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What drug kills more people than any other?

“What’s the drug that kills more people than any other? We had a debate in class and we couldn’t agree on which one it was. I think it’s tobacco but others thought it was illegal drugs like ice and heroin.”

You’re correct – across the world, tobacco kills more people than any other drug. In countries like Australia, alcohol is the second largest cause of drug-related deaths, followed by prescription medications and illicit drugs.

Before we look at the actual numbers, it is important to understand what we mean by a ‘drug death’. In Australia, deaths are considered ‘drug-induced’ if directly attributable to drug use. For example, when an alcohol or drug overdose occurs. Drugs can also contribute to ‘drug-related deaths’ as a result factors such as violence, driving while drunk or intoxicated or when an underlying health condition exists. Deaths often occur as a result of the combined effect of alcohol and illicit drugs and that makes it hard to attribute the death to one specific substance. Despite these difficulties there are estimates of the number of deaths associated with the use of tobacco, alcohol and other drugs.

Smoking is by far the leading cause of preventable death. Worldwide, tobacco kills more than 8 million people each year, amazingly this includes around 1.3 million non-smokers who are exposed to second-hand smoke. The Cancer Council reports that it claims the lives of around 24,000 Australians every year – that’s about 66 each day!

According to the World Health Organisation (WHO), there are around 3 million deaths every year that result from the harmful use of alcohol. That accounts for around one in 20 of all global deaths. In 2022, 1,742 people in Australia died of an alcohol-induced death, such as chronic conditions like liver cirrhosis or acute conditions such as alcohol poisoning. However, there are far more ‘alcohol-related’ deaths (including those who died in car crashes, alcohol-related violence, etc), with around 5,500 Australians dying each year from alcohol-attributable causes – that’s about one every 90 minutes!

When it comes to other drugs, whether they be illegal or pharmaceutical, according to the most recent Australian data it is the opioid group of drugs (e.g., heroin and pharmaceutical painkillers such as oxycodone, morphine and codeine) that result in the most deaths. Benzodiazepines, a range of drugs used to treat anxiety or sleep problems, are the next most likely to be detected in fatal overdoses, with stimulant drugs such as methamphetamine (speed or ice) contributing to about one quarter of drug-induced deaths.

It’s important to note that deaths involving the use of multiple drugs (that is called ‘polydrug use’) are far more common than those associated with just one drug. Using one drug involves risk, but combining alcohol, prescribed or illicit drugs massively increases the possibility of something going wrong.

First published: February 2018
Reviewed and updated: March 2024

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