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Don't believe it? This chart compares those drug deaths with the best available data for cocaine, heroin, and marijuana deaths:. Now, this chart isn't a perfect comparison across the board. One driver of tobacco and alcohol deaths is that both substances are legal and easily available. Other substances would likely be far deadlier if they were as available as tobacco and alcohol. And federal data excludes some deaths, such as drugged driving deaths, which is why the chart focuses on direct health complications for all drugs. Deaths also aren't the only way to compare drugs' harms.
Some drugs, such as alcohol and cocaine, may induce dangerous behavior that makes someone more predisposed to violence or crime. Other drugs, like psychedelicsmay trigger underlying mental health problems or psychotic episodes. When evaluating the overall harm caused by drugs, all of these factors should be taken into.
But the high total of deaths is still a major concern for public health policy. And according to experts and researchers, lawmakers could do Top legal drugs to curb deaths caused by the three deadliest drugs — if only they paid more attention to legal drug policy.
When it comes Top legal drugs deadliness, no single substance comes close to tobacco. To put its risk in perspective, more Americans die from tobacco-caused health problems like lung cancer and heart disease than from reported drug overdosescar crashesand homicides combined. The chart at Top legal drugs top of this article actually understates the of tobacco deaths, since it only considers the most direct causes of deaths and excludes secondhand smoking, perinatal conditions, and residential fires.
Overall, cigarette smoking is linked to one in five deaths in the US each year, according to CDC estimates for average annual fatalities based on deaths between and Nearly 42, of the totaldeaths from smoking are caused by secondhand smoke. US tobacco use has greatly declined in the past several decades, although nearly one in six high school students and adults still smoked cigarettes in and Experts attribute the decline to various factorsincluding education campaigns, mandatory warning labels, public and workplace smoking bans, and higher taxes on tobacco products.
Continuing these efforts, public health officials hope, will continue pushing down the rate of smoking in the US. But states could also take additional steps, like increasing the smoking age. Alcohol-induced health problems, such as liver disease, led to more than 33, deaths in But that actually undercounts the of deaths caused by alcohol: When including Top legal drugs causes of death like drunk driving and homicides, the toll rises to 88, per year. This might be an undercount too, since it's an estimate for to and alcohol-linked deaths have steadily risen over the past several years.
The death toll may understate the more general risk of alcohol. A analysisled by British researcher David Nutt and published in The Lancettook a comprehensive look at 20 of the world's most popular drugs and the risks they pose in the UK. A conference of drug experts measured all the factors involved — mortality, other physical damage, chance of developing dependence, impairment of mental function, effect on crime, and so on — and ased each drug a score.
They concluded alcohol is by far the most dangerous drug to society as a whole. What makes alcohol so dangerous? The health effects of excessive drinking and drunk driving are Top legal drugs obvious problems. But there are other major issues rooted in alcohol-induced aggression and erratic behavior: injuries, economic productivity costs, family adversities, and crime. Alcohol is a factor in 40 percent of violent crimes, according to the National Council on Alcoholism and Drug Dependence. Still, The Lancet 's report has come under some major criticisms. Although drug policy experts generally agree that alcohol is dangerous — and definitely more dangerous than marijuana — they argue the report misses some of the nuance behind each drug's harms.
For one, it doesn't entirely control for the availability of these drugs, so it's possible heroin and crack cocaine in particular would be ranked higher if they were as readily available as alcohol. And the findings are based on the UK, so the specific scores would likely differ to some extent for the US — particularly for meth, which is more widely available in the states. To show the Nutt analysis's flaws, Jon Caulkins, a drug policy expert at Carnegie Mellon University, gave the example of an alien race visiting Earth and asking which land animal is the biggest.
If the question is about weight, the Top legal drugs elephant is the biggest land Top legal drugs. But if it's about height, the giraffe is the biggest. And if the question is about length, the reticulated python is the biggest. The blunt measures of drug harms present similar issues.
Alcohol, tobacco, and opioid painkillers are likely deadlier than other drugs because they are legal, so comparing their aggregate effects to illegal drugs is difficult. Some drugs are very harmful to individuals, but they're so rarely used that they may not be a major public health threat. A few drugs pose more short-term than long-term risks through overdose heroinwhile others are more dangerous in the long term due to chronic health problems tobacco.
And looking at deaths or other harms caused by certain drugs doesn't always for substances, such as prescription medications, that are often mixed with others, making them more deadly or harmful than they would be alone. Still, experts acknowledge, it's clear alcohol is dangerous and deadly. To curb the deaths and risks linked to alcohol, they often suggest tighter regulations, higher taxes, more education, and even taking away some people's right to drink. A analysis by the RAND Corporation found that states that sold alcohol through tightly regulated, state-run establishments kept prices higher, reduced access for youth, and decreased drinking overall.
Studies show that higher alcohol taxes could reduce consumption and, as a result, the problems the drug causes. Highly addictive opioid painkillers are now part of a national epidemic of overdose deaths. In the s, drug companies, such as Purdue Pharmapushed opioid painkillers on doctors and patients through an aggressive, misleading marketing campaign.
Doctors, who were under pressure from advocates and government agencies to treat pain as a serious medical issue, prescribed the drugs in huge droves, letting them proliferate — not just to patients, but to the patients' family and friends and the black market. As a result, opioid painkiller deaths skyrocketed. Opioid overdose deaths sometimes involve multiple Top legal drugs. Benzodiazepines and alcohol, for instance, can increase the risk of an opioid overdose. But without opioids, these deaths may have been avoided entirely.
Policymakers have responded to the rise in deaths by putting tighter restrictions on the distribution of opioid painkillers and cracking down on "pill mills," which are doctors, clinics, and pharmacies that dispense opioid painkillers unscrupulously or for nonmedical reasons. In part as a response to the crackdown, some opioid users turned to other opioids that are more potent and potentially more easily accessible — notably, heroin and fentanyl.
For public health officials, this has emphasized the need to increase prevention and treatment programs, particularly medication-assisted treatments such as methadone and Suboxone, to try to get people off opioids for good. After all, unless people overcome their addiction, cuts in the supply are only going to lead people to try to get their fix somewhere else. There's also concerns that restricting painkillers Top legal drugs much makes it more difficult for people to get the medicine they genuinely need for chronic, debilitating pain.
A report from the Institute of Medicine found that many Americans are undertreated for acute and chronic pain. And multiple reports suggest doctors have avoided working in chronic pain treatment because the legal and regulatory hurdles are so big.
Still, the evidence on whether opioid painkillers can even treat chronic pain is weak at besteven as it's clear that prolonged use can result in very bad risks and complications. One way to fill this need for treatment without resorting to dangerous opioids may be medical marijuana.
Several studies have found that states that allow pot for medicinal purposes — particularly states that allow dispensaries, where marijuana is sold — have fewer prescription painkiller deaths than one would otherwise expect. Intuitively, this makes sense: Marijuana is a potent painkiller for some types of pain, so it can potentially substitute deadlier and Top legal drugs addictive opioids in some cases.
Still, while marijuana may work for some patients, it may not for many others. This leaves opioid painkillers as one of the few medications for some pain patients, which requires doctors and regulators to balance out patients' needs with the risk these addictive, deadly drugs present. There's admittedly no good federal mortality data on the less direct and long-term Top legal drugs of illicit drug use. But there's reason to think the scale of overall deadliness in the chart at the top of this article wouldn't change much with additional data.
The deadliness of the harder drugs, like crack and cocaine, is severely limited in part because very few people use such substances, especially in the long term. About 0. This could change if the illicit drugs were legal and more accessible. Still, these harder drugs are dangerous. Cocaine and crack can lead to heart attack and stroke, and they can cause violent behaviors that make someone more prone to crime. And heroin poses a massive risk of deadly overdose — a risk that only gets worse as someone uses heroin more and more. Marijuana is more widely used, but it's never been definitively linked to direct deaths or even other medical conditions.
The most thorough review of the research yetfrom the National Academies of Sciences, Engineering, and Medicinefound that pot poses a variety of possible downsides — including respiratory problems if smoked, schizophrenia and psychosis, car crashes, general social achievement in life, and potentially babies in the womb. But pot doesn't appear to pose a high risk, if any, of deadliness outside of car crashes Top legal drugs other accidental deaths.
The research review found smoking pot doesn't even seem to cause some of the major health problems that are typically linked to tobacco, particularly lung cancer and head and neck cancers. And the studies reviewed also suggest marijuana carries several Top legal drugs, particularly for chronic pain, multiple sclerosis, and chemotherapy-induced nausea and vomiting.
There wasn't enough research to gauge if pot is truly good for some of the other ailments people say it's good for, such as epilepsy and irritable bowel syndrome. When that's hours per day times years, that's bad. Caulkins of Carnegie Mellon University put it another way: "At some level, we know that spending more than half of your waking hours intoxicated for years and years on end is not increasing the likelihood that you'll win a Pulitzer Prize or discover the cure for cancer.
So a drug's deadliness isn't everything we need to know about its harms. But deadliness is still a powerful measure — and it suggests that the Top legal drugs and policymakers shouldn't assume that a substance is more dangerous to society as a whole just because it's illegal. In fact, based on the s, it's legal drugs that may require more policy attention.
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Commonly Abused Prescription and OTC Drugs