Trends in Unintentional Poisoning Deaths and Death Rates

National Safety Council Statistics Department

March 2008

Summary

Unintentional (accidental) poisoning deaths and death rates have more than tripled over the past twenty years. Unintentional poisonings now exceed falls and are the second leading cause of accidental deaths after motor-vehicle crashes.

The combined evidence seems to indicate that the increase in poisoning mortality is primarily among adults (ages 20-64) of both sexes and is mainly attributable to abuse of opioid analgesics.

Trends

  • The age cohort most affected by poisoning deaths is people born in the 1950’s, that is, in the middle of the Baby Boom years.
  • The most rapid growth in the death rate from 1992 through 2005 occurred among the 45-64 year old age group followed by the 25-44 age group and the 15-24 age group.
  • The increase in poisoning deaths, particularly those involving drugs, occurred among both males and females.
  • Poisoning deaths due to drugs, medicaments, and biologicals tripled from 1992 to 2003 while deaths due to other substances remained constant.

Unintentional Poisoning Involving Adults

  • Between 1993 and 2003, the overall increase in the poisoning death rate for the 20-64 age group was 107%.
  • The greatest increases in death rates occurred among non-Hispanic white females (+320%) followed by non-Hispanic white males (157%).
  • The largest numerical increases also occurred among non-Hispanic white males and females.
  • Drug poisoning deaths among other races and among Hispanics changed relatively little over the decade.
  • Three-year average (2002-2004) drug-related poisoning death rates for males, blacks and whites, and in large and medium metropolitan areas (250,000 or greater population) are greater than the overall average.

Poisoning Exposures (Fatal and Nonfatal)

  • From 1995 to 2003, the overall increase in adult poison exposures was +23%, from nearly 650,000 to nearly 800,000.
  • Analgesics, which includes both over-the-counter and prescription pain relievers, ranked first both years and exposures increased by 85%.

OTC, Prescription and Illicit Drugs

  • Over the counter (OTC) medications, while still a problem, are not associated with the increase in drug-related unintentional poisonings.
  • From 1999 to 2004, there is a very strong correlation between prescription drug sales per capita and the unintentional poisoning death rate, indicating that mortality rates are associated with prescription drug use.
  • With the exception of PCP, increased use of many illicit drugs is strongly correlated with the increased number of unintentional poisoning deaths.
  • There is a very strong relationship between unintentional drug poisoning death rates and total sales of opioid analgesics. Oxycodone and hydrocodone account for most of the increase in sales of opioid analgesics.
  • The most rapid growth in new nonmedical users of drugs has been users of pain relievers.
  • The rate of sales of prescription opioid analgesics in states is related to the drug poisoning mortality rate. There is a strong and statistically significant correlation between high drug-poisoning mortality rates and high overall consumption of opioid analgesics in states. The correlation was greatest for oxycodone and methadone.