Packets of heroin, a syringe and a spoon displayed by the Drug Enforcement Agency in Portland, Maine, in this 2002 file photo. (AP Photo/Robert F. Bukaty)

More people die from drugs than vehicles in 36 states. In fact, in half of all states, drugs are the leading cause of any injury-related death.

That’s according to a new, nearly 90-page report on injury prevention from the Trust for America’s Health and the Robert Wood Johnson Foundation, which grades states and offers recommendations on injury prevention policy based on the advice of an expert committee. The rankings were based on everything from seat belt laws to child abuse and neglect protections to drug monitoring policies.

The latest data show that drug overdose is not only the leading cause of injury-related death nationwide, but also in more than two thirds of states. Yet, the overdose death rate varies dramatically by state: In West Virginia, the leader in overdose fatalities, the rate is more than 12 times greater than in bottom-ranked North Dakota. West Virginia was followed by Kentucky, New Mexico, Nevada and Utah — the five states with overdose fatality rates of more than 20 per 100,000 people.


Drug overdose death rates by state. (TFAH/RWJF)

The overdose death rate has surged in recent years, with 28 states and Washington, D.C., seeing rates rise between the three-year periods ending in 2009 and 2013. At the same time, the rates fell in just four states: Alabama, Arkansas, Florida and Maine.

Drug overdose death rate change from 2007-2009 to 2011-2013. (TFAS/RWJF)
Drug overdose death rate change from 2007-2009 to 2011-2013. (TFAH/RWJF)

Roughly half of the nearly 44,000 annual drug-related deaths result from prescription drugs, with the death rate related to such drugs rising dramatically over the last 15 years. From 1999 to 2011, sales of prescription painkillers quadrupled, while the number of related fatalities nearly quadrupled as well.


The prescription drug death rate has increased dramatically since 2000. (TFAH/RWJF)

So, what can states do to help offset the rising drug abuse death rate?

The report advisory group issued a number of recommendations aimed at curbing prescription abuse, making it easier to help those who are overdosing, and improving poison control centers.

To rein in prescription drug abuse, all states should implement prescription drug monitoring programs — databases that track the prescription and distribution of such drugs, which are in place in only half the states. The authors also argued for improved prevention, education and access to treatment.

In order to help those who are overdosing, the report’s authors argue that states should pass more laws easing access to rescue drugs like nalaxone — which counters the effects of prescription painkillers, heroin and other opioids — and pass Good Samaritan laws protecting bystanders who call for medical assistance.

Access to nalaxone has been facilitated — in some form — in 34 states and D.C., while 26 states and D.C. have passed Good Samaritan laws.


Rescue drug access and good samaritan laws by state. (TFAH/RWJF/Public Health Law Network)