Drug overdose

{{Short description|Use of an excessive amount of a drug}}

{{Redirect2|Overdose|drug poisoning|other uses}}

{{Use mdy dates|date=February 2024}}

{{Infobox medical condition (new)

| name = Drug overdose

| synonyms = Overdose, OD, hotshot, wasted, intoxication, gassed, medicinal poisoning

| image = DrugOverdose.jpg

| caption = A photograph showing a person who had overdosed

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| field = Toxicology

| symptoms = Vary depending on the drug and the amount used

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File:Fentanyl. 2 mg. A lethal dose in most people.jpg. 2 mg (white powder to the right) is a lethal dose in most people.[https://www.dea.gov/galleries/drug-images/fentanyl Fentanyl]. Image 4 of 17. US DEA (Drug Enforcement Administration). See [https://web.archive.org/web/20181008000027/https://www.dea.gov/galleries/drug-images/fentanyl archive] with caption: "photo illustration of 2 milligrams of fentanyl, a lethal dose in most people". US penny is 19 mm (0.75 in) wide.]]

A drug overdose (overdose or OD) is the ingestion or application of a drug or other substance in quantities much greater than are recommended.{{usurped|1=[https://web.archive.org/web/20110227202513/http://www.treatment-now.com/resources/definitions/ Definitions]}} Retrieved on September 20, 2014.[http://www.uphs.upenn.edu/addiction/berman/glossary/ "Stairway to Recovery: Glossary of Terms"] {{webarchive|url=https://web.archive.org/web/20110709032249/http://www.uphs.upenn.edu/addiction/berman/glossary/ |date=July 9, 2011}}. Retrieved on March 19, 2021 Typically the term is applied for cases when a risk to health is a potential result. An overdose may result in a toxic state or death.

Classification

The word "overdose" implies that there is a common safe dosage and usage for the drug; therefore, the term is commonly applied only to drugs, not poisons, even though many poisons as well are harmless at a low enough dosage. Drug overdose is sometimes used as a means to commit suicide, as the result of intentional or unintentional misuse of medication. Intentional misuse leading to overdose can include using prescribed or non-prescribed drugs in excessive quantities in an attempt to produce euphoria.

Usage of illicit drugs, in large quantities, or after a period of drug abstinence can also induce overdose. Cocaine and opioid users who inject intravenously can easily overdose accidentally, as the margin between a pleasurable drug sensation and an overdose is small.Study on [http://www.biomedcentral.com/1471-2458/7/31 fatal overdose] {{webarchive|url=https://web.archive.org/web/20120119041854/http://www.biomedcentral.com/1471-2458/7/31 |date=January 19, 2012 }} in New-York City 1990-2000, visited May 11, 2008, Unintentional misuse can include errors in dosage caused by failure to read or understand product labels. Accidental overdoses may also be the result of over-prescription, failure to recognize a drug's active ingredient or unwitting ingestion by children."What to do with leftover medicines". Medicines Talk, Winter 2005. Available at {{cite web |url=http://www.nps.org.au/consumers/publications/medicines_talk/mt14/what_to_do_with_left-over_medicines2 |title=What to do with left-over medicines: National Prescribing Service Ltd NPS |access-date=January 6, 2010 |url-status=dead |archive-url=https://web.archive.org/web/20091024010012/https://www.nps.org.au/consumers/publications/medicines_talk/mt14/what_to_do_with_left-over_medicines2 |archive-date=October 24, 2009}} A common unintentional overdose in young children involves multivitamins containing iron.

The term 'overdose' is often misused as a descriptor for adverse drug reactions or negative drug interactions due to mixing multiple drugs simultaneously.

Signs and symptoms

Signs and symptoms of an overdose vary depending on the drug or exposure to toxins. The symptoms can often be divided into differing toxidromes. This can help one determine what class of drug or toxin is causing the difficulties.

Symptoms of opioid overdoses include slow breathing, heart rate and pulse.{{cite web |last=Chandler |first=Stephanie |title=Symptoms of an opiate overdose |url=http://www.livestrong.com/article/68582-symptoms-opiate-overdose/ |publisher=Live Strong |access-date=May 17, 2012 |url-status=live |archive-url=https://web.archive.org/web/20120418164856/http://www.livestrong.com/article/68582-symptoms-opiate-overdose/ |archive-date=April 18, 2012}} Opioid overdoses can also cause pinpoint pupils, and blue lips and nails due to low levels of oxygen in the blood. A person experiencing an opioid overdose might also have muscle spasms, seizures and decreased consciousness. A person experiencing an opiate overdose usually will not wake up, even if their name is called or they are shaken vigorously.

Causes

The drugs or toxins that are most frequently involved in overdose and death (grouped by ICD-10):

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=Added flavoring=

Masking undesired taste may impair judgement of the potency, which is a factor in overdosing. For example, lean is usually created as a drinkable mixture, the cough syrup is combined with soft drinks, especially fruit-flavored drinks such as Sprite, Mountain Dew or Fanta, and is typically served in a foam cup.{{Cite web |url=https://www.tmz.com/2010/09/02/t-i-arrest-sizzurp-drugs-controlled-substance-tiny-codeine/ |title=T.I. Arrest -- Sippin' on Sizzurp? |website=TMZ |date=September 2, 2010 |language=en |access-date=August 19, 2019}}{{cite news |newspaper=The Daily Beast |author=Melissa Leon |date=March 17, 2013 |url=http://www.thedailybeast.com/articles/2013/03/17/lil-wayne-hospitalization-what-the-hell-is-sizzurp.html |title=Lil Wayne Hospitalization: What the Hell Is Sizzurp?}} A hard candy, usually a Jolly Rancher, may be added to give the mixture a sweeter flavor.{{cite book |title=Country Fried Soul: Adventures in Dirty South Hip-hop |author=Tamara Palmer |publisher=Outline Press Limited |year=2005 |page=188}}

Diagnosis

The substance that has been taken may often be determined by asking the person. However, if they will not, or cannot, due to an altered level of consciousness, provide this information, a search of the home or questioning of friends and family may be helpful.

Examination for toxidromes, drug testing, or laboratory test may be helpful. Other laboratory test such as glucose, urea and electrolytes, paracetamol levels and salicylate levels are typically done. Negative drug-drug interactions have sometimes been misdiagnosed as an acute drug overdose, occasionally leading to the assumption of suicide.[http://www.preskorn.com/columns/0207.html "Column—Fatal Drug-Drug Interaction As a Differential Consideration in Apparent Suicides"] {{webarchive|url=https://web.archive.org/web/20080223185230/http://www.preskorn.com/columns/0207.html |date=February 23, 2008 }}.

class="wikitable"

|+ Toxidromes{{cite book |author=Goldfrank, Lewis R. |title=Goldfrank's toxicologic emergencies |publisher=Appleton & Lange |location=Norwalk, CT |year=1998 |isbn=0-8385-3148-2}}

! Symptoms !! Blood
Pressure
!! Heart rate !! Respiratory
Rate
!! Temperature !! Pupils !! Bowel
Sounds
!! Diaphoresis

Anticholinergic~
{{clarify|date=February 2020}}
up~updilateddowndown
Cholinergic~~unchangedunchangedconstrictedupup
Opioiddowndowndowndownconstricteddowndown
Sympathomimeticupupupupdilatedupup
Sedative-hypnoticdowndowndowndown~downdown

Prevention

The distribution of naloxone to injection drug users and other opioid drug users decreases the risk of death from overdose.{{cite journal |author=Piper TM |title=Evaluation of a naloxone distribution and administration program in New York City |journal=Subst Use Misuse |volume=43 |issue=7 |pages=858–870 |year=2008 |pmid=18570021 |doi=10.1080/10826080701801261 |author2=Stancliff S |author3=Rudenstine S |display-authors=3 |last4=Sherman |first4=Susan |last5=Nandi |first5=Vijay |last6=Clear |first6=Allan |last7=Galea |first7=Sandro |hdl=2027.42/60330 |s2cid=31367375 |hdl-access=free}} The Centers for Disease Control and Prevention (CDC) estimates that U.S. programs for drug users and their caregivers prescribing take-home doses of naloxone and training on its utilization are estimated to have prevented 10,000 opioid overdose deaths.{{cite journal |title=Community-Based Opioid Overdose Prevention Programs Providing Naloxone—United States, 2010 |journal=Centers for Disease Control and Prevention |date=December 2010 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6106a1.htm |url-status=live |archive-url=https://web.archive.org/web/20170909005149/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6106a1.htm |archive-date=September 9, 2017}} Healthcare institution-based naloxone prescription programs have also helped reduce rates of opioid overdose in the U.S. state of North Carolina, and have been replicated in the U.S. military.{{cite journal |vauthors=Albert S, Brason FW 2nd, Sanford CK, Dasgupta N, Graham J, Lovette B |title=Project Lazarus: community-based overdose prevention in rural North Carolina |journal=Pain Medicine |date=June 2011 |pmid=21668761 |doi=10.1111/j.1526-4637.2011.01128.x |volume=12 |issue=Suppl 2 |pages=S77–85 |doi-access=free}}{{cite report |title=Closing Death's Door: Action Steps to Facilitate Emergency Opioid Drug Overdose Reversal in the United States |year=2009 |url=https://medicine.wright.edu/sites/medicine.wright.edu/files/page/attachments/Naloxonewhitepaper09.pdf |publisher=Temple University Beasley School of Law |url-status=live |via=Boonshoft School of Medicine |archive-url=https://web.archive.org/web/20230127043207/https://medicine.wright.edu/sites/medicine.wright.edu/files/page/attachments/Naloxonewhitepaper09.pdf |archive-date=January 27, 2023 |ssrn=1437163 |vauthors=Beletsky L, Burris SC, Kral AH}} Nevertheless, scale-up of healthcare-based opioid overdose interventions is limited by providers' insufficient knowledge and negative attitudes towards prescribing take-home naloxone to prevent opioid overdose.{{cite journal |vauthors=Beletsky L, Ruthazer R, Macalino GE, Rich JD, Tan L, Burris S |title=Physicians' knowledge of and willingness to prescribe naloxone to reverse accidental opiate overdose: challenges and opportunities |journal=Journal of Urban Health |date=January 2007 |pmid=17146712 |doi=10.1007/s11524-006-9120-z |volume=84 |issue=1 |pmc=2078257 |pages=126–36}} Programs training police and fire personnel in opioid overdose response using naloxone have also shown promise in the U.S.{{cite journal |author=Lavoie D. |title=Naloxone: Drug-Overdose Antidote Is Put In Addicts' Hands |journal=Huffington Post |date=April 2012 |url=http://www.huffingtonpost.com/2012/04/26/naloxone-drug-overdose-antidote_n_1456531.html |url-status=live |archive-url=https://web.archive.org/web/20120518161613/http://www.huffingtonpost.com/2012/04/26/naloxone-drug-overdose-antidote_n_1456531.html |archive-date=May 18, 2012}}

Supervised injection sites (also known as overdose prevention centers) have been used to help prevent drug overdoses by offering opioid reversal medications such as naloxone, medical assistance and treatment options. They also provide clean needles to help prevent the spread of diseases like HIV/AIDS and hepatitis.{{cite news |last=Oladipo |first=Gloria |date=November 30, 2021 |title=New York to open supervised injection sites in bid to curb overdose deaths |url=https://www.theguardian.com/us-news/2021/nov/30/new-york-supervised-injection-sites-overdose |work=The Guardian |access-date=December 1, 2021}}{{cite news |last=Kim |first=Lisa |date=November 30, 2021 |title=NYC Close To Opening Supervised Injection Sites To Prevent Overdoses, After Years Of Setbacks, Report Says |url=https://www.forbes.com/sites/lisakim/2021/11/30/nyc-close-to-opening-supervised-injection-sites-to-prevent-overdoses-after-years-of-set-back-report-says/ |work=Forbes |access-date=December 1, 2021}}{{cite news |last= |first= |date=September 7, 2018 |title=What's The Evidence That Supervised Drug Injection Sites Save Lives? |url=https://www.npr.org/sections/health-shots/2018/09/07/645609248/whats-the-evidence-that-supervised-drug-injection-sites-save-lives?t=1638390331632 |work=NPR |access-date=December 1, 2021}}{{cite journal |last1=Ng |first1=Jennifer |last2=Sutherland |first2=Christy |last3=Kolber |first3=Michael |date=November 2017 |title=Does evidence support supervised injection sites? |journal=Canadian Family Physician |volume=63 |issue=11 |page=866 |doi= |pmc=5685449 |pmid=29138158}}

Management

File:CharcoalPO.jpg is a commonly used agent for decontamination of the gastrointestinal tract in overdoses.]]

Stabilization of the person's airway, breathing, and circulation (ABCs) is the initial treatment of an overdose. Ventilation is considered when there is a low respiratory rate or when blood gases show the person to be hypoxic. Monitoring of the patient should continue before and throughout the treatment process, with particular attention to temperature, pulse, respiratory rate, blood pressure, urine output, electrocardiography (ECG) and O2 saturation.{{cite book |title=Oxford Handbook of Clinical Medicine |last=Longmore |first=Murray |author2=Ian Wilkinson |author3=Tom Turmezei |author4=Chee Kay Cheung |year=2007 |publisher=Oxford |location=United Kingdom |isbn=978-0-19-856837-7}} Poison control centers and medical toxicologists are available in many areas to provide guidance in overdoses both to physicians and to the general public.

=Antidotes=

Specific antidotes are available for certain overdoses. For example, naloxone is the antidote for opiates such as heroin or morphine. Similarly, benzodiazepine overdoses may be effectively reversed with flumazenil. As a nonspecific antidote, activated charcoal is frequently recommended if available within one hour of the ingestion and the ingestion is significant.{{cite journal |last=Vanden Hoek |first=TL |author2=Morrison, LJ |author3=Shuster, M |author4=Donnino, M |author5=Sinz, E |author6=Lavonas, EJ |author7=Jeejeebhoy, FM |author8=Gabrielli, A |title=Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care |journal=Circulation |date=November 2, 2010 |volume=122 |issue=18 Suppl 3 |pages=S829–61 |pmid=20956228 |doi=10.1161/CIRCULATIONAHA.110.971069 |doi-access=free}} Gastric lavage, syrup of ipecac, and whole bowel irrigation are rarely used.

Epidemiology and statistics

{{globalize|section|date=December 2022}}

{{Further|US drug overdose death rates and totals over time}}

File:2 milligrams of fentanyl on pencil tip. A lethal dose for most people. US Drug Enforcement Administration.jpg dose of fentanyl powder (on pencil tip) is a lethal amount for most people.{{Cite web |title=One Pill Can Kill |url=https://www.dea.gov/onepill |access-date=November 15, 2023 |website=US Drug Enforcement Administration |archive-date=November 15, 2023 |archive-url=https://web.archive.org/web/20231115200822/https://www.dea.gov/onepill |url-status=live}}]]

The UN gives a figure of 300,000 deaths per year in the world through drug overdose.{{fact|date=April 2025}}

In the US around 84,100 people died in the 12-month period ending October 31, 2024, at a rate of 230 deaths per day. The peak was around 112,600 in 2022.[https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm Products - Vital Statistics Rapid Release - Provisional Drug Overdose Data]. Centers for Disease Control and Prevention. Hover cursor over the end of the graph in Figure 1A to get the latest number. Scroll down the page and click on the dropdown data table called "Data Table for Figure 1a. 12 Month-ending Provisional Counts of Drug Overdose Deaths". The number used is the "predicted value" for the 12 month period that is ending at the end of that month. That number changes as more info comes in. If there are problems use a different browser. The U.S. drug overdose death rate has gone from 2.5 per 100,000 people in 1968 to the peak rate of 33.7 per 100,000 in 2022.

1,015,060 US residents died from drug overdoses from 1968 to 2019. 22 people out of every 100,000 died from drug overdoses in 2019 in the US.Data is from these saved tables from CDC Wonder at the Centers for Disease Control and Prevention, National Center for Health Statistics. The tables have totals, rates, and US populations per year.

  • 1968-1978 data: [https://wonder.cdc.gov/controller/saved/D74/D72F578 Compressed Mortality File 1968-1978]. CDC WONDER Online Database, compiled from Compressed Mortality File CMF 1968-1988, Series 20, No. 2A, 2000. Accessed at http://wonder.cdc.gov/cmf-icd8.html on March 13, 2021, 5:04:32 PM.
  • 1979-1998 data: [https://wonder.cdc.gov/controller/saved/D16/D72F579 Compressed Mortality File 1979-1998]. CDC WONDER On-line Database, compiled from Compressed Mortality File CMF 1968-1988, Series 20, No. 2A, 2000 and CMF 1989-1998, Series 20, No. 2E, 2003. Accessed at http://wonder.cdc.gov/cmf-icd9.html on March 13, 2021, 5:19:27 PM.
  • 1999-2019 data: [https://wonder.cdc.gov/controller/saved/D77/D72F580 Multiple Cause of Death 1999-2019]. CDC WONDER Online Database, released in 2020. Data are from the Multiple Cause of Death Files, 1999-2019, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on March 13, 2021, 5:05:13 PM. From 1999 to Feb 2019 in the United States, more than 770,000 people have died from drug overdoses.[https://www.cdc.gov/nchs/pressroom/podcasts/20190911/20190911.htm STATCAST—Week of September 9, 2019. NCHS Releases New Monthly Provisional Estimates on Drug Overdose Deaths]. National Center for Health Statistics. 70,630 people died from drug overdoses in 2019.

The National Center for Health Statistics reports that 19,250 people died of accidental poisoning in the U.S. in the year 2004 (eight deaths per 100,000 population).[https://www.cdc.gov/nchs/fastats/acc-inj.htm Referral Page—FASTSTATS—Accidents or Unintentional Injuries] {{webarchive|url=https://web.archive.org/web/20170715221935/https://www.cdc.gov/nchs/fastats/acc-inj.htm |date=July 15, 2017 }} Retrieved on September 20, 2014.

In 2008 testimony before a Senate subcommittee, Leonard J. Paulozzi,[https://www.cdc.gov/media/subtopic/sme/paulozzi.htm CDC Expert, Leonard J. Paulozzi, MD, MPH] {{webarchive|url=https://web.archive.org/web/20140220063006/http://www.cdc.gov/media/subtopic/sme/paulozzi.htm |date=February 20, 2014 }} Retrieved on September 20, 2014. a medical epidemiologist at the Centers for Disease Control and Prevention said that in 2005 more than 22,000 American people died due to overdoses, and the number is growing rapidly. Paulozzi also testified that all available evidence suggests unintentional overdose deaths are related to the increasing use of prescription drugs, especially opioid painkillers.[https://www.cdc.gov/washington/testimony/2008/t20080312a.htm CDC Washington Testimony March 5, 2008] {{webarchive|url=https://web.archive.org/web/20170715204919/https://www.cdc.gov/washington/testimony/2008/t20080312a.htm |date=July 15, 2017 }} Retrieved on September 20, 2014. However, the vast majority of overdoses are also attributable to alcohol. It is very rare for a victim of an overdose to have consumed just one drug. Most overdoses occur when drugs are ingested in combination with alcohol.[http://www.peele.net/lib/heroinoverdose.html "The Persistent, Dangerous Myth of Heroin Overdose"] {{webarchive|url=https://web.archive.org/web/20150323005132/http://www.peele.net/lib/heroinoverdose.html |date=March 23, 2015 }}.

Drug overdose was the leading cause of injury death in 2013. Among people 25 to 64 years old, drug overdose caused more deaths than motor vehicle traffic crashes. There were 43,982 drug overdose deaths in the United States in 2013. Of these, 22,767 (51.8%) were related to prescription drugs.[https://www.cdc.gov/drugoverdose/epidemic/index.html "Understanding the Epidemic | Drug Overdose | CDC Injury Center"] {{webarchive|url=https://web.archive.org/web/20170909011619/https://www.cdc.gov/drugoverdose/epidemic/index.html |date=September 9, 2017 }}.

The 22,767 deaths relating to prescription drug overdose in 2013, 16,235 (71.3%) involved opioid painkillers, and 6,973 (30.6%) involved benzodiazepines. Drug misuse and abuse caused about 2.5 million emergency department (ED) visits in 2011. Of these, more than 1.4 million ED visits were related to prescription drugs. Among those ED visits, 501,207 visits were related to anti-anxiety and insomnia medications, and 420,040 visits were related to opioid analgesics.[https://www.cdc.gov/drugoverdose/data/overdose.html "Prescription Opioid Overdose Data | Drug Overdose | CDC Injury Center"] {{webarchive|url=https://web.archive.org/web/20170118060815/https://www.cdc.gov/drugoverdose/data/overdose.html |date=January 18, 2017 }}.

New CDC data in 2024 demonstrates U.S. drug overdose deaths have significantly declined, marking the potential for the first year with fewer than 100,000 fatalities since 2020.{{Cite web |last=Facher |first=Lev |date=2024-11-13 |title=U.S. drug overdose deaths on pace to fall below 100,000 this year |url=https://www.statnews.com/2024/11/13/overdose-deaths-decline-cdc-reports-under-100-thousand-fatalities/?utm_campaign=pharmalittle&utm_medium=email&_hsenc=p2ANqtz--rTTYZjsEaai3ff1gKOGAT5nVEQ1kG2cWMTIfcEXF2n5qmZsgI8WKof5HYT5UnK3DKjrhwllr37szs3S-qanDc8yvMDg&_hsmi=333935728&utm_content=333935728 |access-date=2024-11-17 |website=STAT |language=en-US}} The CDC data shows a nearly 17% drop in reported overdose deaths during the 12 months ending in June, totaling 93,087.{{Cite web |date=2024-03-19 |title=Products - Data Briefs - Number 491 - March 2024 |url=https://www.cdc.gov/nchs/products/databriefs/db491.htm |access-date=2024-11-17 |website=www.cdc.gov |language=en-us}} This is a notable decrease from the 111,615 deaths recorded in the same period ending in June 2023. While the opioid crisis continues to take a heavy toll, fentanyl remains a major driver, contributing to the majority of these fatalities.{{Cite web |title=CDC says US drug overdose deaths have declined |url=https://www.bbc.com/news/articles/c8ek5l04yy7o |access-date=2024-11-17 |website=www.bbc.com |language=en-GB}}

File:US timeline. Number of overdose deaths from all drugs.jpg|U.S. yearly overdose deaths from all drugs.[http://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates Overdose Death Rates]. And {{webarchive|url=https://web.archive.org/web/20151128091723/http://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates |date=2015-11-28}}. By National Institute on Drug Abuse.

File:US timeline. Drugs involved in overdose deaths.jpg|US yearly overdose deaths, and the drugs involved. Among the 70,200 deaths in 2017, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (synthetic opioids) with 28,466 deaths.

File:US timeline. Benzodiazepine deaths.jpg|U.S. yearly overdose deaths involving benzodiazepines.

File:US timeline. Cocaine deaths.jpg|U.S. yearly overdose deaths involving cocaine.

File:US timeline. Prescription opioid pain reliever deaths.jpg|U.S. yearly deaths involving prescription opioids. Non-methadone synthetics is a category dominated by illegally acquired fentanyl, and has been excluded.

File:Timeline. Overdose death rates involving opioids, by type, United States.gif|U.S. overdose deaths involving all opioids. Deaths per 100,000 population.[https://www.cdc.gov/drugoverdose/data/analysis.html Opioid Data Analysis and Resources. Drug Overdose. CDC Injury Center]. Centers for Disease Control and Prevention. Click on "Rising Rates" tab for a graph. See data table below the graph.

File:Timeline of US overdose deaths involving heroin, by other opioid involvement.jpg|U.S. yearly overdose deaths involving heroin.

File:Timeline. US drug overdose death rate by race and ethnicity.gif|Timeline of US drug overdose death rates by race and ethnicity.[https://www.cdc.gov/nchs/data-visualization/drug-poisoning-mortality NCHS Data Visualization Gallery—Drug Poisoning Mortality]. From National Center for Health Statistics. Open the dashboard dropdown menu and pick "U.S. Trends". From the menus on the right pick all races, all ages, and both sexes. Run your cursor over the graph to see the data. Rate per 100,000 population.

See also

  • {{annotated link|27 Club}}
  • {{annotated link|Adulterants}}
  • {{annotated link|Brandon Vedas}}
  • {{annotated link|Drug checking}}
  • {{annotated link|Drug interactions}}
  • {{annotated link|Hepatotoxicity}}
  • {{annotated link|List of deaths from drug overdose and intoxication}}
  • {{annotated link|Reagent testing}}
  • {{annotated link|Responsible drug use}}
  • {{sectionlink|Suicide methods|Drug overdose}}
  • {{annotated link|Water intoxication}}

References

{{Reflist}}

Further reading

{{Refbegin}}

  • {{cite book |author1=Nelson, Lewis H. |author2=Flomenbaum, Neal |author3=Goldfrank, Lewis R. |author4=Hoffman, Robert Louis |author5=Howland, Mary Deems |author6=Neal A. Lewin |title=Goldfrank's toxicologic emergencies |publisher=McGraw-Hill, Medical Pub. Division |location=New York |year=2015 |isbn=978-0-07-143763-9}}
  • {{cite book |author=Olson, Kent C. |title=Poisoning & drug overdose |publisher=Lange Medical Mooks/McGraw-Hill |location=New York |year=2004 |isbn=0-8385-8172-2 |url=https://archive.org/details/poisoningdrugove00olso |url-access=registration}}

{{Refend}}