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Anti-Drugwar Strategy: Deciphering Death Statistics

Deaths due to the use of drugs is one of the cornerstone reasons given for waging the drug war. To comprehend death statistics with respect to drug use requires that we have access to mortality data and to population and drug use data. With those three pieces of information, we can create the coherent context that allows various claims to be evaluated. At this point, though, we need to be clear about some of the common terminology used to make claims about how drugs are involved as an agent of death. In general, statistics about deaths as they relate to drugs can be divided into two types: those which result from a direct causal chain of events in which the use of the drug was followed immediately by death (these are "drug-induced" deaths), and those that are caused by the cumulative effects of the use of the drugs over some period of time, and the ensuing physical consequences somehow related to the use of the drugs (these are "drug-related" deaths).

With respect to deciphering claims about drug deaths, I believe that all discussion of mortality and drug use needs to be confined to those that are "drug-induced." Primarily I make this statement because such deaths are the only sort of drug mortality statistic where the underlying data set is invariate. These numbers are based on the "official" underlying cause of death determinations entered on the certificate of death, while those used to generate statistics about "drug-related" deaths use varying criteria for inclusion making them difficult to reconcile across claims made by different researchers. In addition, the ONDCP uses drug-induced as the criteria for their tally of annual deaths due to drug use. Also, and perhaps of greater importance, cumulative effects of various lifestyle choices are themselves subject to tremendous variations across different populations and exclusion or inclusion criteria. Ultimately, though, let's be practical: if what you do takes a while to kill you, it really can't be so "dangerous" that it requires legal intervention to "protect" you from it.

Sources: US Census Bureau
Centers For Disease Control

Pertinent Data Sources & Critical Questions

Primary Data Source(s): Centers For Disease Control On-line Mortality Database
National Vital Statistics Reports -- Deaths: Final Data For 2003 (3.7M PDF File)
Context Data Source(s): National Survey on Drug Use and Health: 2004 Results
Census Bureau Annual Population Estimates: On-Line Query
Critical Questions:
  • 1. What percentage of the population dies every year?
  • 2. What percentage of all deaths involve drugs?
  • 3. What percentage of drug deaths are due to illegal drugs?
  • 4. What percentage of illegal drug users die from drug-induced causes?
  • 5. What other accidental causes of death kill the same number of people or more than illegal drugs?
  • 6. If some human activity kills more people than drugs do, should that activity also be illegal?

Obviously this same set of data and questions can be applied on a drug by drug basis. Unfortunately, going directly to the source data is not always easy and the CDC's mortality database requires that you have the proper codes for causes of death in order to do your own queries. The specific codes used to tally drug-induced mortality can be found in the NVSR link above and entered into the CDC WONDER interface. But that's one of the thing's I'm here for, and I've already crunched the mortality numbers in a variety of ways using the queries hyperlinked below in the answers.

And Pertinent Answers

Question 1: About 0.85 percent (less than one percent) of Americans died in 2002 from all causes: 2,443,387 deaths out of the total population of 288,356,713.

Question 2: Slightly over 1 percent (1.07) of all deaths were classified as drug-induced in 2002: 26,204 deaths out of 2,443,387 total deaths. That is less than one one-hundreth of one percent (0.009) of the entire population. However, alcohol is also a drug, and there were a total 19,928 alcohol induced deaths, accounting for eight-tenths of one percent (0.815) of all deaths. There were 155,476,000 past year alcohol users in 2002, meaning that just over one one-hundredth of one percent (0.013) of all past year alcohol users died directly from alcohol-induced causes. Combining all drug-induced and all alcohol-induced deaths yields 46,132 such deaths: or about 0.016% of the total population, and nearly 1.9 percent (1.88) of all deaths. While pursuing some of these other numbers, I discovered this item of interest: 58,866 deaths in 2002 (0.02 percent of the total population, 2.4 percent of all deaths) were caused by Alzheimer's Disease -- but there is no war on it.

Question 3: This one is a little tough to properly tease out, but removing the codes from question 2 that are clearly related only to legal drugs yields 12,770 deaths, or about 49 percent of all drug-induced deaths. That number, however, likely includes a lot of deaths that are caused by the misuse of completely legal pharmaceutical drugs and other situations which may or may not qualify them as being induced by "illicit" drug use. The total number of deaths clearly attributable to drug misuse of some sort, however, is thus about one-half of one percent of all deaths from all causes, or slightly over 4 one-thousandths of one percent (0.0044) of the total population.

Interestingly, according to the 2003 data in the National Vital Statistics Reports, some new categories of causes of death have been added to the criteria for tabulating drug induced deaths. Using the new codes on the 2002 data involves the following ICD-10 codes: group 1 codes, group 2 codes, group3 codes [NOTE: these "groups" are arbitrary and necessitated by the query interface limitations]. Using these additional codes for the 2002 data only yields 162 more deaths to add to the total for drug-induced causes of death -- none of which are from illegal drugs. Other codes have also been instituted for alcohol-induced deaths beginning in 2003. When added to the existing codes for the 2002 data, 290 additional deaths can be classified as "alcohol-induced."

Question 4: For this we need to know how many people were involved in illicit drug use within the past year for the given year of interest. That data is in the latest National Survey on Drug Use and Health, in Appendix H, which tallies 35,132,000 Americans who had used an illegal substance, or misused a legal substance during the year 2002. Thus, if 12,770 deaths can be shown to have potentially involved either illegal drugs or the misuse of legal drugs it means that nearly four one-hundredths of one percent (0.036) of past year recreational drug users died from drug-induced causes in 2002 -- which is less than half the general mortality rate (0.85%) for death from all causes among the general population. It should also be noted that of all drug-induced deaths in 2002, 16,394 (63%) were due to accidental overdose, while another 3,884 (15%) were due to intentional overdose.

Question 5: Now this is fun! Obviously, you can examine all the numbers on all the causes of death for 2002 and scroll through it to you heart's delight. However, I believe it pertinent to narrow the focus to causes of death that are due more to human folly than to disease mechanisms. So with that in mind, I narrowed the query to accidental deaths. Humans do a lot of silly things.

Question 6: I studied all the drug induced causes of death for the years 1979 through 1998 and while having my attention diverted to other questions about various causes of death generated my "big list of deaths" comparison table. It tallies the deaths on a drug by drug basis and puts those numbers in context with a lot of other things that are "preventable" causes of death. I will do the same thing for the newer data (starting in 1999 the coding system was changed), but it is extremely difficult to do direct comparisons between the two data sets -- particularly for "drug-induced" deaths. Once I acquire all the raw data for the years since 1999, I intend to do a full exploitation of it so I can get a more accurate answer as to how many "drug-induced" deaths since 1999 actually involved the use of illegal drugs. The 20 year precedent (1979 - 1998) is that 79 percent of such deaths involve only legal drugs. Meanwhile, during that time, skin cancer killed nearly three times as many people as all illegal drugs combined. Should we make it "illegal" to get a sunburn?

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