The True Death Toll of Drug Abuse (It’s Not Just Overdoses)

Sad paramedic

The answer to the question “How many people are killed by drugs” is not a simple one. That’s because there are many, many ways that drugs can kill a person.

The simplest and most direct answer to this question—and the one you will read about in the news—is the statistic related to drug overdose deaths. You can turn to the Centers for Disease Control and Prevention for that answer. The CDC will tell you that as of July 2022, America lost more than 109,000 people in the prior twelve-month period.

This is a terrible, tragic level of loss. More than 100,000 families across the country are grieving due to their recent losses. There are hundreds of thousands more who have not yet recovered from more distant losses, if they ever will.

But our crushing burden of drug-related loss is much greater than that. There are so many other ways that drugs take lives.

The Many Deadly Impacts of Drugs and Alcohol on American Lives

There are many other ways that drugs or alcohol steal our loved ones, neighbors, or community members from us.

Alcohol overdose: The drug overdose statistic cited above does not include alcohol-related deaths. The loss of life to alcohol is harder to track because relatively few people die of “alcohol poisoning.” In other words, they drink so much alcohol that their body fully shuts down. This is how the singer Amy Winehouse died. Her blood contained more than five times the legal limit for drivers when she died. In 2020, America lost more than 2,600 people who died as a result of alcohol overdose.

Cancer: Alcohol is classified as a carcinogen, or a cancer-causing chemical. In fact, alcohol causes cancers of the liver, larynx, mouth and throat, esophagus, colon, and breast cancers in women. It also increases the risk of prostate cancer.

Alcohol-related liver disease: A person who drinks too much, too often can wind up with cirrhosis of the liver. First, the liver becomes inflamed, and then, normal liver tissue is replaced by scar tissue, at which point cirrhosis is diagnosed. This problem can cause kidney failure, intestinal bleeding, and liver cancer. In 2020, nearly 30,000 people died from alcoholic liver disease.

Rushing blurred ambulance

Alcohol-related traffic accidents: Alcohol is well-known for causing driver impairment. In 2020, we lost 11,654 people in alcohol-impaired driving crashes.

Drug-related traffic accidents: Drug tests performed on drivers who were fatally injured in a traffic accident revealed that 38% tested positive for marijuana, 16% were positive for opioids, and 4% tested positive for both. An increasing number of alcohol-positive drivers who died in crashes have begun testing positive for drugs as well.

Brain damage: Long-term drinking that damages the liver can also cause a potentially fatal brain disorder called hepatic encephalopathy. Alcoholics can also develop Wernicke–Korsakoff syndrome, also called wet brain syndrome, a debilitating condition that can cause confusion, memory loss, and difficulty coordinating muscles. If not treated, Wernicke–Korsakoff syndrome can be fatal.

Stroke: The main drugs associated with stroke are alcohol, cocaine, amphetamines, ecstasy, heroin/opioids, PCP, LSD, marijuana, and synthetic marijuana. One study found that drug users between the ages of 15 and 44 were 6.5 times more likely to suffer strokes. Also, in 2008, as the opioid epidemic emerged, rates of stroke resulting from opioid-related heart infections began to increase sharply.

HIV: Sharing needles results in the increased spread of HIV infections. About 18,000 people died from HIV infections in 2020; 11% of new cases involved injection drug use.

Hepatitis C: Injecting drug users may also spread hepatitis C when they share their needles. Between 2009 and 2018, the rate of hepatitis C infection tripled as the opioid epidemic grew. It’s estimated that 72% of these cases resulted from injection drug use. Hepatitis C can result in liver failure, liver cancer, or death.

Suicide: Alcohol or substance use disorders greatly increase the likelihood of planning, attempting, or accomplishing suicide. The two drugs most associated with suicide are alcohol and opioids, with marijuana, cocaine, and amphetamines following. More than one-third of people dying from suicide test positive for alcohol. People who use opioids are 14 times more likely to die from suicide than a person who does not.

Heart-related deaths: Both heavy alcohol consumption and drug abuse are very hard on the heart. Stimulants like cocaine, methamphetamine, and ecstasy stress the entire cardiovascular system. Opioid injections can cause infections in the heart. Heavy alcohol consumption can lead to an enlarged heart that cannot pump properly (cardiomyopathy). Heart failure and death can result.


Lowered immunity: Marijuana, cocaine, heroin and other opioids, and alcohol all harm human immunity. Once immunity is damaged, illnesses like HIV, endocarditis, cellulitis, pneumonia, hepatitis, and infections from staph, Legionella, and other viruses and bacteria can become more serious, even life-threatening.

Accidents resulting in deaths among the impaired: Drug or alcohol impairment is involved in many falls, drownings, and other accidental injuries that result in death. As much as 70% of water recreation deaths (swimming, boating) involve alcohol. Alcohol is involved in 30–50% of all traumatic injuries. Further, the U.S. Department of Labor estimates that drug or alcohol abuse is involved in 65% of workplace accidents.

Total number of alcohol-related deaths: According to the National Institute on Alcohol Abuse and Alcoholism, 140,000 Americans die from alcohol-related causes each year.

Summing Up Our Situation

It should be obvious by now that both legal and illegal drugs claim lives in many, many ways—more ways than are listed here. For example, alcohol and drugs are often involved in assaults, murders, and many other health conditions that can turn fatal.

Addiction help

These examples of life-ending problems resulting from drug abuse or excessive alcohol consumption should make one thing quite apparent: drug overdose deaths are just the tip of the iceberg concerning how many of our loved ones, friends, neighbors, and community members we are actually losing.

Nationally, drug and alcohol use are claiming hundreds of thousands of lives each year. Fighting this problem must take place on many fronts: prevention, drug interdiction, and rehabilitation, for a start. To save someone you care about from these life-threatening fates, getting them to an effective drug rehab as soon as possible is a must.


  • CDC. “Provisional Drug Overdose Death Counts.” CDC, 2023. CDC.
  • Centers for Disease Control and Prevention. “Alcohol-induced Death Rates in the United States, 2019–2020.” CDC, undated. CDC.
  • Centers for Disease Control and Prevention. “Alcohol and Cancer.” CDC, 2023. CDC.
  • National Highway Transportation Safety Administration. “Summary of Motor Vehicle Crashes.” NHTSA, 2022. NHTSA.
  • Governors Highway Safety Association. “Drug-Impaired Driving: Marijuana and Opioids Raise Critical Issues for States.” GHSA, 2018. GHSA.
  • National Institute on Alcohol Abuse and Alcoholism. “Alcohol’s Damaging Effects on the Brain.” NIAAA, 2004. NIAAA.
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  • Centers for Disease Control and Prevention. “New HIV Diagnoses and People with Diagnosed HIV in the US and Dependent Areas by Area of Residence, 2020.” CDC, 2022. CDC.
  • Health Affairs. “What’s A Syndemic? Hepatitis C Among Injection Drug Users Is An Urgent Example.” Health Affairs, 2021. Health Affairs.
  • National Library of Medicine. “Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders.” NLM, 2021. NLM.
  • National Library of Medicine. “Microbial Infections, Immunomodulation, and Drugs of Abuse.” NLM, 2003. NLM.
  • Centers for Disease Control and Prevention. “Drowning Prevention.” CDC, 2022. CDC.
  • American College of Surgeons. “Statement on Insurance, Alcohol-Related Injuries, and Trauma Centers.” FACS, 2006. FACS.
  • Occupational Health & Safety. “Drug Testing & Safety: What's the Connection?” OHS, 2014. OHS.
  • National Institute on Alcohol Abuse and Alcoholism. “Alcohol-Related Emergencies and Deaths in the United States.” NIAAA, 2023. NIAAA.


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.