Far and away the biggest drug killer is tobacco based products most often death by cigarette. Nicotine is the substance within tobacco products that cause addiction. Tobacco will kill almost 500,000 Americans in 2010.
Alcohol is the second largest drug killer. Over 100,000 Americans will die this year of alcohol related death not including unnatural deaths such as homicide, suicide and accidents.
Polysubstance overdose is the third largest drug killer. A combination of benzodiazepines and opiates can cause respiratory depression followed quickly by respiratory failure. The largest simultaneous polysubstance user is a xanax-oxycontin addict. This is a very deadly combination. See Oxycontin Express:
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