Estimated Per Capita Death Rates by Drugs

Drug    Users           Deaths per Year         Deaths per 100,000
Tobacco 60 million      390,000 (a)             650
alcohol 100 million     150,000 (b)             150
Heroin  500,000         400 (c)                 80 (400)
Cocaine 5 million       200 (c)                 4 (20)

(a) "Reducing the Health Consequences of Smoking: 25 Years of Progress" Surgeon General's Report (1989).

(b) Estimates vary greatly, depending upon whether all health consequences, or only those traditionally associated with alcoholism, are considered. The Fifth Special Report to the U.S. Congress on Alcoholism and Health from the Secretary of Health and Human Services contains two references indicating a death toll of 200,000: The report states, first, that alcohol "plays a role in 10% of all deaths in the United States," which comes to about 200,000 deaths each year. P. vi. It further states that present estimates of the death toll from alcohol abuse are as high as 93.2 per 100,000. Ibid., p. x. This ratio translates into a total of about 210,000.

(c) These figures were determined as follows: Drug Abuse Warning Network (DAWN) heroin and cocaine fatalities for 1984, 1985, and 1986 were averaged. The number of suicides was subtracted. The figures were discounted to account for deaths in which both heroin and cocaine played a role. Since DAWN covers about one-third of the nation's population but almost all major urban areas where drug use florishes, totals were doubled to arrive at yearly estimates of 2,000 for heroin deaths and 1,000 for cocaine deaths. Finally, these figures were dis- counted by 80 percent in accordance with the analysis presented in the text.