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Lessons from the past
  1. Leonard Paulozzi,
  2. Ann Dellinger,
  3. Linda Degutis
  1. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  1. Correspondence to Dr Leonard Paulozzi, CDC El Paso Quarantine Station, 601 Sunland Park Drive, Suite 200, El Paso, TX 79912, USA; lbp4{at}

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The National Center for Health Statistics (NCHS) recently announced that poisoning had passed motor vehicle (MV) crashes as the leading cause of injury death in the USA in 2008.1 The NCHS also noted that nearly 90% of poisoning deaths were due to drugs, which have driven the overall poisoning mortality increase since at least 1980. Much of the increase in drug poisoning mortality was due to prescription drugs, especially opioid painkillers. Similar trends related to prescription opioids have been noted in other developed countries.2 3

Preliminary mortality data from 2009 suggest an additional large decline in MV crash deaths,4 5 while emergency department data suggest a continued increase in prescription drug overdoses in 2009.6 It is likely that drug poisoning alone now causes more deaths than MV crashes in the USA.

These reported and anticipated changes represent a major milestone in injury prevention. A hundred years ago, falls were the leading mechanism of injury death in the USA.7 Beginning around 1910, MV …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.