-6). For males, the age-adjusted death rate for alcohol-induced causes in 2010 was three times the rate for females. Compared with the rate for the white population, the rate for the black population was 26.3 percent lower.
    "Among the major race-sex and race-ethnic-sex groups, the age-adjusted death rate increased in 2010 from 2009 for white males (4.3 percent), AIAN males (19.9 percent), and non-Hispanic white males (4.5 percent). No other major race-sex and race-ethnic-sex groups experienced significant changes."

    Source: 
    Sherry L. Murphy, BS; Jiaquan Xu, MD; and Kenneth D. Kochanek, MA, Division of Vital Statistics, "Deaths: Final Data for 2010," (Atlanta, GA: Centers for Disease Control), Vol. 61, Number 4, May 8, 2013, p. 18.
    http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf

  3. (Drug Overdose Deaths and Pharmaceutical Drugs, 2010) "In 2010, there were 38,329 drug overdose deaths in the United States; most (22 134; 57.7%) involved pharmaceuticals; 9429 (24.6%) involved only unspecified drugs. Of the pharmaceutical-related overdose deaths, 16,451 (74.3%) were unintentional, 3780 (17.1%) were suicides, and 1868 (8.4%) were of undetermined intent. Opioids (16,651; 75.2%), benzodiazepines (6497; 29.4%), antidepressants (3889; 17.6%), and antiepileptic and antiparkinsonism drugs (1717; 7.8%) were the pharmaceuticals (alone or in combination with other drugs) most commonly involved in pharmaceutical overdose deaths. Among overdose deaths involving opioid analgesics, the pharmaceuticals most often also involved in these deaths were benzodiazepines (5017; 30.1%), antidepressants (2239; 13.4%), antiepileptic and antiparkinsonism drugs (1125; 6.8%), and antipsychotics and neuroleptics (783; 4.7%)."

    Source: 
    Christopher M. Jones, PharmD, Karin A. Mack, PhD, and Leonard J. Paulozzi, MD, "Pharmaceutical Overdose Deaths, United States, 2010," Journal of the American Medical Association, February 20, 2013, Vol 309, No. 7, p. 658.
    http://jama.jamanetwork.com/article.aspx?articleid=1653518

  4. (Polydrug Involvement in Pharmaceutical Overdose Deaths in the US, 2010) "Opioids were frequently implicated in overdose deaths involving other pharmaceuticals. They were involved in the majority of deaths involving benzodiazepines (77.2%), antiepileptic and antiparkinsonism drugs (65.5%), antipsychotic and neuroleptic drugs (58.0%), antidepressants (57.6%), other analgesics, antipyretics, and antirheumatics (56.5%), and other psychotropic drugs (54.2%). Among overdose deaths due to psychotherapeutic and central nervous system pharmaceuticals, the proportion involving only a single class of such drugs was highest for opioids (4903/16 651; 29.4%) and lowest for benzodiazepines (239/6497; 3.7%)."

    Source: 
    Christopher M. Jones, PharmD, Karin A. Mack, PhD, and Leonard J. Paulozzi, MD, "Pharmaceutical Overdose Deaths, United States, 2010," Journal of the American Medical Association, February 20, 2013, Vol 309, No. 7, p. 658.
    http://jama.jamanetwork.com/article.aspx?articleid=1653518

  5. (Role of Psychopharmaceuticals in Overdose Deaths) "This analysis confirms the predominant role opioid analgesics play in pharmaceutical overdose deaths, either alone or in combination with other drugs. It also, however, highlights the frequent involvement of drugs typically prescribed for mental health conditions such as benzodiazepines, antidepressants, and antipsychotics in overdose deaths. People with mental health disorders are at increased risk for heavy therapeutic use, nonmedical use, and overdose of opioids.4-6 Screening, identification, and appropriate management of such disorders is an important part of both behavioral health and chronic pain management."

    Source: 
    Christopher M. Jones, PharmD, Karin A. Mack, PhD, and Leonard J. Paulozzi, MD, "Pharmaceutical Overdose Deaths, United States, 2010," Journal of the American Medical Association, February 20, 2013, Vol 309, No. 7, p. 659.
    http://jama.jamanetwork.com/article.aspx?articleid=1653518

  6. (Opioid Deaths) "From 1999 to 2007, the number of U.S. poisoning deaths involving any opioid analgesic (e.g., oxycodone, methadone, or hydrocodone) more than tripled, from 4,041 to 14,459, or 36% of the 40,059 total poisoning deaths in 2007. In 1999, opioid analgesics were involved in 20% of the 19,741 poisoning deaths. During 1999–2007, the number of poisoning deaths involving specified drugs other than opioid analgesics increased from 9,262 to 12,790, and the number involving nonspecified drugs increased from 3,608 to 8,947."

    Source: 
    "Number of Poisoning Deaths* Involving Opioid Analgesics and Other Drugs or Substances — United States, 1999–2007," Morbidity and Mortality Weekly Report, August 20, 2010, Vol. 59, No. 32 (Atlanta, GA: US Centers for Disease Control), p. 1026.
    http://www.cdc.gov/mmwr/pdf/wk/mm5932.pdf

  7. (Opiate Pain Reliever OD Deaths) "During 1999–2008, overdose death rates, sales, and substance abuse treatment admissions related to OPR increased in parallel (Figure 2). The overdose death rate in 2008 was nearly four times the rate in 1999. Sales of OPR in 2010 were four times those in 1999."

    Source: 
    Centers for Disease Control and Prevention, "Vital Signs: Overdoses of Prescription Opioid Pain Relievers — United States, 1999–2008," Morbidity and Mortality Weekly Report (Atlanta, GA: 2011), Vol. 60, No. 43, p. 1488.
    http://www.cdc.gov/mmwr/pdf/wk/mm6043.pdf

  8. (MDMA Mortality Risk) "Schifano et al. (2010) analysed the government data on recreational stimulant deaths in the UK between 1997 and 2007. Over this period, there were 832 deaths related to amphetamine or methamphetamine and 605 deaths related to Ecstasy/MDMA. Many were related to multiple-drug ingestion or ‘polydrug’ use. However, in the analysis of ‘mono-intoxication’ fatalities, Schifano et al. (2010) found that deaths following Ecstasy use were significantly more represented than deaths following amphetamine/methamphetamine use (p < 0.007)."

    Source: 
    Parrott, Andrew C., "Human Psychobiology of MDMA or 'Ecstasy': An Overview of 25 Years of Empirical Research," Human Psychopharmacology: Clinical and Experimental, 2013; 28:289-307. DOI: 10.1002/hup.2318
    http://onlinelibrary.wiley.com/doi/10.1002/hup.2318/pdf

  9. (Prescription Drug ODs) "In 2008, a total of 36,450 deaths were attributed to drug overdose, a rate of 11.9 per 100,000 population (Table 1), among which a drug was specified in 27,153 (74.5%) deaths. One or more prescription drugs were involved in 20,044 (73.8%) of the 27,153 deaths, and OPR were involved in 14,800 (73.8%) of the 20,044 prescription drug overdose deaths."

    Source: 
    Centers for Disease Control and Prevention, "Vital Signs: Overdoses of Prescription Opioid Pain Relievers — United States, 1999–2008," Morbidity and Mortality Weekly Report (Atlanta, GA: 2011), Vol. 60, No. 43, p. 1488.
    http://www.cdc.gov/mmwr/pdf/wk/mm6043.pdf

  10. (Marijuana Mortality) "Indeed, epidemiological data indicate that in the general population marijuana use is not associated with increased mortality."

    Source: 
    Janet E. Joy, Stanley J. Watson, Jr., and John A Benson, Jr., "Marijuana and Medicine: Assessing the Science Base," Division of Neuroscience and Behavioral Research, Institute of Medicine (Washington, DC: National Academy Press, 1999), p. 109.
    http://www.nap.edu/openbook.php?isbn=0309071550&page=109

  11. (Alcohol Mortality and Other Annual Costs in the US) "Excessive alcohol use* accounted for an estimated average of 80,000 deaths and 2.3 million years of potential life lost (YPLL) in the United States each year during 2001–2005, and an estimated $223.5 billion in economic costs in 2006. Binge drinking accounted for more than half of those deaths, two thirds of the YPLL, and three quarters of the economic costs."

    * Excessive alcohol use includes binge drinking (defined by CDC as consuming four or more drinks per occasion for women or five or more drinks per occasion for men), heavy drinking (defined as consuming more than one drink per day on average for women or more than two drinks per day on average for men), any alcohol consumption by pregnant women, and any alcohol consumption by youths aged less than 21 years.

    Source: 
    Kanny, Dafna; Garvin, William S.; and Balluz, Lina, "ital Signs: Binge Drinking Prevalence, Frequency, and Intensity Among Adults — United States, 2010," Morbidity and Mortality Weekly Report (Atlanta, GA: Centers for Disease Control and Prevention, January 13, 2012) Vol. 61, No. 1, p. 14.
    http://www.cdc.gov/mmwr/pdf/wk/mm6101.pdf

  12. (Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost (YPLL) in the US) "Overall, we found that alcohol use accounted for approximately 3.5% of all cancer deaths, or about 19 500 persons, in 2009. It was a prominent cause of premature loss of life, with each alcohol-attributable cancer death resulting in about 18 years of potential life lost. Although cancer risks were greater and alcohol-attributable cancer deaths more common among persons who consumed an average of more than 40 grams of alcohol per day (‡ 3 drinks), approximately 30% of alcohol-attributable cancer deaths occurred among persons who consumed 20 grams or less of alcohol per day. About 15% of breast cancer deaths among women in the United States were attributable to alcohol consumption."

    Source: 
    David E. Nelson, Dwayne W. Jarman, Jürgen Rehm, Thomas K. Greenfield, Grégoire Rey, William C. Kerr, Paige Miller, Kevin D. Shield, Yu Ye, and Timothy S. Naimi. (2013). Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost in the United States. American Journal of Public Health. e-View Ahead of Print. doi: 10.2105/AJPH.2012.301199
    Abstract at http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301199

  13. (Alcohol-Attributable Cancer Deaths in the US) "Our estimate of 19,500 alcohol-related cancer deaths is greater than the total number of deaths from some types of cancer that receive much more prominent attention, such as melanoma or ovarian cancer,36 and it amounted to more than two thirds of all prostate cancer deaths in 2009.36 Reducing alcohol consumption is an important and underemphasized cancer prevention strategy, yet receives surprisingly little attention among public health, medical, cancer, advocacy, and other organizations in the United States, especially when compared with efforts related to other cancer prevention topics such as screening, genetics, tobacco, and obesity."

    Source: 
    David E. Nelson, Dwayne W. Jarman, Jürgen Rehm, Thomas K. Greenfield, Grégoire Rey, William C. Kerr, Paige Miller, Kevin D. Shield, Yu Ye, and Timothy S. Naimi. (2013). Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost in the United States. American Journal of Public Health. e-View Ahead of Print. doi: 10.2105/AJPH.2012.301199
    Abstract at http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301199

  14. (Suicide 2010) The US Centers for Disease Control reports that in 2010, there were a total of 38,364 deaths from suicide in the US.

    Source: 
    Sherry L. Murphy, BS; Jiaquan Xu, MD; and Kenneth D. Kochanek, MA, Division of Vital Statistics, "Deaths: Final Data for 2010," (Atlanta, GA: Centers for Disease Control), Vol. 61, Number 4, May 8, 2013, Table 10.
    http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf

  15. (Drug-Induced Deaths 2010) "In 2010, a total of 40,393 persons died of drug-induced causes in the United States (Tables 10, 12 and 13). This category includes deaths from poisoning and medical conditions caused by use of legal or illegal drugs, and also includes deaths from poisoning due to medically prescribed and other drugs. It excludes unintentional injuries, homicides, and other causes indirectly related to drug use, as well as newborn deaths due to the mother's drug use. (For a list of drug-induced causes, see 'Technical Notes.' See also the discussion of poisoning mortality that uses the more narrow definition of poisoning as an injury in the section titled “Injury mortality by mechanism and intent.”)
    "In 2010, the age-adjusted death rate for drug-induced causes for the U.S. population increased 2.4 percent from 12.6 in 2009 to 12.9 in 2010 (Internet Tables I-3 and I-4). For males in 2010, the age-adjusted death rate for drug-induced causes was 1.6 times the rate for females. The age-adjusted death rate for black females was 45.6 percent lower than the rate for white females, and the rate for black males was 34.5 percent lower than the rate for white males.
    "Among the major race-sex and race-ethnic-sex groups in 2010 from 2009, the age-adjusted death rate for drug-induced causes increased significantly for white males (2.3 percent), white females (6.5 percent), non-Hispanic white males (3.1 percent), and non-Hispanic white females (6.6 percent), and decreased significantly for black males (6.5 percent), AIAN males (16.3 percent), and non-Hispanic black males (7.0 percent). Other major race-sex and race-ethnic-sex groups did not change significantly."

    Source: 
    Sherry L. Murphy, BS; Jiaquan Xu, MD; and Kenneth D. Kochanek, MA, Division of Vital Statistics, "Deaths: Final Data for 2010," (Atlanta, GA: Centers for Disease Control), Vol. 61, Number 4, May 8, 2013, pp. 17-18.
    http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf

  16. (Homicides 2010) The US Centers for Disease Control reports that in 2010, there were a total of 16,259 deaths by homicide in the US.

    Source: 
    Sherry L. Murphy, BS; Jiaquan Xu, MD; and Kenneth D. Kochanek, MA, Division of Vital Statistics, "Deaths: Final Data for 2010," (Atlanta, GA: Centers for Disease Control), Vol. 61, Number 4, May 8, 2013, Table 10.
    http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf

  17. (Mortality Risk from MDMA Use) "Hall and Henry (2006) reviewed the medical scenarios and treatment options for physicians dealing with MDMA-related medical emergencies: ‘Hyperpyrexia and multi-organ failure are now relatively well-known, other serious effects have become apparent more recently. Patients with acute MDMA toxicity may present to doctors working in Anaesthesia, Intensive Care, and Emergency Medicine. A broad knowledge of these pathologies and their treatment is necessary for those working in an acute medicine speciality’.
    "Despite rapid medical intervention, some disorders are difficult to reverse and deteriorate rapidly, with occasional fatal outcomes (Schifano et al., 2003). In an early report, Henry et al. (1992) described MDMA-induced fatalities in seven young party goers, whose body temperatures at the intensive care unit ranged between 40 C and 43 C. The causes of death include various forms of organ failure. MDMA induces apoptosis, or programmed cell death, in cultured liver cells (Montiel-Duarte et al., 2002), and another form of death is from acute liver failure (Smith et al., 2005). Other fatalities result from cardiac arrest, brain seizure, ‘rhabdomyolysis’ or the destruction of skeletal muscle tissue, and ‘disseminated intravascular coagulation’ or the failure of blood clotting—which results in uncontrollable bleeding through multiple sites (Henry et al., 1992; Hall and Henry, 2006)."

    Source: 
    Parrott, Andrew C., "Human Psychobiology of MDMA or 'Ecstasy': An Overview of 25 Years of Empirical Research," Human Psychopharmacology: Clinical and Experimental, 2013; 28:289-307. DOI: 10.1002/hup.2318
    http://onlinelibrary.wiley.com/doi/10.1002/hup.2318/pdf

  18. (Global Estimated Drug-Related Mortality, 2011) "UNODC estimates that there were between 102,000 and 247,000 drug-related deaths in 2011, corresponding to a mortality rate of between 22.3 and 54.0 deaths per million population aged 15-64. This represents between 0.54 per cent and 1.3 per cent of mortality from all causes globally among those aged 15-64.20 The extent of drug-related deaths has essentially remained unchanged globally and within regions."

    Source: 
    UNODC, World Drug Report 2013 (United Nations publication, Sales No. E.13.XI.6), p. 10.
    https://www.unodc.org/unodc/secured/wdr/wdr2013/World_Drug_Report_2013.p...

  19. (Leading Causes of Death by Race/Ethnicity, 2008) The Centers for Disease Control reported that in 2008, HIV disease was the 25th leading cause of death in the US for non-Hispanic whites, the 10th leading cause of death for non-Hispanic blacks, and the 17th leading cause of death for Hispanics.

    Source: 
    Heron, Melonie P., PhD, "Deaths: Leading Causes for 2008," National Vital Statistics Reports, Vol. 60, No. 6 (Hyattsville, MD: National Center for Health Statistics, June 6, 2012), p. 12, Table E.
    http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_06.pdf

  20. (Deaths and Serious Patient Outcomes from FDA-Approved Drugs) "These data describe the outcome of the patient as defined in U.S. reporting regulations (21 CFR 310.305, 314.80, 314.98, 600.80) and Forms FDA 3500 and 3500A (the MedWatch forms). Serious means that one or more of the following outcomes were documented in the report: death, hospitalization, life-threatening, disability, congenital anomaly and/or other serious outcome. Documenting one or more of these outcomes in a report does not necessarily mean that the suspect product(s) named in the report was the cause of these outcomes."

    AERS1 Patient Outcomes by Year
    Year Death Serious
    2000 19,445 153,818
    2001 23,988 166,384
    2002 28,181 159,000
    2003 35,173 177,008
    2004 34,928 199,510
    2005 40,238 257,604
    2006 37,465 265,130
    2007 36,834 273,276
    2008 49,958 319,741
    2009 63,846 373,535
    2010 82,724 471,291
    Total 2000-2010 452,780 2,816,297
    Total 2001-2005 162,508 959,506
    Total 2006-2010 270,827 1,702,973
    % Chg +66.7% +77.5%

    1 AERS = Adverse Events Reporting System. This system managed by the US Food and Drug Administration (FDA) contains over four million reports of adverse events and reflects data from 1969 to the present. Data from AERS are presented as summary statistics. These summary statistics cover data received over the last ten years. These data are presented at the individual report level; some of the numbers may reflect duplicate reporting due to factors such as follow-up reports received on a case or different persons reporting on the same patient case.

     
    Source: 
    "AERS Patient Outcomes by Year," Food and Drug Administration (Washington, DC: U.S. Department of Health and Human Services, March 31, 2010).
    http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveil...

  21. (Illicit Drug Use) "Illicit drug use is associated with suicide, homicide, motor-vehicle injury, HIV infection, pneumonia, violence, mental illness, and hepatitis. An estimated 3 million individuals in the United States have serious drug problems. Several studies have reported an undercount of the number of deaths attributed to drugs by vital statistics; however, improved medical treatments have reduced mortality from many diseases associated with illicit drug use. In keeping with the report by McGinnis and Foege, we included deaths caused indirectly by illicit drug use in this category. We used attributable fractions to compute the number of deaths due to illicit drug use. Overall, we estimate that illicit drug use resulted in approximately 17000 deaths in 2000, a reduction of 3000 deaths from the 1990 report."

    Source: 
    Mokdad, Ali H., PhD, James S. Marks, MD, MPH, Donna F. Stroup, PhD, MSc, Julie L. Gerberding, MD, MPH, "Actual Causes of Death in the United States, 2000," Journal of the American Medical Association, (March 10, 2004), G225 Vol. 291, No. 10, 1242.
    http://www.csdp.org/research/1238.pdf

  22. (Homicide Rates - Basic International Comparisons, 2012) "The global average homicide rate stands at 6.2 per 100,000 population, but Southern Africa and Central America have rates over four times higher than that (above 24 victims per 100,000 population), making them the sub-regions with the highest homicide rates on record, followed by South America, Middle Africa and the Caribbean (between 16 and 23 homicides per 100,000 population). Meanwhile, with rates some five times lower than the global average, Eastern Asia, Southern Europe and Western Europe are the sub-regions with the lowest homicide levels.
    "Almost three billion people live in an expanding group of countries with relatively low homicide rates, many of which, particularly in Europe and Oceania, have continued to experience a decrease in their homicide rates since 1990. At the opposite end of the scale, almost 750 million people live in countries with high homicide levels, meaning that almost half of all homicides occur in countries that make up just 11 per cent of the global population and that personal security is still a major concern for more than 1 in 10 people on the planet."

    Source: 
    UNODC Global Study on Homicide 2013 (United Nations publication, Sales No. 14.IV.1), p. 12.
    http://www.unodc.org/documents/gsh/pdfs/2014_GLOBAL_HOMICIDE_BOOK_web.pd...

  23. (Leading Causes of Death 2000) "The leading causes of death in 2000 were tobacco (435,000 deaths; 18.1% of total US deaths), poor diet and physical inactivity (400,000 deaths; 16.6%), and alcohol consumption (85,000 deaths; 3.5%). Other actual causes of death were microbial agents (75,000), toxic agents (55,000), motor vehicle crashes (43,000), incidents involving firearms (29,000), sexual behaviors (20,000), and illicit use of drugs (17,000)."

    Note: According to a correction published by the Journal on January 19, 2005, "On page 1240, in Table 2, '400,000 (16.6)' deaths for 'poor diet and physical inactivity' in 2000 should be '365,000 (15.2).' A dagger symbol should be added to 'alcohol consumption' in the body of the table and a dagger footnote should be added with 'in 1990 data, deaths from alcohol-related crashes are included in alcohol consumption deaths, but not in motor vehicle deaths. In 2000 data, 16,653 deaths from alcohol-related crashes are included in both alcohol consumption and motor vehicle death categories."

    Source: 
    Mokdad, Ali H., PhD, James S. Marks, MD, MPH, Donna F. Stroup, PhD, MSc, Julie L. Gerberding, MD, MPH, "Actual Causes of Death in the United States, 2000," Journal of the American Medical Association, (March 10, 2004), G225 Vol. 291, No. 10, p. 1238, 1240.
    http://proxy.baremetal.com/csdp.org/research/1238.pdf
    Source for Correction: Journal of the American Medical Association, Jan. 19, 2005, Vol. 293, No. 3, p. 298.

  24. (Adverse Drug Reactions) "Adverse drug reactions are a significant public health problem in our health care system. For the 12,261,737 Medicare patients admitted to U.S. hospitals, ADRs were projected to cause the following increases: 2976 deaths, 118,200 patient-days, $516,034,829 in total charges, $37,611,868 in drug charges, and $9,456,698 in laboratory charges. If all Medicare patients were considered, these figures would be 3 times greater."

    Source: 
    C. A. Bond, PharmD, FASHP, FCCP, and Cynthia L. Raehl, PharmD, FASHP, FCCP, Department of Pharmacy Practice, School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, Texas, "Adverse Drug Reactions in United States Hospitals" Pharmacotherapy, 2006;26(5):601-608.
    http://www.ncbi.nlm.nih.gov/pubmed/16637789

  25. (Adverse Drug Reaction Deaths in US Hospitals) "Our study revealed that experiencing an ADR [Adverse Drug Reaction] while hospitalized substantially increased the risk of death (1971 excess deaths, OR 1.208, 95% CI 1.184-1.234). This finding reflects about a 20% increase in mortality associated with an ADR in hospitalized patients. Extrapolating this finding to all patients suggests that 2976 Medicare patients/year and 8336 total patients/year die in U.S. hospitals as a direct result of ADRs; this translates to approximately 1.5 patients/hospital/year."

    Source: 
    C. A. Bond, PharmD, FASHP, FCCP and Cynthia L. Raehl, PharmD, FASHP, FCCP, "Adverse Drug Reactions in United States Hospitals," Pharmacotherapy, 2006;26(5):601-608.
    http://www.medscape.com/viewarticle/531809
    http://www.ncbi.nlm.nih.gov/pubmed/16637789

  26. (Marijuana Safety - DEA Administrative Law Judge's Ruling)
    "3. The most obvious concern when dealing with drug safety is the possibility of lethal effects. Can the drug cause death?
    "4. Nearly all medicines have toxic, potentially lethal effects. But marijuana is not such a substance. There is no record in the extensive medical literature describing a proven, documented cannabis-induced fatality.
    "5. This is a remarkable statement. First, the record on marijuana encompasses 5,000 years of human experience. Second, marijuana is now used daily by enormous numbers of people throughout the world. Estimates suggest that from twenty million to fifty million Americans routinely, albeit illegally, smoke marijuana without the benefit of direct medical supervision. Yet, despite this long history of use and the extraordinarily high numbers of social smokers, there are simply no credible medical reports to suggest that consuming marijuana has caused a single death.
    "6. By contrast aspirin, a commonly used, over-the-counter medicine, causes hundreds of deaths each year.
    "7. Drugs used in medicine are routinely given what is called an LD-50. The LD-50 rating indicates at what dosage fifty percent of test animals receiving a drug will die as a result of drug induced toxicity. A number of researchers have attempted to determine marijuana's LD-50 rating in test animals, without success. Simply stated, researchers have been unable to give animals enough marijuana to induce death.
    "8. At present it is estimated that marijuana's LD-50 is around 1:20,000 or 1:40,000. In layman terms this means that in order to induce death a marijuana smoker would have to consume 20,000 to 40,000 times as much marijuana as is contained in one marijuana cigarette. NIDA-supplied marijuana cigarettes weigh approximately .9 grams. A smoker would theoretically have to consume nearly 1,500 pounds of marijuana within about fifteen minutes to induce a lethal response.
    "9. In practical terms, marijuana cannot induce a lethal response as a result of drug-related toxicity."

    Source: 
    US Department of Justice, Drug Enforcement Administration, "In the Matter of Marijuana Rescheduling Petition" (Docket #86-22), September 6, 1988, p. 56-57.
    http://druglibrary.net/olsen/MEDICAL/YOUNG/young4.html

  27. (Dangers of New Prescription Drugs) "Each year offers new examples of injuries and deaths caused by untoward dangers in prescription drugs. Prominent illustrations from recent years include Vioxx, a popular arthritis painkiller that more than doubled the risk of heart attacks and strokes,6 a risk that lingered long after users stopped taking the drug;7 'Phen-fen,' a diet drug that caused heart damage;8 and Propulsid, a drug that reduced gastric acid but also threatened patients’ hearts.9 Once information on these side-effects became known to the public, the manufacturers of each of these drugs stopped selling them and, eventually, paid millions or billions of dollars to settle claims for resulting injuries.10 Merck, for example, having withdrawn the profitable Vioxx drug11 from the market in 2004, settled nearly 50,000 Vioxx cases in late 2007 for $4.85 billion.12 In 2009, Eli Lilly agreed to plead guilty and pay $1.415 billion in criminal and civil penalties for promoting its antipsychotic drug, Zyprexa, as suitable for uses not approved by the Food and Drug Administration (“FDA”).13 These cases may be among the more prominent, but they represent just the tip of the iceberg of damage caused by prescription drugs."

    Source: 
    Owen, David G., "Dangers in Prescription Drugs: Filling a Private Law Gap in the Healthcare Debate," Connecticut Law Review (Hartford, CT: University of Connecticut School of Law, February 2010) Volume 42, Number 3, p. 737.
    http://uconn.lawreviewnetwork.com/files/documents/DavidG.Owen-DangersinP...

  28. (Acetaminophen-Related Liver Injury)
    "... acetaminophen-related liver injury led to approximately
    • 56,000 emergency department visits (1993–1999),
    • 26,000 hospitalizations (1990–1999), and
    • 458 deaths (1996–1998).
    "Of these cases, unintentional acetaminophen overdose was associated with
    • 13,000 emergency department visits (1993–1999),
    • 2189 hospitalizations (1990–1999), and
    • 100 deaths (1996–1998) (71 FR 77314 at 77318)."

    Source: 
    Federal Register, "Organ-Specific Warnings; Internal Analgesic, Antipyretic, and Antirheumatic Drug Products for Over-the-Counter Human Use; Final Monograph," Vol. 74, No. 81, Wednesday, April 29, 2009, p. 19385.
    http://www.gpo.gov/fdsys/pkg/FR-2009-04-29/pdf/E9-9684.pdf

  29. (NSAIDS) "Each year, use of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) accounts for an estimated 7,600 deaths and 76,000 hospitalizations in the United States." (NSAIDs include aspirin, ibuprofen, naproxen, diclofenac, ketoprofen, and tiaprofenic acid.)

    Source: 
    Robyn Tamblyn, PhD; Laeora Berkson, MD, MHPE, FRCPC; W. Dale Jauphinee, MD, FRCPC; David Gayton, MD, PhD, FRCPC; Roland Grad, MD, MSc; Allen Huang, MD, FRCPC; Lisa Isaac, PhD; Peter McLeod, MD, FRCPC; and Linda Snell, MD, MHPE, FRCPC, "Unnecessary Prescribing of NSAIDs and the Management of NSAID-Related Gastropathy in Medical Practice," Annals of Internal Medicine (Washington, DC: American College of Physicians, 1997), September 15, 1997, 127:429-438.
    http://annals.org/article.aspx?articleid=710808
    Citing: Fries, JF, "Assessing and understanding patient risk," Scandinavian Journal of Rheumatology Supplement, 1992;92:21-4.

  30. (Lethal Dose by Substance) "The most toxic recreational drugs, such as GHB (gamma-hydroxybutyrate) and heroin, have a lethal dose less than 10 times their typical effective dose. The largest cluster of substances has a lethal dose that is 10 to 20 times the effective dose: These include cocaine, MDMA (methylenedioxymethamphetamine, often called 'ecstasy') and alcohol. A less toxic group of substances, requiring 20 to 80 times the effective dose to cause death, include Rohypnol (flunitrazepam or 'roofies') and mescaline (peyote cactus). The least physiologically toxic substances, those requiring 100 to 1,000 times the effective dose to cause death, include psilocybin mushrooms and marijuana, when ingested. I’ve found no published cases in the English language that document deaths from smoked marijuana, so the actual lethal dose is a mystery."

    Source: 
    Gable, Robert S., "The Toxicity of Recreational Drugs," American Scientist (Research Triangle Park, NC: Sigma Xi, The Scientific Research Society, May-June 2006) Vol. 94, No. 3, p. 207.
    http://www.americanscientist.org/libraries/documents/200645104835_307.pd...