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Notes -
Drug deaths and related "deaths of despair" have been wildly underappreciated for at least a decade. They tend to kill prime age people, and for reference they dwarf US annual losses in Vietnam (the worst year -1968 - was about 17,000; average over 20 years was about 3,000).
Preventable drug deaths have been compounding YoY since at least 1998, when there were about 11,000 "preventable" deaths. About 80% of deaths are due to opiates. Max statewide variation is almost 10X, with Nebraska, South Dakota, Iowa, Texas near the bottom (approx 14 deaths/100k), and West Virginia, Tennessee, Louisiana, Kentucky at the top (about 60 deaths/100k). Cali, NY, Washington, Oregon are middling (about 27 deaths/100k). Large clusters are found in the rust and coal belt. Unsurprisingly, "manufacturing job loss predicts a substantial share of drug and opioid overdose deaths for women and men" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725949/).
In my experience, there is a threshold for enjoyment depending on the person. I simply didn't find opiates all that interesting (prescription, tincture, inhaled), even at highly inebriating levels. Nevertheless, vs other drugs, the likelihood for life-deranging enjoyment is probably unmatched.
https://injuryfacts.nsc.org/home-and-community/safety-topics/drugoverdoses/data-details/#:~:text=In%202021%2C%2098%2C268%20people%20died,%2C%20homicide%2C%20and%20undetermined%20intents.
https://www.cdc.gov/nchs/pressroom/sosmap/drug_poisoning_mortality/drug_poisoning.htm
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