Some drugs are particularly risky and may lead to death if abused, including such drugs as cocaine, MDMA, and methamphetamine, in addition to the chronic abuse of anabolic-androgenic steroids. The individual who abuses these drugs may die of respiratory failure, a stroke or a heart attack, or by other means.

Some drugs also increase the individual's level of aggression and may increase the risk of the commission of a homicide of a child or adult, as with methamphetamine and anabolic steroids.

Cocaine is also a drug that is associated with death among long-time users. According to Dr. Karch in his 1999 article for the Journal of the Royal Society of Medicine, 60 percent of deaths from cocaine abuse among long-term users are caused by an individual using a chronic and toxic dosage of cocaine. In 20 percent of the cases of those who abuse or are dependent on cocaine, the victims are murdered. Suicide accounts for about 10 percent of the deaths of cocaine abusers. The other cocaine-related deaths are caused by stroke, excited delirium, myocardial infarction (heart attack), and sudden cardiac death.

The abuse of methylenedioxymethamphetamine (MDMA/ecstasy) can cause a very rapid and escalating high fever, which, if untreated, can cause death.

A study in the American Journal of Preventive Medicine analyzed 1,906 accidental deaths from medical examiner statistics from 1994 to 2003 in New Mexico, the state which has had the highest rate of drug-induced deaths since 1990. The rate of prescription drug overdose death increased from 1.9 people per 100,000 in 1994 to 5.3 per 100,000 in 2003, a 179 percent increase.

In considering all drug overdose deaths, the researchers discovered that about 77 percent of the people who died were male and about 55 percent were Hispanic, 40 percent were white non-Hispanic, and 2 percent were American Indians. About a third of deaths related to drug abuse were caused by a combination of alcohol and drugs.

Opioid painkillers were involved in 77 percent of deaths caused by prescription drugs, followed by tranquilizers (34 percent), antidepressants (26 percent), and co-intoxication with over-the-counter drugs (10 percent). In many cases, however, the deceased person used more than one type of drug.

Another category of drugs that can lead to deaths are depressants. Abuse of depressants can slow the heart rate and decrease the body temperature (hypothermia) and, as a result, may cause death. Examples of depressants are medications in the benzodiazepine category, such as alprazolam (Xanax) and diazepam (Valium), as well as barbiturates, including such drugs as pentobarbital sodium (Nembutal) and butalbital (Fiorcet).

Inhalants are another category of drugs that may lead to death, owing to cardiac arrthymia, even the first time the substance is inhaled.

Injecting illegal drugs can also cause death. A 2004 study discussed in Archives of Internal Medicine found that intravenous drug users had a high risk of death, particularly IV users ages 25-34 years. Most died from an overdose; however, some contracted the human immunodeficiency virus (HIV), which then progressed to acquired immune deficiency syndrome (AIDS) and then to death.

Some individuals die from drug withdrawal, whether they choose to stop taking the drug or the choice is made for them, as when they are imprisoned. Whether death occurs depends on the type of the drug and the degree of the addiction. Some people addicted to alprazolam (Xanax) have died in jail from withdrawal symptoms.

References:

Copeland, Lorraine, et al. "Changing Patterns in Cause of Death in a Cohort of Injecting Drug Users, 1980-2001," Archives of Internal Medicine 165 (June 14, 2004): 1,214-1,220.

Karch, Steven B., M.D. "Cocaine: History, Use, Abuse," Journal of the Royal Society of Medicine 92 (August 1999): 393-397.

Mokdad, Ali H., et al. "Actual Causes of Death in the United States, 2000." Journal of the American Medical Association 291, no. 10 (March 10, 2004): 1,238-1,245.

Mueller, Mark R., et al. "Unintentional Prescription Drug Overdose Deaths in New Mexico, 1994-2003," American Journal of Preventive Medicine 30, no. 5 (2006): 423-429.

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