What's the drug that 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.

Well, you were right - 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. For example, a stimulant drug may cause death in a vulnerable individual with an undiagnosed heart problem.

It is often the case that a death occurs as a result of the combined effect of alcohol and illicit drugs making it difficult to attribute the death to one specific substance. Sometimes deaths may occur as a result of ill health caused by alcohol or drug use many years ago and there are instances when doctors may not record drugs on a death certificate even where drugs might be involved. Despite these difficulties there are estimates of the number of deaths associated with different tobacco, alcohol and drugs.

When you look at the statistics, smoking is by far the leading cause of preventable death. Worldwide, tobacco use causes nearly 6 million deaths per year, and current trends show that tobacco use will cause more than 8 million deaths annually by 2030. Around 15,000 people die every year in Australia due to smoking – that's about 40 each day!

According to the World Health Organisation, in 2012, there were around 3.3 million deaths attributable to alcohol consumption. That accounts for around one in 20 of all global deaths. The number of Australians that die due to alcohol can vary each year from between 3,500 up to more than 5,000. That means up to 15 alcohol-related deaths per day.

There are many prescription drugs that can cause death and in recent years it is the painkillers such as oxycodone, morphine and codeine and benzodiazepines, a range of drugs used to treat anxiety or sleep problems, which lead to many accidental and intentional fatal overdoses. Using drugs in combination (or 'polydrug' use) is often the cause of death. For example, the latest statistics show that in 2016 over 96% of benzodiazepine deaths in Australia involved other drugs including alcohol.

In 2014, there were an estimated 207,400 illicit drug-related deaths worldwide. Overdose deaths account for almost half of these worldwide, and in most cases the drugs involved were opioids (i.e., drugs like heroin). According to the latest Australian statistics, in 2016 the total number of prescription and illicit drug-related deaths was 1,808 – the highest number in 20 years. Stimulant drugs including methamphetamine (speed or ice) and MDMA (ecstasy), as well as heroin accounted for 724 of these deaths.

Using any drug involves risk. Using alcohol, prescribed or illicit drugs at the same time massively increases the risk of illness and death.