# How many people die due to various substance (illegal ones/legal/dangerous ones) per user?

It says 88000 people die from Alcohol related causes

What I want to know is the number of people that die compared to the number of alcohol users.

Then I want to compare that with the same ratio for

1. Alcohol
2. Cigarettes
3. LSD
4. MDMA
5. Meth
6. Heroin
7. Cocaine
8. Crack Cocaine How many death per users per year?

Is death per user increase or decrease in places where those are legal/criminalized?

How do I get that data? Anyone studying this?

It's a simple statistic.

If I did some research I often see graphs like this

The graphs are too subjective. One is made by lancet I think. I forget the rest. I will find some sources. However, I am just pointing out that the graphs are too subjective.

The lancet source is this https://en.wikipedia.org/wiki/Substance_abuse

However, this may not convince many skeptics.

The graphs simply say MDMA is less dangerous than alcohol. Danger is subjectively defined.

So I tried something objective.

How many people that use MDMA will die due to MDMA.

I will also take into account that MDMA are less addictive. So yes. We will be comparing those who use MDMA like once every 2 months with heavy smokers. It's still a fair comparison because cigarettes are addictives and MDMA isn't.

I wonder if such research have been done?

Another thing I want to examine will be dangerous that doesn't lead to death. Things like permanent IQ decrease, for example. However, this question ask about something whose meaning is obvious. Death.

Another useful stats is usage vs https://en.wikipedia.org/wiki/Years_of_potential_life_lost

I wonder if there is any research on that.

This one says that there are 600 death due to MDMA usage https://drugwarfacts.org/node/3484

However, it doesn't tell how many people use MDMA in US. So I can't compute the ratio and compare the ration with cigarettes.

Sample of good answer will be something like this:

https://thedea.org/mdma-risks-science-and-statistics-technical-faq/mdma-molly-ecstasy-use-and-death-rate-statistics/

The death rate for MDMA, assuming that there really were about 60 deaths directly caused by MDMA in 2000, would be roughly 2 in 100,000 users. The death rate from smoking, by contrast, is on the order of 400 per 100,000 users. Even alcohol, America’s official “it’s not really a drug” drug, nets about 50 deaths per 100,000 users each year:3

I just want more complete pictures for more popular drugs.

I repeat that again

1. Alcohol
2. Cigarettes
3. LSD
4. MDMA
5. Meth
6. Heroin
7. Cocaine
8. Crack Cocaine

So we already got 3. Alcohol, Cigarettes, and MDMA. I want more numbers to around those 8 I think?

If it's too broad, then I just want MDMA, Meth, Heroin, Cocaine, and LSD, and Weed.

Partial answer is good enough. So if you know the ratio for weed, then that's good enough. The best answer will be the one that show more.

• Comments are not for extended discussion; this conversation has been moved to chat. Sep 14, 2019 at 4:10

I have found data from different sources, mainly for the UK. Please note that the data are for substance-related deaths, so they include substance-specific deaths plus deaths related to the use of a drug (for example, heroin-associated death can be from fentanyl in it, and alcohol-related deaths can include car accidents).

Substance use-related deaths per 100,000 users/year:

Substance use-related deaths per 100,000 users in 2011 in UK (The Single Colony, sources: Home Office and Office of National Statistics):

• Heroin: 1,753
• Tobacco: 865
• Amphetamines: 27
• Cocaine (powder and crack): 16
• Alcohol: 13
• MDMA (Ecstasy): 11
• Cannabis: <1
• Ketamine: <1 (5 deaths in the entire UK in y. 2012 (St George's University of London, p.92 and 93 ; 3 deaths in July 2017- June 2018 in Ontario)
• LSD: 0
• Psilocybin: 0

Why did heroin-related deaths per 100,000 user increase?

The discrepancy between 141 heroin-related deaths per 100,000 users in y. 2000 in the US and 1,753 deaths per 100,000 users in y. 2011 in the UK could be explained by the fact that in recent years fentanyl has been often added to heroin and that fentanyl-related deaths have greatly increased.

However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl. It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product—with or without the user’s knowledge—to increase its euphoric effects.

Overdose deaths involving synthetic opioids other than methadone, which includes fentanyl, increased almost 47% from 2016 to 2017.

Reports from law enforcement indicate that much of the synthetic opioid overdose increase may be due to illegally or illicitly made fentanyl. According to data from the National Forensic Laboratory Information System, confiscations, or seizures, of fentanyl increased by nearly 7 fold from 2012 to 2014.

Why did methadone-related deaths per 100,000 users increase?

Methadone has been initially prescribed as part of recovery from heroin addiction, but is now also prescribed as analgesic. Methadone has a short analgesic duration (6-8 hours) and long elimination half-life (128 hours), which increases the chance of overdose when taken every 6-8 hours. Further, the use of street methadone, which may not be pure methadone has increased in recent years. So, circumstances in which methadone is used recently have changed, which may explain increasing methadone-related deaths per 100,000 users from 2007 and 2011 in the UK.

• While I appreciate the effort that went into researching this answer, as different sources give so varying figures (~1200% difference for Heroin) I really doubt if any conclusions can be drawn from this statistic. Also, when are deaths substance-use related? There seems to be a lot of grey area... Not a criticism of your answer, rather a frame challenge to the post itself. OP criticises other statistics for being too subjective, I don't think that this statistic (requested by OP themselves) is any better. Epidemiology is a tough subject... Sep 26, 2019 at 20:18
• @Narusan...The first data for heroin is from US, 2000 and the second from UK, 2011, so this is not really comparable. Death is considered substance-specific, when it is clearly a direct effect of a substance, and substance-related when it is associated with its use (for example, a heroin user may die from fentanyl in it or a MDMA user can die from water intoxication, but MDMA contributed to it).
– Jan
Sep 27, 2019 at 7:27
• The main problem the OP had was that he could mainly find data for deaths per 1000,000 population and I presented data per 100,000 users, which is what he asked. I asked him which sources he would find reliable and he said any data could help and as you can see he has accepted the answer. The data are mainly for UK - this can differ a lot from country to country and the year observed. Data per 100,000 users are scarce, but are mainly from official sources. The both lists quite agree about which substances are commonly and which rarely associated with death.
– Jan
Sep 27, 2019 at 7:56
• Don't get me wrong - your answer is great and I upvoted them. I'm just questioning the sources themselves. // How come heroin was much less deadly in 2000 in the U.S. than in 2011 in the U.K.? Has the medical coverage deteriorated? Is the U.K.'s health system so much worse than the U.S.'s? // Again, not a criticism of your answer but of the statistics. Some numbers don't seem to add up... Sep 27, 2019 at 7:57
• @Narusan, since the data are for substance-related deaths, different researchers could use different criteria about what counts as related. Many deaths from heroin are actually from fentanyl added to heroin in recent years - I added some data.
– Jan
Sep 27, 2019 at 9:01