Key Takeaways
Death rates from unintentional injury related to drug use rose nearly 60% from 2018 to 2023.
Men are most at risk — for every one woman who dies from a drug-related accident, about two men die.
When drugs are involved in a traumatic injury, there are more difficulties in treating these patients compared with patients whose injuries were not related to drug use.
CHICAGO (October 3, 2025) — An increasing number of people are dying from drug-related accidental injuries. The rate has risen by nearly 60% within the last five years, according to new study findings.
The research will be presented at the American College of Surgeons (ACS) Clinical Congress 2025 in Chicago, October 4-7.
"Drug use is now contributing to more accidental injury deaths, especially in middle-aged adults. As a result, it is reshaping the way we need to think about trauma and trauma prevention," said study co-author Krista L. Haines, DO, MA, assistant professor of trauma, critical care, and acute care surgery at Duke University Medical Center in Durham, North Carolina. "We need to focus more on overdoses overall, and not just on overdoses at home. The medical response in trauma is much more complicated when drugs are involved, making resuscitating patients more difficult. As a result, our response needs to consider whether drug use was involved when treating traumatic injuries."
In a first-of-its-kind study, researchers looked at the role of drug use in accidental injury in the United States. Using data from the Centers for Disease Control and Prevention's (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER), a national database that compiles death certificates from each state, researchers examined trends in mortality rates specifically for drug-related unintentional injury from 2018 to 2023. Age-adjusted rates per 100,000 individuals were derived and grouped by drug-induced, alcohol-induced, and all other causes. Substance use included opioids, recreational drugs, and prescribed medications. Alcohol-induced death was excluded from the analysis — the authors only included substances that are not traditionally associated with unintentional injury and trauma deaths.
Key Findings
From 2018 to 2023, the total number of deaths from unintentional injury in the United States was 534,000.
Drug-related death rates from unintentional injury rose from 19.5% to 30.8% in the five-year period analyzed.
Death rates increased significantly for adults in the 35 to 44 age group. Of all deaths from drug-induced injuries from 2018 to 2023, about half (51.4%) were within that age category.
Black patients had the highest mortality rates. Of all those who died of drug-induced unintentional injury over the five-year period, 34.9% were Black patients.
After adjusting for age differences between groups, men died at twice the rate of women (38.4% versus 15.6%).
Study Findings Raise Public Health Concern
"It's very surprising to discover just how much drug use is contributing to death from accidental injury, increasing nearly 60% in just five years," said lead study author Christina Shin, a fourth-year medical student at the Medical College of Georgia in Augusta. "The bottom line is that drug use is reshaping the pattern of accidental injury death. Public health efforts need to address not only overdoses but also the rising role of drugs in accidental injuries, bridging addiction medicine and trauma care."
According to the CDC , about half of Americans take at least one prescription drug. Based on another study , one in five Americans use more than one drug, either recreationally or medically.
"We hope that we continue to use drugs appropriately. The goal of this project was not to stigmatize drug use, but rather to understand the causation so that we can better take care of patients, because it's becoming more prevalent in the U.S. population," Shin said.
This analysis was limited by the data collected from death certificates. In future research, the study authors plan to analyze the root causes of these trends and develop interventions, which may involve creating partnerships between trauma care and addiction medicine as well as identifying the health care needs of this vulnerable population.
Study co-authors are Esther H. Park, BA; Jennifer Freeman, MD, FACS; Scott Gallagher, MD, FACS; and Suresh Agarwal, MD, FACS.
Disclosures: The authors have no relevant disclosures.
Citation: Shin GJ, et al. Middle-Aged Adults at Greater Risk of Death from Drug-Induced Unintentional Injuries, Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2025.
Note: This research was presented as an abstract at the ACS Clinical Congress Scientific Forum. Research abstracts presented at the ACS Clinical Congress Scientific Forum are reviewed and selected by a program committee but are not yet peer reviewed.
