Psychiatric Medications Kill More Americans than Heroin

In 2014, 10,574 people died of heroin overdose while 15,778 died from an overdose of psychiatric medications, nearly 50% more.

We often hear the shocking fact that deaths from heroin increased nearly 5 fold (374%) between 1999 and 2014, but rarely – if ever – do we hear that deaths from psychiatric drug overdoses have increased nearly 4 fold (278%) over the same time period. The data are summarized in Figure 1.

The biggest killers are sedatives (benzodiazepines such as Xanax and Z-drugs such as Ambien), antidepressants, psychostimulants (Ritalin, amphetamine, and methamphetamine), and antipsychotics, in that order, as shown in Figure 2.

What accounts for this high overdose death rate for users of psychiatric medications and for the steep climb in death rates over the past 15 years? A number of factors appear to contribute to this, including increased prescribing, increased polypharmacy (prescribing multiple drugs to the same person at once), increased off-label prescribing, and increased prescribing of psychiatric drugs by non specialists, including general practitioners, nurse practitioners, and others untrained in the field of psychiatry. We will proceed to look at each of these factors below.

According to data from the MEPS (Medical Expenditure Panel Survey) database, the number of prescriptions for psychiatric medications (i. e. sedatives, antidepressants, psychostimulants, and antipsychotics) increased 117% between 1999 and 2013, from 197,247,557 prescriptions in 1999 to 427,837,506 prescriptions in 2013. Meanwhile, death rates from psychiatric medication overdose climbed a whopping 240% over the same time period, from 1.31 deaths per 100,000 in 1999 to 4.46 deaths per 100,000 in 2013 (we are excluding the CDC death rate data from 2014 since the MEPS 2014 data has not yet been published).

Details of prescribing by drug class are given in Figure 3 and percentage of increase in prescribing is in Figure 4. Although the increase in number of prescriptions partially accounts for the increase in death rates, it is clear that it does not account for all of them, and that there must be other factors involved. Those primary factors are most likely polypharmacy, off-label prescribing, and non-specialist prescribing.


Although medical scholars use the word polypharmacy in several different ways, the simplest definition is “the prescription of two or more drugs at the same time.” In other words, drug mixing. In some cases, such as HIV treatment, polypharmacy is an evidence-based best practice. In other cases, such as psychiatric treatment, there is little research to back up most instances of polypharmacy; moreover, inappropriate polypharmacy can be harmful or even deadly.

Kingsbury and Lotito (2007) state that:

A great deal of data exists about the dangers of polypharmacy. Persons with psychiatric disorders experience increased risk for adverse drug interactions because of the great frequency with which multiple medications are used. Using multiple antipsychotics concomitantly has been associated with increased mortality in patients with schizophrenia. Reports of adverse psychiatric polypharmacy effects are abundant, including increased duration of hospital stay.

Kukreja et al. (2013) tell us that:

While evidence for the added benefit of psychiatric polypharmacy is limited, there is growing evidence regarding the increased adverse effects associated with such combinations. Concerns with polypharmacy include not only possibilities of cumulative toxicity and increased vulnerability to adverse events but also adherence issues which emerge with increasing regimen complexity.

Mojtabai and Olfson (2010) report major increases in psychiatric polypharmacy: in office-based psychiatry practices in the United States the median number of medications prescribed per visit doubled from 1 in 1996-1997 to 2 in 2005-2006 and the mean number increased by 40.1% from 1.42 in 1996-1997 to 1.99 in 2005-2006.

In Figure 5 we show the percentage of deaths due to drug mixing in each psychiatric medication class in 2014. Figure 6 lists the drug combinations with psychiatric medications which had the highest death rates in 2014.

Off-label and general practitioner prescribing of psychiatric medications: Off-label prescribing refers to prescribing a drug for a reason other than one which has been approved by the FDA. Although there are instances where off-label prescribing is based on sound published scientific evidence, this is not so in the vast majority of cases. Radley et al. (2006) found that only 4% of off-label psychiatric prescriptions had strong scientific support. Ali and Ajmal (2012) report that off-label prescribing carries clinical risks, such as adverse effects and unproven efficacy. Additionally, Mojtabai and Olfson (2011) report that 72.7% of antidepressant prescriptions in 2007 were written in the absence of any psychiatric diagnosis. Moreover, according to Mark et al. (2009) less than one fourth of prescriptions for psychiatric medications are written by psychiatrist, over three fourths are written by general practitioners, nurse practitioners, and others untrained in the field of psychiatry.

In my personal experience running an alcohol support group, I have had countless women tell me that, despite admitting they were drinking too much, their GPs still prescribed an SSRI antidepressant and, shortly after starting the antidepressant, their alcohol consumption went through the roof. This is not surprising, in light of the fact that research by Naranjo et al. (1995) showed that women treated with SSRIs drank significantly more than women given a placebo; a survey by Graham and Massak (2007) also found antidepressants were useless for reducing drinking in women. Unfortunately, doctors who have been encouraged to write off-label prescriptions frequently jump to the conclusion that women who drink too much must be depressed, so they wind up prescribing an antidepressant that actually makes them drink more. There is a great deal of potential harm which can result from off-label prescribing.

Alternatives to Drug Therapy

Wouldn’t it be great if there were some way we could permanently change the wiring of the brain to ameliorate or eliminate things like depression, anxiety, and schizophrenia without a lifetime reliance on potentially deadly drugs? Actually there is: it is called psychotherapy.

Everything you do which changes the way you think also changes your brain. Recent neuroimaging studies of people who have undergone Cognitive Behavioral Therapy (CBT) by Porto et al. and by Quide et al. show different patterns of brain function than those who have not had such therapy. There is another type of psychotherapy known as Dialectical Behavioral Therapy (DBT) which incorporates mindfulness and meditation practices into CBT. A large body of neuroimaging studies by Newberg demonstrate that mindfulness and meditation practices also permanently change the functioning of the brain.

But what about schizophrenia? Isn’t the only hope for schizophrenics to keep them doped up in a zombified stupor until the day they day? A recent New York Times article titled “New Approach Advised to Treat Schizophrenia” says no; the best treatment for schizophrenics is minimal use of antipsychotic drugs and lots of psychosocial therapy. The article then goes on to tell us that there is actually nothing “new” in this treatment approach, as it has been used in Scandinavia and Australia with great success for decades. It is only new to American psychiatrists who are too ignorant and arrogant to learn anything from the rest of the world and will only accept a study that has been carried out in America. But the reality is that it is not new – even in America. It is the model pioneered by Loren Mosher back in the 1970’s before Big Pharma got him fired from his post as chief of NIMH’s Center for the Study of Schizophrenia…because he was interfering with the profits from their latest huge money maker: antipsychotic drugs.

The reality is that drugging patients into a stupor with huge doses of antipsychotics prevents recovery from schizophrenia. This is why third world countries like India and Nigeria have much higher recovery rates for schizophrenia than the US; they cannot afford antipsychotic drugs which have good short term effects and very bad long term effects. Harding’s Vermont study found that half to two thirds of unmedicated schizophrenics recovered and Harrow found similar results. This is in stark contrast to medicated schizophrenics whose recovery rate is around 10 to 20%.


When prescribed appropriately, psychiatric medications are lifesaving, life changing wonder drugs. However, when over-prescribed or inappropriately prescribed they can lead to great harm and even death. What is needed is a major curtailment of polypharmacy, off-label prescribing, and non-specialist prescribing. The use of psychiatric drugs needs to be reduced to a mere fraction of current use rates and needs to be replaced or supplemented with appropriate psychosocial interventions which include not only therapy but such basics as housing, food security, and education. Money needs to be invested in social change rather than pill popping if we wish to create a healthy nation.

Would we say that just because insulin is good for diabetics that everyone should take it? No, that is nonsense because it would totally destroy a normal metabolism. Yet this is exactly the approach we are taking with psychiatric medications thanks to the misinformation that Big Pharma feeds to doctors and the general public in order to increase their sales and line their pockets.

Definitions Used in this Article

Sedatives: MCD codes T42.3 Barbiturates, T42.4 Benzodiazepines, and T42.6 Other antiepileptic and sedative-hypnotic drugs (Z-drugs such as Ambien and Lunesta)

Antidepressants: MCD codes T43.0 Tricyclic and tetracyclic antidepressants, T43.1 Monoamine-oxidase-inhibitor antidepressants, and T43.2 Other and unspecified antidepressants (SSRIs/SNRIs)

Antipsychotics: MCD codes T43.3 Phenothiazine antipsychotics and neuroleptics, T43.4 Butyrophenone and thioxanthene neuroleptics, and T43.5 Other and unspecified antipsychotics and neuroleptics

Psychostimulants: MCD codes T43.6 Psychostimulants with abuse potential

These MCD codes were used with UCD codes X40-X44, X60-X64, X85, Y10-Y14 to extract data from CDC WONDER.

Image Courtesy of iStock

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of We do believe in healthy dialogue on all topics and we welcome the opinions of our professional contributors.

What Are Your Thoughts on this Topic?

  • Huey

    There are many, many people who are not dead but who are suffering horribly from psych drugs’ side effects, interactions, and withdrawal symptoms. As multidrug prescribing increases, so will deaths, but so also will these illnesses, which some call brain damage. One of the sad things is that prescribing doctors–whether psychiatrists or not–have a tendency to treat psychdrug withdrawal symptoms by simply switching to or adding another dangerous drug and, often, changing the diagnosis. Psych drug manufacturers, of course, vastly downplay these dangers. There are many sites which deal with these issues and serve as support groups for those unfortunate enough to be suffering from illnesses that the medical profession neglects or denies. The best one is probably Surviving Antidepressants link to Those interested in the treatment of addiction should become more aware of the dangers of psych meds and this article, Kenneth, is a very good start. Thank you.

    • alicia arol

      I know (because I’m SMART) that the so called “experts” may have a LONG list of possible side effects for each individual psychiatric medication but have no idea in the world what types of adverse reactions any particular individual might experience as a result of his psychiatrist prescribing him a number of different psychiatric medications to take simultaneously: A depressed individual being prescribed ONE anti depressant like Prozac dramatically differs from my mother who was diagnosed chronic schizophrenic 37 years ago and put on ONLY Prolixin that, fortunately for her, worked just fine/kept her stable enough to work HARD at the same company for 22 years-right up until 2009. Over the last 7 years since her Prolixin UNFORTUNATELY suddenly “stopped working” my 70 year old mother has been sectioned in and out of various “mental health facilities” & put on different COMBINATIONS of every psychiatric medication imaginable. Unfortunately for her, she began exhibiting signs of mania a couple or so years ago so is now viewed as BI-POLAR as well as CHRONIC SCHIZOPHRENIC: Each BRAND NEW to her case psychiatrist who treats her once she’s locked up in yet another “mental health facility” & under a BRAND NEW doctor’s “care” FALSELY BELIEVES that his way of “treatment” will be the one that finally works for my ‘Guinea Pig” mother. ***In my UNWAVERING, NON MAINSTREAM, viewpoint my poor, elderly, mother’s body is so BEYOND TOXIC from 37 years worth of ingesting into her body all these various psychiatric medications ABSOLUTELY NO COMBINATION OF ANY PSYCHIATRIC DRUGS IS EVER GONNA WORK FOR HER (ie keep her stable & prevent her from having yet another breakdown & consequently being sectioned YET AGAIN into yet another “mental health facility”) FOR VERY LONG ANYMORE… ):

  • Huey

    Those interested in the treatment of addiction should become more aware of the dangers of psych meds and this article, Kenneth, is a very good start. Thank you.

    There are very many people who are not dead but who are suffering horribly from psych drugs’ side effects, interactions, and withdrawal symptoms. As multidrug prescribing increases, so will deaths, but so also will these illnesses, which some call brain damage. One of the sad things is that prescribing doctors–whether psychiatrists or not–have a tendency to treat psychdrug withdrawal symptoms by simply switching to or adding another dangerous drug and, often, changing the diagnosis. Psych drug manufacturers, of course, vastly downplay these dangers. There are many sites which deal with these issues and serve as support groups for those unfortunate enough to be suffering from illnesses that the medical profession neglects or denies. The best one is probably Surviving Antidepressants.

    • Todd Nease

      I concur fully Huey. As someone who has lived with both situations, having some issue with so called “addiction” and having taken piles of psyche meds for almost a decade before getting off of them over 5 years ago.

      Kenneth really nailed a lot of the important issues I personally experienced during that dark decade. And you did too.

      Psychotherapy is so needed. One thing I think he did not mention is access to a real nutritionist is also something that could really benefit the mentally ill. With bi-polar as I experience it, diet is often a large part of the problem, and sleep as well.

      Though stress may be the catalyst for a manic episode, the sleep and eating disruptions that follow tend to be that which will determine the severity and/or duration of the episode.

      It took me decades to figure this out, because every body repeats the mantra you “have” to be on medications.

    • Frances Elizabeth Curley

      I have permanent, disabling, torturous damage to my CNS from antipsychotic drugs. Thanks Big Pharma.

    • alicia arol

      I Agree!!!

  • Gary Thompson

    The lead clinicians stubbornly refuse to change this life threatening protocol of chest compressions only for drug OD. Causing an increase in in morbidity and mortality as well as making the clinicians and everyone else victims.

    Live human study chest compressions only for drug overdose, but is causing deaths to anyone suffering any breathing emergency.

    My letter Emergency Medicine News Dec. 2015

    link to

    Beyond grey medical literature live human study in Ontario, chest compressions only for respiratory emergency Can. J. Public Health 2013;104(3):e200-4

    ‘Development and implementation of an opioid overdose prevention and response program in Toronto, Ontario.’ link to

    Was also published in the 2015 AHA & ILCOR CPR guidelines about this life threatening intervention.

    Read all comments under this deputation Toronto Board of Health link to

    Best Wishes


  • Crabpaws

    Is the data for Figures 1 and 2 from the MEPS database? How was cause of death determined?

    • Kenneth Anderson

      Data in Figures 1 and 2 is from the CDC WONDER database. Cause of death is entered into the database by the CDC from every death certificate filed in the US. So it is the doctor who fills out the death certificate who determines cause of death.

  • CAFranco

    I understand that psychiatric medications are pharmaceutical companies big money profit making. They seem to want to makes a medication to all kinds of human discomfort even if those discomforts are the results of normal life.

    Then we wonder why we have a drug problem. Better Life Through Chemistry of course.

    • Frances Elizabeth Curley

      Mental illness is not part of “normal life”.

      • CAFranco

        But 396 diagnosis on the DSM5 is not normal. Most of those diagnosis haven’t been validated by science. They are nearly fabricated by the American Psychiatric Association. The National Institute of Mental Health has decided to start their own system based on scientific research like the diagnosis in all other fields of health. That’s abnormal voodoo psychiatry what the APA has created. Claiming that humans in this planet are mentally ill. RUBBISH.

        • alicia arol


  • Todd Giffen

    This article is flawed because it falsely states only 15000 a year die from psych meds a year but that’s just the overdoses. There are deaths from the drugs caused by complications and the normal functions of the drugs. In the senior population over 500000 die annually from psych meds alone. There are articles claiming in the general population at least 50000 citizens die a year from antipsychotic drugs. An American Medical Association published report indicated more than 100000 we’re dying from pharmacuticals in general yearly not due to complications or overdose but when correctly prescribed and administered.
    here are a few links:
    link to

    The facts on this are largely covered up by the minstream media because of greed, fraud and corruption. As such you don’t hear the facts on psych meds like this and the industry is largely protected.

    link to

    It appears that government is fine killing a percentage of people using these deadly medications. They used to call it eugenics but have abandoned the term and kept the extermination programs in place.

    link to

    link to

    The AMA article is old from the year 2000 since then drug use has expanded even more and is killing more.

    • Huey

      Thanks for pointing out that overdose isn’t the main cause of death for those on psych meds. I hope those in the addiction treatment field realize these dangers before they put their patients on them as a part of, or adjunct to, rehab. (I’m worried about suboxone too, as I don’t think an unbiased damage assessment has been made.)

      The 500,000 psych med deaths for seniors you claim is not realistic as it would constitute a high proportion of all deaths, but someone must be making these sorts of calculations. I’d like to know who is doing it, how it’s calculated, and what the actual figure(s) are. It’s been said that the SSRI period of American psychiatry will go down as a shameful one. Your links are very helpful. Thank you.

      I would use the term incomplete rather than flawed. It was good to see someone say anything at all about the dangers of psych meds in Pro Talk. Much more talk is needed.

      p.s. For some reason–probably my fault–two pretty identical versions of my other comment have been posted and, try as I might, I haven’t managed to delete either one.

    • Kenneth Anderson


      Your statements are quite correct. I limited myself to overdose in the article so I could easily compare apples to apples. It is more complicated to compare all heroin related causes of deaths to all psych med related causes of death–although that is certainly a worthwhile project for someone willing to undertake the work involved.

  • Janice Marie

    Thank you for pointing out the things mainstream medicine seems to be repeatedly ignoring. Polydrugging and overdrugging people is so dangerous – is it really that hard for a doctor to just say I don’t think I can help you let me send you to a therapists.. or something like that? Destruction by greed and ego.

  • K.W. Lee

    Appropriate prescriptions of psych meds are life & family savers. The most important thing is not to overdose and abuse. Don’t mix with drinks and dangerous drugs !

  • compassion

    Treating Diabetes with insulin is the same as treating Depression with a psych med according to many mental professionals. The thing is with mental health if you solve someones basic needs, like healthy food, housing, and income, you could cure most patients. This is the same with everyone else really, even a diabetic wouldn’t need insulin with healthy food and weight loss from exercise. Its just that we’re dependent and conditioned to believe what makes other people money is best. Provide for all their needs, and them have the right to self determination and a lot of people will be cured from their diseases. Some may take longer than others, but that is where you use compassion to be patient rather than judgement that their lazy and just looking for handouts, or malingering..

    • Dana Watkins Mullins

      Your statement about diabetes in completely untrue. A type 1 diabetic will need insulin their entire life and no amount of diet or food choices will change that. It has been proven that it starts from an auto-immune malfunction and can be hereditary. It has nothing to do with food choices, weight or activity levels.

  • Bryan

    People use drugs to deal with pain — physical and/or emotional. We can also learn to regular our moods and think more rationally. If using a legal medication helps you manage yourself, then use it. The unfortunate and ignorant ones who don’t know how dysfunctional they and their families are can also learn but often do not because it’s easier to be an addict, even it kills you. They could at least not have children IMO

  • Someone Else

    I’d like to point out that there should be a discussion regarding what is actually “appropriate” prescribing of these so called “wonder drugs.” Especially, given today’s current recommended treatments for “bipolar disorder” do include poly pharmacy. They include combining the antipsychotics, antidepressants, and benzos.

    link to

    This, despite the fact, all doctors should be well aware of the reality that combining these drug classes is medically known to cause anticholinergic toxidrome.

    “Substances that may cause this toxidrome include the four ‘anti’s of antihistamines, antipsychotics, antidepressants, and antiparkinsonian drugs[3] as well as atropine, benztropine, datura, and scopolamine.”

    And the central symptoms of anticholinergic intoxication syndrome are almost medically indistinguishable from the positive symptoms of “schizophrenia.” They are, from

    “Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

    I’m quite certain today’s claimed “appropriate” guidelines for treating “bipolar” are quite inappropriate. In that they are basically a recipe for how to create “psychosis” and “hallucinations” with psychiatric drug cocktails.

  • Silver Damsen

    One thing that I take away from this article is something that I already knew but nonetheless I was still taken off guard. Media shapes which social problems are understood as real problems and which are not. Media is influenced by those in power. Thus, people can believed they are informed, but they are actually being manipulated. The attitude towards drugs and illegal drugs is the area that seems most prone for manipulation and misinformation.

    The only thing to be thankful for is that there are people who know the truth, such as Kenneth Anderson, and who tell it.

    Still because of the way our media is disseminated, it is no longer an issue of needing censorship on “sensitive topics.” Alack, while the truth can be told, but it is still received with apathy if not delivered in the primary news media, which, then acts as a kind of censorship–despite the US being built on the idea of no censorship.
    So then the issue is how to spread the truth to create a saner, better, safer drug policy????

    • Krissy Anderson

      Precisely. And it’s simply called PR. Publicity: People generally believe what they read, however I believe it is changing. There have been too many lies, obvious opinion in editorial, untrained self-proclaimed journalists with no idea how important it is to research, interview and check facts. The media is a mess. It’s a sloppy diluted industry that used to be one of information, truth and respectfulness. I was in the media and I hate to see how things have changed. Granted there are still many, many great journalists and writers, but they can’t be responsible for the state of affairs we’re in now. Everything boils down to education, from the first pill a person takes to the last article s/he reads. Without education, the muddled and grey areas grow and grow. But who is responsible for education? That question is becoming harder and harder to answer. A new industry must be developed just for education, and it has to start with babies.

  • Sandra Villarreal

    I’d like you to take into account the number of suicides from side effects, adverse effects, and the mentally torturous withdrawals that many don’t survive from taking their medicine. When every baby, child, teenager, man & women receives a ‘so called’ mental diagnosis to treat their imaginary chemically imbalanced brain, in this country it becomes a ‘life sentence’. I received mine 35 years ago. The drugs never stopped. And our local Community Mental Healthcare facilities poly-prescribe the most ‘off label’ drugs in the entire mental health system. And I believe they use Fraud to do it. Otherwise, how can DBT classes through my mental healthcare place charge $39,000 for one-year of treatment? When I saw this/my bill I was shocked. Why don’t they have Psychiatric Drug Withdrawal programs in place either? I almost died when they told me it was ‘just fine’ to cold turkey off Klonopin that I’d been on for 10+ years.

  • cowboybob

    There is too much money tied up in psychiatry and the related meds to change anything. Every person for themselves.

  • The Spark

    I’m appalled that the media isn’t covering this!

  • Staci English

    Logic determines a person’s thoughts. Psychological logic can be debugged just like bad code in a software program. Adequate exposure to good logic to replace the bad code is key.

  • Silver Damsen

    It is interesting and frightening to compare Anderson’s observations here with the findings of Angus Deaton on the increased mortality of poor, white, “mentally ill,” “addicts” (something only happening in the US and no other 1st World Nations and happening at an alarming rate); and also to observations that AA/ 12 Step (essentially religious but non-medication based “addiction” treatment) is horrifically ineffective and yet the later is widely “prescribed” and often even legally required. Similarly, some psychiatric patients have to agree to medication (that can be over-medication) or it can be legally forced on them, even including signing away their rights if the medication that they are forced to take harms or kills them (the last Anderson doesn’t talk about but is standard psychiatric practice).

    In all cases people are who seemingly shouldn’t be dying are dying because they are dying as a result of the “best” medical advice available, or so they think. And the more medication they receive from so called medical experts, the higher their mortality seems to be.

    In some cases, as Anderson documents, medical professionals are over-prescribing, but deaths are also occurring from medical professionals not prescribing medications that can be useful for treating “addiction” but instead are more less forcing “patients” to attend AA. So it isn’t just necessarily just that medical professionals have a tendency to over-prescribe medication. The common thread for all is that Big Business supports drug rehabs (indeed, the only real increase in medical treatment for the poor with Obama care was that the poor now get/or can even be forced into the very expensive and very ineffective rehab facilities) and also Big Business makes money with over-medicating.

    So we live in a situation where most people are just cogs in the machine of Big Business so that their value as a person is only in how much they can earn a corporation. If this is what capitalism has become we need a huge overall on not just the medical field (which we do need) but also on how Big Business impacts our health. It is at the point where we might even start think of calling Big Business, the “Big Business of Death.”

  • massive

    Really great piece Ken!

    I liken it to Cancer Death-. some 600,000 died in 2015. But I don’t hear them rushing for a cure. Just more cutting, radiation and chemo-

    19,000 died of Opiate deaths, how many died from Crack, Meth and before that Ice and COCAINE before that..still a small number compared to Cancer.

    19,000 or 600,000 —- what is killing more ? ——— Cancer—- oh yea —– thats not interesting enough for scaring people and getting everyone in DC all worked up till you or your lover or you mother die from it.

    Also – what are the police doing to stop in the sale of Heroin? Are they too busy handing out DUI ‘s in Upper class neighborhoods. Easy money- Dis empowering young people.

    Keep up the good work Kenneth !