Want to guess? At least in the United States the second biggest unintentional injury killer (leaving aside murders and suicides) killer? Beware poisons.

• In 2005, 23,618 (72%) of the 32,691 poisoning deaths in the United States were unintentional, and 3,240 (10%) were of undetermined intent (CDC 2008). Unintentional poisoning death rates have been rising steadily since 1992.
• Unintentional poisoning was second only to motor vehicle crashes as a cause of unintentional injury death in 2005 (CDC 2008). Among people 35 to 54 years old, unintentional poisoning caused more deaths than motor vehicle crashes.

Yet car accident deaths down to only 34k per year aren't all that much higher than the 23k unintentional poison deaths.

But these killer poisons are mostly not arsenic or other compounds that are purely toxic without redeeming value. What kills us are compounds we use to reduce suffering. Beware your pain killer drugs.

• In 2004, 95% of unintentional and undetermined poisoning deaths were caused by drugs (WONDER 2007). Opioid pain medications were most commonly involved, followed by cocaine and heroin (Paulozzi et al. 2006).
• Among those treated in EDs for nonfatal poisonings involving intentional, nonmedical use (such as misuse or abuse) of prescription or over-the-counter drugs in 2004, opioid pain medications and benzodiazepines were used most frequently (SAMHSA 2006).

Think about how to reduce your car accident risks. You'll win two ways because some of those people dying from pain killers were probably treating themselves for pain caused by car accident injuries.