Annual Causes of Death in the United States

Tobacco	435,000¹
Poor Diet and Physical Inactivity	365,000¹
Alcohol	85,000 ¹
Microbial Agents	75,000¹
Toxic Agents	55,000¹
Motor Vehicle Crashes	26,347¹
Adverse Reactions to Prescription Drugs	32,000²
Suicide	30,622³
Incidents Involving Firearms	29,000¹
Homicide	20,308⁴
Sexual Behaviors	20,000¹
All Illicit Drug Use, Direct and Indirect	17,000^{1, 5}
Non-Steroidal Anti-Inflammatory Drugs Such As Aspirin	7,600⁶
Marijuana	0⁷

1. (2000): "The leading causes of death in 2000 were tobacco (435,000 deaths; 18.1% of total US deaths), poor diet and physical inactivity (400,000 deaths; 16.6%), and alcohol consumption (85,000 deaths; 3.5%). Other actual causes of death were microbial agents (75,000), toxic agents (55,000), motor vehicle crashes (43,000), incidents involving firearms (29,000), sexual behaviors (20,000), and illicit use of drugs (17,000)." (Note: According to a correction published by the Journal on Jan. 19, 2005, "On page 1240, in Table 2, '400,000 (16.6)' deaths for 'poor diet and physical inactivity' in 2000 should be '365,000 (15.2).' A dagger symbol should be added to 'alcohol consumption' in the body of the table and a dagger footnote should be added with 'in 1990 data, deaths from alcohol-related crashes are included in alcohol consumption deaths, but not in motor vehicle deaths. In 2000 data, 16,653 deaths from alcohol-related crashes are included in both alcohol consumption and motor vehicle death categories." Source: Journal of the American Medical Association, Jan. 19, 2005, Vol. 293, No. 3, p. 298.)

Source: Mokdad, Ali H., PhD, James S. Marks, MD, MPH, Donna F. Stroup, PhD, MSc, Julie L. Gerberding, MD, MPH, "Actual Causes of Death in the United States, 2000," Journal of the American Medical Association, March 10, 2004, Vol. 291, No. 10, pp. 1238, 1241.

2. (Average 1982-1998): According to Canadian researchers, approximately 32,000 hospitalized patients (and possibly as many as 106,000) in the USA die each year because of adverse reactions to their prescribed medications.

Source: Lazarou, J, Pomeranz, BH, Corey, PN, "Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies," Journal of the American Medical Association (Chicago, IL: American Medical Association, 1998), 1998;279:1200-1205, also letters column, "Adverse Drug Reactions in Hospitalized Patients," JAMA (Chicago, IL: AMA, 1998), Nov. 25, 1998, Vol. 280, No. 20, from the web at http://jama.ama-assn.org/issues/v280n20/ffull/jlt1125-1.html, last accessed Feb. 12, 2001.

3. (2001): The US Centers for Disease Control reports that in 2001, there were a total of 30,622 deaths from suicide in the US.

Source: Arias, Elizabeth, Ph.D.; Robert N. Anderson, Ph.D.; Hsiang-Ching Kung, Ph.D.; Sherry L. Murphy, B.S.; Kenneth D. Kochanek, M.A.; Division of Vital Statistics, "Deaths: Final Data for 2001," National Vital Statistics Reports, Vol. 50, No. 3 (Hyattsville, MD: National Center for Health Statistics, Sept. 18, 2003), Table C, p. 8, from the web at http://www.cdc.gov/nchs/data/nvsr/nvsr52/nvsr52_03.pdf, last accessed Jan. 27, 2004.

4. (2001): The US Centers for Disease Control reports that in 2001, there were a total of 20,308 deaths from homicide in the US.

5. (2000): "Illicit drug use is associated with suicide, homicide, motor-vehicle injury, HIV infection, pneumonia, violence, mental illness, and hepatitis. An estimated 3 million individuals in the United States have serious drug problems. Several studies have reported an undercount of the number of deaths attributed to drugs by vital statistics; however, improved medical treatments have reduced mortality from many diseases associated with illicit drug use. In keeping with the report by McGinnis and Foege, we included deaths caused indirectly by illicit drug use in this category. We used attributable fractions to compute the number of deaths due to illicit drug use. Overall, we estimate that illicit drug use resulted in approximately 17000 deaths in 2000, a reduction of 3000 deaths from the 1990 report."

6. (1996): "Each year, use of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) accounts for an estimated 7,600 deaths and 76,000 hospitalizations in the United States." (NSAIDs include aspirin, ibuprofen, naproxen, diclofenac, ketoprofen, and tiaprofenic acid.)

Source: Robyn Tamblyn, PhD; Laeora Berkson, MD, MHPE, FRCPC; W. Dale Jauphinee, MD, FRCPC; David Gayton, MD, PhD, FRCPC; Roland Grad, MD, MSc; Allen Huang, MD, FRCPC; Lisa Isaac, PhD; Peter McLeod, MD, FRCPC; and Linda Snell, MD, MHPE, FRCPC, "Unnecessary Prescribing of NSAIDs and the Management of NSAID-Related Gastropathy in Medical Practice," Annals of Internal Medicine (Washington, DC: American College of Physicians, 1997), September 15, 1997, 127:429-438, from the web at http://www.acponline.org/journals/annals/15sep97/nsaid.htm, last accessed Feb. 14, 2001, citing Fries, JF, "Assessing and understanding patient risk," Scandinavian Journal of Rheumatology Supplement, 1992;92:21-4.

7. An exhaustive search of the literature finds no credible reports of deaths induced by marijuana. The US Drug Abuse Warning Network (DAWN) records instances of drug mentions in medical examiners' reports, and though marijuana is mentioned, it is usually in combination with alcohol or other drugs. Marijuana alone has not been shown to cause an overdose death.

Source: Drug Abuse Warning Network (DAWN), available on the web at http://www.samhsa.gov/; also see Janet E. Joy, Stanley J. Watson, Jr., and John A. Benson, Jr., "Marijuana and Medicine: Assessing the Science Base," Division of Neuroscience and Behavioral Research, Institute of Medicine (Washington, DC: National Academy Press, 1999), available on the web at http://www.nap.edu/html/marimed/; and US Department of Justice, Drug Enforcement Administration, "In the Matter of Marijuana Rescheduling Petition" (Docket #86-22), September 6, 1988, p. 57.