NCHS Data Brief ■ No. 81 ■ December 2011

Drug Poisoning Deaths in the United States, 1980–2008

Margaret Warner, Ph.D.; Li Hui Chen, Ph.D.; Diane M. Makuc, Dr.P.H., 

Robert N. Anderson, Ph.D.; and Arialdi M. Miniño, M.P.H.

Key fi ndings

Data from the National 

Vital Statistics System 

Mortality File

• In 2008, poisoning became 

the leading cause of injury 

death in the United States and 

nearly 9 out of 10 poisoning 

deaths are caused by drugs. 

• During the past three 

decades, the number of drug 

poisoning deaths increased 

sixfold from about 6,100 in 

1980 to 36,500 in 2008.

• During the most recent 

decade, the number of drug 

poisoning deaths involving 

opioid analgesics more than 

tripled from about 4,000 in 

1999 to 14,800 in 2008. 

• Opioid analgesics were 

involved in more than 40% of 

all drug poisoning deaths in 

2008, up from about 25% in 

1999.

• In 2008, the drug poisoning 

death rate was higher for males, 

people aged 45–54 years, 

and non-Hispanic white and 

American Indian or Alaska 

Native persons than for females 

and those in other age and 

racial and ethnic groups. 

In 2008, over 41,000 people died as a result of a poisoning. One of the 

Healthy People 2020 objectives, retained from Healthy People 2010, is to 

reduce fatal poisonings in the United States (1). However, poisoning mortality 

increased during the Healthy People 2010 tracking period. Drugs—both legal 

and illegal—cause the vast majority of poisoning deaths. Misuse or abuse of 

prescription drugs, including opioid analgesic pain relievers, is responsible for 

much of the increase in drug poisoning deaths (see “Defi nitions” section). This 

report highlights trends in poisoning deaths, drug poisoning deaths, and the 

type of drugs involved in drug poisoning deaths and updates a previous data 

brief on this topic (2).

Keywords: opioid analgesics • overdose • prescription pain relievers • 

National Vital Statistics System Mortality File 

Poisoning is now the leading cause of death from injuries 

in the United States and nearly 9 out of 10 poisoning deaths 

are caused by drugs.

Drug poisoning

Poisoning

Motor vehicle traffic

0

5

10

15

20

25

Deaths per 100,000 population

1980 1984 1988 1992 1996 2000 2004 2008

Year

Figure 1. Motor vehicle traffic, poisoning, and drug poisoning death rates: United States, 

1980–2008

NOTE: In 1999, the International Classification of Diseases, Tenth Revision (ICD–10) replaced the previous revision of the ICD 

(ICD–9). This resulted in approximately 5% fewer deaths being classified as motor-vehicle traffic–related deaths and 2% more

deaths being classified as poisoning-related deaths. Therefore, death rates for 1998 and earlier are not directly comparable with

those computed after 1998. Access data table for Figure 1 at http://www.cdc.gov/nchs/data/databriefs/db81_tables.pdf#1. 

SOURCE: CDC/NCHS, National Vital Statistics System.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics
NCHS Data Brief ■ No. 81 ■ December 2011

■ 2 ■

In 2008, the number of poisoning deaths exceeded the number of motor vehicle traffi c deaths 

for the fi rst time since at least 1980. In 2008, there were more than 41,000 poisoning deaths, 

compared with about 38,000 motor vehicle traffi c deaths. In 2008, 89% of poisoning deaths were 

caused by drugs.

During the past three decades, the poisoning death rate per 100,000 population nearly tripled from 

4.8 in 1980 to 13.5 in 2008, while the motor vehicle traffi c death rate decreased by almost onehalf from 22.9 in 1980 to 12.5 in 2008 (Figure 1). In the most recent decade, from 1999 to 2008, 

the poisoning death rate increased 90%, while the motor vehicle traffi c death rate decreased 15%.

From 1980 to 2008, the percentage of poisoning deaths caused by drugs increased from 56% to 

89%. In 2008, about 77% of the drug poisoning deaths were unintentional, 13% were suicides, 

and 9% were of undetermined intent (see Appendix table). 

Poisoning is the leading cause of death from injury in 30 states. 

In 2008, poisoning was the leading cause of injury death in the following 30 states: Alaska, 

Arizona, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Indiana, 

Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, 

New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, 

Washington, West Virginia, and Wisconsin (Figure 2).

In 2008, age-adjusted poisoning death rates varied by state, ranging from 7.6 to 30.8 per 100,000 

population. In 20 states, the age-adjusted poisoning death rate was signifi cantly higher than the 

U.S. rate of 13.4 deaths per 100,000 population.

The fi ve states with the highest poisoning death rates were New Mexico (30.8), West Virginia 

(27.6), Alaska (24.2), Nevada (21.0), and Utah (20.8). In 43 states over 80% of poisoning deaths 

were caused by drugs (data not shown). 

Figure 2. Age-adjusted poisoning death rates: Comparison of state and U.S. rates: United States, 2008

NOTES: The poisoning death rate for Georgia may not be based on the final numbers of poisoning deaths. See “Data source and methods” for details. Figure 2 at 

http://www.cdc.gov/nchs/data/databriefs/db81_tables.pdf#2. 

SOURCE: CDC/NCHS, National Vital Statistics System.

MT

WY

ID

OR*

ND

SD

NE

CO*

TX

KS

AR

LA

IA

MN*

W I*

IL* IN*

GA

FL*

S C

VA

OH*

MI* NY*

PA*

MD*

DE*

NJ*

CT*

R I*

MA*

ME* NH*

NM* OK

MO

TN NC

KY*

WV*

VT*

NV* UT*

AK*

HI* Rate significantly higher than U.S. rate 

*Poisoning is the leading cause of injury death.

Rate significantly lower than U.S. rate

Rate not significantly different than U.S. rate

DC

MS AL

WA*

C A*

AZ*
NCHS Data Brief ■ No. 81 ■ December 2011

■ 3 ■

Opioid analgesics were involved in more than 40% of drug poisoning 

deaths in 2008. 

Of the 36,500 drug poisoning deaths in 2008, more than 40% (14,800) involved opioid analgesics 

(Figure 3). For about one-third (12,400) of the drug poisoning deaths, the type of drug(s) involved 

was specifi ed on the death certifi cate but it was not an opioid analgesic. The remaining 25% 

involved drugs, but the type of drugs involved was not specifi ed on the death certifi cate (for 

example, “drug overdose” or “multiple drug intoxication” was written on the death certifi cate).

Figure 3. Number of drug poisoning deaths involving opioid analgesics and other drugs: United States, 1999–2008

1 Opioid analgesics include natural and semi-synthetic opioid analgesics (for example, morphine, hydrocodone, and oxycodone) and synthetic opioid analgesics (for 

example, methadone and fentanyl). Some deaths in which the drug was poorly specified or unspecified may involve opioid analgesics.

NOTES: Drug categories are mutually exclusive. Access data table for Figure 3 at http://www.cdc.gov/nchs/data/databriefs/db81_tables.pdf#3.

SOURCE: CDC/NCHS, National Vital Statistics System.

Year

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

Number of deaths

Any opioid analgesic1

Specified drug(s) other

than opioid analgesic

Only nonspecified drug(s)

From 1999 to 2008, the number of drug poisoning deaths involving opioid analgesics increased 

from about 4,000 to 14,800, more rapidly than deaths involving only other types of drugs or only 

nonspecifi ed drugs.

From 1999 to 2008, the number of drug poisoning deaths involving only nonspecifi ed drugs 

increased from about 3,600 to about 9,200. Some drug poisoning deaths for which the drug was 

not specifi ed may involve opioid analgesics.

Natural and semi-synthetic opioid analgesics such as morphine, 

hydrocodone, and oxycodone were involved in over 9,100 drug poisoning 

deaths in 2008, up from about 2,700 in 1999. 

Of the 14,800 drug poisoning deaths involving opioid analgesics in 2008, the majority involved 

natural and semi-synthetic opioid analgesics such as morphine, hydrocodone, and oxycodone. 

The number of drug poisoning deaths involving natural and semi-synthetic opioid analgesics 

increased steadily each year from about 2,700 deaths in 1999 to over 9,100 deaths in 2008 

(Figure 4).

The number of drug poisoning deaths involving methadone, which is a synthetic opioid analgesic 

used to treat opioid dependency as well as pain, increased sevenfold from about 800 deaths in 

1999 to about 5,500 in 2007. Between 2007 and 2008, the number of deaths involving methadone 

decreased by nearly 600 deaths, the fi rst decrease since 1999.
NCHS Data Brief ■ No. 81 ■ December 2011

■ 4 ■

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

Year

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

NOTES: Opioid analgesic categories are not mutually exclusive. Deaths involving more than one opioid analgesic category shown in this figure are counted 

multiple times. Natural and semi-synthetic opioid analgesics include morphine, hydrocodone, and oxycodone; and synthetic opioid analgesics include fentanyl. 

Access data table for Figure 4 at http://www.cdc.gov/nchs/data/databriefs/db81_tables.pdf#4. 

SOURCE: CDC/NCHS, National Vital Statistics System.

Figure 4. Number of drug poisoning deaths involving opioid analgesic by opioid analgesic category: 

United States, 1999–2008 Number of deaths

Natural and 

semi-synthetic 

opioid analgesic

Methadone

Synthetic opioid

analgesic,excluding 

methadone

The number of drug poisoning deaths involving synthetic opioid analgesics other than methadone, 

such as fentanyl, tripled from about 700 in 1999 to 2,300 in 2008.

In 2008, the drug poisoning death rate was higher among those aged 45–54 

years than among those in other age groups.

From 1999 to 2008, the drug poisoning death rate increased among all age groups. In 2004, the 

drug poisoning death rate among those aged 45–54 years surpassed the rate among those aged 

35–44 years, and became the age group with the highest drug poisoning death rate (Figure 5).

65 years and over

55–64 years

45–54 years

35–44 years

25–34 years

15–24 years

0

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

5

10

15

20

25

30

Year

NOTE: Access data table for Figure 5 at http://www.cdc.gov/nchs/data/databriefs/db81_tables.pdf#5. 

SOURCE: CDC/NCHS, National Vital Statistics System.

Figure 5. Drug poisoning death rates by age: United States, 1999–2008 Deaths per 100,000 population

From 1999 to 2008, the age-adjusted drug poisoning death rate increased for males and females 

and for all race and ethnicity groups (Appendix table). In 2008, the rate was higher for males than 
NCHS Data Brief ■ No. 81 ■ December 2011

■ 5 ■

for females, and higher for non-Hispanic American Indian or Alaska Native and non-Hispanic 

white persons than for those in other race and ethnicity groups.

Appendix table. Age-adjusted drug poisoning death rates, by demographic characteristics and intent: United States, 

1999–2008

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Age-adjusted death rate

Total 6.1 6.2 6.8 8.1 8.9 9.3 10.0 11.4 11.8 11.9

Sex

 Male 8.2 8.3 9.0 10.5 11.4 11.7 12.7 14.6 14.8 14.8

 Female 3.9 4.1 4.7 5.8 6.4 6.9 7.3 8.2 8.9 9.0

Race and ethnicity

 Hispanic 5.5 4.6 4.4 5.3 5.6 5.2 5.7 6.2 5.9 5.9

 Non-Hispanic white 6.1 6.6 7.4 9.2 10.1 10.9 11.7 13.5 14.4 14.7

 Non-Hispanic Black 7.5 7.3 7.6 8.2 8.2 8.3 9.4 10.9 9.8 8.5

 Non-Hispanic American Indian 

 or Alaska Native

6.0 5.5 6.8 8.4 10.6 12.3 12.9 13.9 13.9 15.6

 Non-Hispanic Asian or Pacifi c

 Islander 

1.2 1.0 1.2 1.4 1.4 1.5 1.7 1.9 1.9 1.8

Intent1

 Unintentional 4.0 4.2 4.6 5.7 6.3 6.8 7.5 8.8 9.1 9.2

 Suicide 1.1 1.2 1.2 1.3 1.3 1.4 1.4 1.5 1.5 1.6

 Undetermined 0.9 0.9 1.0 1.1 1.2 1.1 1.0 1.1 1.2 1.1

1

Age-adjusted drug poisoning rates for homicides, legal interventions, and operations of war rates are less than 0.1 per 100,000 population each year and are not 

shown.

SOURCE: CDC/NCHS, National Vital Statistics System.

Summary

In 2008, the number of poisoning deaths exceeded the number of motor vehicle traffi c deaths 

and was the leading cause of injury death for the fi rst time since at least 1980. During the past 

three decades, the poisoning death rate nearly tripled, while the motor vehicle traffi c death rate 

decreased by one-half. During this period, the percentage of poisoning deaths that were caused by 

drugs increased from about 60% to about 90%. 

The population groups with the highest drug poisoning death rates in 2008 were males, people 

aged 45–54 years, and non-Hispanic white and American Indian or Alaska Native persons. The 

vast majority of drug poisoning deaths are unintentional (see Appendix table). Opioid analgesics 

were involved in more drug poisoning deaths than other specifi ed drugs, including heroin and 

cocaine. Opioid analgesics were involved in nearly 15,000 deaths in 2008, while cocaine was 

involved in about 5,100 deaths and heroin was involved in about 3,000 deaths (data not shown). 

Deaths involving opioid analgesics may involve other drugs as well, including benzodiazepines 

(2). 

In addition to an increase in the number of deaths caused by drug poisoning, increases in drug 

use, abuse, misuse, and nonfatal health outcomes have been observed. In the past two decades, 

there has been an increase in the distribution and medical use of prescription drugs, including 

opioid analgesics (3). From 1999 to 2008, the use of prescription medications increased (4). In 

2007–2008, 48% of Americans used at least one prescription drug in the past month and 11% 

of Americans used fi ve or more prescriptions in the past month. Analgesics for pain relief were 
NCHS Data Brief ■ No. 81 ■ December 2011

■ 6 ■

among the common drugs taken by adults aged 20–59 years (4). In 2009–2010, over 5 million 

Americans reported using prescription pain relievers nonmedically in the past month (that is, 

without a doctor’s prescription or only for the experience or feeling they caused), and the majority 

of people using prescription pain relievers nonmedically reported getting the drugs from friends 

or family (5,6). From 2004 to 2008, the estimated rate of emergency department visits involving 

nonmedical use of opioid analgesics doubled from 49 per 100,000 to 101 per 100,000 (7). 

Government agencies and other organizations joined together to achieve great reductions in the 

number of deaths from motor vehicle crashes in the past three decades (8,9). A comprehensive 

approach, including improvements in the safety of vehicles; improvements in roadways; 

increased use of restraint systems, such as seat belts and child safety seats; reductions in speed; 

and also efforts to reduce driving under the infl uence of alcohol and drugs, contributed to the 

decline in motor vehicle related deaths (8,9). Using a comprehensive, multifaceted approach, it 

may be possible to reverse the trend in drug poisoning mortality. 

Defi nitions

Injury deaths: Include deaths that are caused by forces external to the body. Examples of causes 

of injury death include drowning, fall, fi rearm, fi re or burn, motor vehicle traffi c, poisoning, and 

suffocation.

Poisoning deaths: Include drug poisonings resulting from unintentional or intentional overdoses 

of a drug, being given the wrong drug, taking the wrong drug in error, or taking a drug 

inadvertently. Poisoning deaths also include poisoning resulting from other toxic substances, 

gases, or vapors. 

Opioid analgesics: Drugs that are usually prescribed to relieve pain and include: Natural and 

semi-synthetic opioid analgesics such as morphine, codeine, hydrocodone, and oxycodone; 

methadone, which is a synthetic opioid analgesic used to treat opioid dependency as well as pain; 

and other synthetic opioid analgesics (excluding methadone) such as fentanyl and propoxyphene. 

Opium and heroin are not included in this class of drugs.

Data source and methods

Estimates are based on the National Vital Statistics System multiple cause of death mortality 

fi les (10). Deaths were classifi ed using the International Classifi cation of Diseases (ICD), Tenth 

Revision (ICD–10) in 1999–2008 and the Ninth Revision of the ICD (ICD–9) in 1980–1998. 

Poisoning deaths were defi ned as having ICD–10 underlying cause of death code (UCOD): X40–

X49, X60–X69, X85–X90, Y10–Y19, Y35.2, or *U01(.6–.7) and ICD–9 UCOD: E850.0–E869.9, 

E950.0–E952.9, E962(.0–.9), E972, or E980.0–E982.9. Drug poisoning deaths were defi ned as 

having ICD–10 UCOD: X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), Y10–

Y14 (undetermined intent) and ICD–9 UCOD: E850–E858, E950.0–E950.5, E962.0, or E980.0–

E980.5. Motor vehicle traffi c deaths were defi ned as having ICD–10 UCOD: V02–V04(.1,.9), 

V09.2, V12–V14(.3–.9), V19(.4–.6), V20–V28(.3–.9), V29–V79(.4–.9), V80(.3–.5), V81–

V82(.1), V83–V86(.0–.3), V87(.0–.8), or V89.2 and ICD–9 UCOD: E810.0–E819.9, E958.5, 

or E988.5. When the ICD–10 replaced ICD–9 in 1999, approximately 5% fewer deaths were 

classifi ed as motor vehicle deaths and 2% more deaths were classifi ed as poisoning deaths (11). 
NCHS Data Brief ■ No. 81 ■ December 2011

■ 7 ■

The identifi cation of individual drugs and drug classes involved in drug poisoning deaths 

is limited by the classifi cation structure of the ICD. Trends involving individual drugs and 

drug classes begin with 1999 when the ICD–10 replaced ICD–9, because the classifi cation of 

individual drugs and drug classes is not comparable between ICD revisions. Among deaths with 

drug poisoning as the underlying cause, the following ICD–10 codes indicate the type of drug(s) 

involved: only nonspecifi ed drug(s) (only T50.9); specifi ed drug(s) other than opioid analgesic 

(any of the codes T36–T50.8 other than T40.2–T40.4); and any opioid analgesic (any of the codes 

T40.2–T40.4); and natural and semi–synthetic opioid analgesic (T40.2); methadone (T40.3); 

synthetic opioid analgesic, excluding methadone (T40.4); heroin (T40.1); and cocaine (T40.5). 

Age-adjusted death rates were calculated using the direct method and the 2000 standard 

population (10). To identify state rates that were signifi cantly higher or lower than the overall 

U.S. rate, differences between national and state estimates were evaluated using two-sided 

signifi cance tests at the 0.01 level. Georgia was excluded from this comparison because the cause 

of death was inconclusive for a high proportion of deaths in Georgia in the 2008 NVSS mortality 

fi le. When the national mortality fi le was closed to updates, the manner of death was pending for 

8.8% of deaths and was assigned an ill-defi ned cause in 3.5% of deaths for Georgia as compared 

with 0.5% pending and 0.3% ill-defi ned for the nation. Poisoning deaths, which require lengthy 

investigations, are typically among the causes that remain pending at the close of the fi le.

Several factors related to death investigation and reporting may affect measurement of death rates 

involving specifi c drugs. At autopsy, toxicological lab tests may be performed to determine the 

type of legal and illegal drugs present. The substances tested for and circumstances in which the 

tests are performed vary by jurisdiction. Measurement errors related to these factors are more 

likely to affect substance specifi c death rates than the overall drug poisoning death rate.

About the authors

Margaret Warner, Li Hui Chen, and Diane M. Makuc are with the Centers for Disease Control 

and Prevention’s (CDC) National Center for Health Statistics (NCHS), Offi ce of Analysis and 

Epidemiology. Arialdi M. Miniño and Robert N. Anderson are with CDC, NCHS, Division of 

Vital Statistics.

References

1. Healthy People 2020 Topics and Objectives. Available from: http://www.healthypeople.

gov/2020/. Accessed September 30, 2011.

2. Warner M, Chen LH, Makuc DM. Increase in fatal poisonings involving opioid analgesics 

in the United States, 1999–2006. NCHS data brief, no 22. Hyattsville, MD: National Center for 

Health Statistics. 2009. Available from: http://www.cdc.gov/nchs/data/databriefs/db22.htm.

3. Paulozzi L, Mack K, Rudd R, Jones C. Vital signs: Overdoses of prescription opioid pain 

relievers—United States, 1999–2008. MMWR, vol 60, 1487–92. 2011. Available from: http://

www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm.

4. Gu Q, Dilon CF, Burt VL. Prescription drug use continues to increase: U.S. prescription 

drug data for 2007–2008. NCHS data brief, no 42. Hyattsville, MD: National Center for Health 

Statistics. 2009. Available from: http://www.cdc.gov/nchs/data/databriefs/db42.htm.
NCHS Data Brief ■ No. 81 ■ December 2011

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5. Substance Abuse and Mental Health Services Administration. The 

NSDUH Report: Trends in nonmedical use of prescription pain relievers: 

2002 to 2007. Rockville, MD. 2009. Available from: http://oas.samhsa.

gov/2k9/painRelievers/nonmedicalTrends.pdf.

6. Substance Abuse and Mental Health Services Administration. Results 

from the 2010 National Survey on Drug Use and Health: Summary of 

National Findings, NSDUH Series H–41, HHS Publication No. (SMA) 

11–4658. Rockville, MD. 2011. Available from: http://oas.samhsa.gov/

NSDUH/2k10NSDUH/2k10Results.htm.

7. Cai R, Crane E, Poneleit K, Paulozzi L. Emergency department visits 

involving nonmedical use of selected prescription drugs: United States, 

2004–2008 (Reprinted from MMWR, vol 59, 705–9. 2010). JAMA-J Am 

Med Assoc 304(5):514–6. 2010. Available from: http://jama.ama-assn.org/

content/304/5/514.full.

8. CDC. Motor-vehicle safety: A 20th century public health achievement 

(Reprinted from MMWR, vol 48, 369. 1999). JAMA-J Am Med Assoc 

281(22):2080–82. 1999. Available from: http://www.cdc.gov/mmwr/preview/

mmwrhtml/mm4818a1.htm.

9. Longthorne A, Subramanian R, Chen CL. An analysis of the signifi cant 

decline in motor vehicle traffi c fatalities in 2008. DOT HS 811 346. 

Washington, DC 2010. Available from: http://www-nrd.nhtsa.dot.gov/

Pubs/811346.pdf.

10. Miniño AM, Murphy SL, Xu JQ, Kochanek KD. Deaths: Final data 

for 2008. National vital statistics reports; vol 59, no 10. Hyattsville, MD: 

National Center for Health Statistics. 2011. http://www.cdc.gov/nchs/data/

nvsr/nvsr59/nvsr59_10.pdf.

11. Bergen G, Chen L, Warner M, Fingerhut L. Injury in the United States: 

2007 Chartbook. Hyattsville, MD: National Center for Health Statistics. 

2008. Available from: http://www.cdc.gov/nchs/data/misc/injury2007.pdf.

Suggested citation

Warner M, Chen LH, Makuc DM, Anderson 

RN, Miniño AM. Drug poisoning deaths 

in the United States, 1980–2008. NCHS 

data brief, no 81. Hyattsville, MD: National 

Center for Health Statistics. 2011.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Office of Analysis and Epidemiology

Diane M. Makuc, Dr.P.H., Acting Director

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