How Many People Die Every Day from Alcohol and Drugs? Global Toll Hits 3.2 Million a Year — Punjab’s Crisis Explained

New Delhi: Substance use remains one of the world’s biggest preventable causes of death. Alcohol, illegal drugs and other intoxicants, commonly called “nasha”, kill millions of people every year.

According to the World Health Organization’s Global Status Report on Alcohol and Health and Treatment of Substance Use Disorders, which uses 2019 data and was released in June 2024, alcohol caused about 2.6 million deaths in 2019. Psychoactive drug use caused another 600,000 deaths.

Together, alcohol and drugs accounted for around 3.2 million deaths a year. That means these substances contributed to almost 5% of all deaths worldwide.

The figures translate to roughly 266,700 deaths every month and about 8,770 deaths every day.

These numbers represent real people who die from liver cirrhosis, cancer, heart and other cardiovascular diseases, road crashes, violence, suicide, drug overdoses and infections linked to substance use.

The Global Picture: Alcohol Causes Most Deaths, Men Face the Biggest Burden

WHO data show that alcohol caused around 2.6 million deaths in 2019. Men accounted for about 2 million of these deaths, while women accounted for around 600,000.

Drug use caused another 600,000 deaths. Men accounted for about 400,000 of these deaths.

Young adults also face a major risk. People aged 20 to 39 accounted for 13% of all alcohol-related deaths.

Alcohol can cause death through several different pathways.

Of the deaths linked to alcohol:

• Around 1.6 million resulted from non-communicable diseases. These included about 474,000 deaths from cardiovascular diseases and 401,000 from cancer.

• Around 724,000 resulted from injuries, including road crashes, self-harm and violence between people.

• About 284,000 resulted from infectious diseases. Alcohol can weaken the immune system and increase the risk of diseases such as tuberculosis and HIV transmission.

Drugs create another major health crisis, particularly through opioid use.

WHO estimates that opioids account for nearly 80% of the 600,000 annual deaths linked to drug use. Overdoses contribute significantly to these deaths.

More recent analyses by the United Nations Office on Drugs and Crime (UNODC) show that drug use also causes many deaths indirectly. Hepatitis C, HIV and chronic liver disease account for a large share of the wider health burden linked to drug use.

Around 400 million people worldwide live with alcohol use disorders, according to WHO estimates. Around 209 million of them have alcohol dependence.

Men account for a much larger share of substance-use disorders, while certain regions face a particularly high burden. People in low-income countries also face higher death rates for every litre of alcohol consumed.

One important point explains why these numbers may look different from overdose figures.

The WHO figures measure attributable deaths — deaths that would likely not have occurred without alcohol or drug use. They do not count only people who die immediately after consuming or overdosing on a substance.

In other words, an overdose represents only one part of the overall death toll.

India: High Alcohol Death Rates and Growing Overdose Numbers

India faces two major challenges: alcohol-related deaths and drug-related harm.

WHO data put India’s alcohol-attributable death rate at 38.5 deaths per 100,000 people across both sexes. That rate stands at more than twice China’s 16.1 deaths per 100,000.

Indian men record an alcohol-attributable death rate of 63.0 per 100,000, compared with 29.6 in China.

Among women, India records 13.5 deaths per 100,000, compared with 3.3 in China.

Several health studies also show that tobacco, alcohol and other substances together contribute to hundreds of thousands of deaths in India every year.

However, official figures for drug overdoses remain much lower because authorities count only confirmed acute overdose cases.

The National Crime Records Bureau (NCRB) recorded 654 drug-overdose deaths in 2023 and 978 in 2024. Between 2019 and 2023, India recorded around 3,290 such deaths.

These figures almost certainly do not show the full impact of drug use.

Many people die after suffering long-term organ damage or from several factors linked to substance use. Authorities may classify such deaths under liver disease, heart disease, accidents, suicide or other causes instead of recording them as drug overdoses.

Punjab: Ground Zero of India’s Opioid Crisis

Punjab shows how severely drug use can affect a region.

The state’s location near the India-Pakistan border has made it a major route for the trafficking and consumption of heroin and other opioids. Several surveys have documented the scale of the problem.

The 2015 Punjab Opioid Dependence Survey (PODS), conducted by the National Drug Dependence Treatment Centre at AIIMS New Delhi along with the Society for the Promotion of Youth and Masses and the Punjab government, estimated that around 232,000 people in Punjab depended on opioids.

The survey placed the estimated range between roughly 175,000 and 322,000 people.

The figure translated to around 837 opioid-dependent people per 100,000 population, several times higher than the national average for drug dependence at that time.

Heroin remained the most commonly used substance, and a significant number of users injected drugs.

A later household survey also found a high level of alcohol dependence. Around 10.9% of the surveyed population showed current alcohol dependence, while the survey also recorded significant opioid dependence.

A 2022 statewide survey by PGIMER Chandigarh estimated that 15.4% of Punjab’s population used some form of substance.

Government data also show the scale of treatment demand. Nearly 300,000 people have registered at Outpatient Opioid Assisted Treatment (OOAT) clinics, while authorities dispense millions of buprenorphine tablets every month as part of opioid-substitution treatment.

Punjab’s Overdose Deaths Remain High

NCRB figures place Punjab among the states with the highest number of reported drug-overdose deaths.

Punjab recorded 89 overdose deaths in 2023 and 106 in 2024.

Tamil Nadu recorded 313 deaths in 2024, putting it ahead of Punjab nationally.

Punjab recorded an even higher figure of 144 overdose deaths in 2022.

Drug-enforcement figures also show the seriousness of the problem.

Punjab consistently ranks among the states reporting the highest number of cases under the Narcotic Drugs and Psychotropic Substances (NDPS) Act, particularly cases involving drug trafficking and possession.

In 2024, Punjab recorded the second-highest rate of NDPS cases per lakh population. The state also accounted for a large share of heroin seizures.

Authorities now face another challenge: drone-based drug smuggling from across the border.

Officials have detected a large majority of such drone-related smuggling incidents in Punjab in recent years.

The Social Cost of Drug Use

The crisis has affected families and communities far beyond the number of recorded deaths.

Families in border districts have reported clusters of overdose deaths. Prison data submitted to the Punjab and Haryana High Court show that roughly 45% of inmates receive opioid-substitution treatment.

That figure highlights the extent of opioid dependence among people in the prison system.

Drug use also contributes to wider social and economic problems. Local reports and court observations have repeatedly linked substance abuse with domestic violence, school dropouts and financial distress in affected families.

Punjab has expanded its treatment network through OOAT clinics, de-addiction centres and helplines such as Safe Punjab.

However, many people continue to relapse, and treatment does not reach everyone who needs it.

Historically, only a small share of people with substance dependence sought formal treatment.

Why These Numbers Matter — and Why They Do Not Show the Full Picture

The global figure of 3.2 million deaths a year gives us an idea of the scale of alcohol and drug-related harm.

However, the number remains incomplete in several ways.

First, it does not include tobacco, which causes millions of additional premature deaths every year.

Second, many countries do not have strong systems for recording deaths linked to substance use.

India faces the same problem. NCRB overdose figures capture only a small part of the overall burden.

Alcohol and drugs also contribute to liver disease, cancer, cardiovascular disease, accidents, suicide and infectious diseases. Authorities may record these deaths under their immediate medical or social causes instead of linking them directly to substance use.

Punjab’s crisis differs from other parts of India mainly because of its intensity.

High youth unemployment, easy access to synthetic and natural opioids, cross-border trafficking networks and long-standing patterns of substance use have combined to create a serious public-health emergency.

Police action alone cannot solve this problem.

The Way Forward

The WHO has called for faster action to meet Sustainable Development Goal target 3.5, which aims to reduce the harmful use of alcohol and expand treatment for substance-use disorders by 2030.

Experts recommend several evidence-based measures.

These include:

• Increasing alcohol taxes.
• Restricting alcohol availability.
• Expanding opioid-substitution treatment.
• Making naloxone more widely available to reverse opioid overdoses.
• Expanding needle-exchange and other harm-reduction programmes.
• Screening people for substance-use problems at an early stage.
  Increasing investment in mental-health services.

Punjab needs sustained political commitment to tackle the crisis.

The state also needs better coordination between its health and enforcement departments, more accurate real-time data on substance-related deaths and stronger prevention programmes at the community level.

Families and villages that have lost young men to “chitta”, a street term commonly used for heroin, already understand the human cost of the crisis.

The statistics only put numbers to what these communities experience every day.

Substance use is not simply a moral or criminal issue. It is a major and measurable cause of premature death.

Alcohol and drugs kill roughly 8,770 people every day worldwide when we count deaths attributable to their use. Punjab also continues to lose people to overdoses and other health problems linked to substance use.

Evidence-based policies, better treatment and stronger prevention can still save many of these lives.