The list is out and it is not a good one. A new study sheds light on which drugs are causing the most deaths in America and the top killer has never appeared in the top slot before. The list is good information for us so that we know where to apply our enforcement, treatment and prevention efforts.

#5 Alprazolam

This drug also goes by one of the brand names Xanax. It also has some street names like Zannies and Bars (the pill often comes in a long pill that resembles a bar). Drug Recognition Experts classify it as a CNS Depressant and it causes a slow pulse, slow lethargic body movements and slurred speech. These are just a few of the common signs of drug impairment.

Most of the Alprazolam on the street now is not true pharmaceutical Alprazolam. It is usually a powder, like the picture below, that is pressed into pills and then sold on the street. This new version on the street is dangerous because the drug traffickers pressing the drug into a pill do not adequately measure the dose going into the pill.

#4 Methamphetamine

This drug also goes by the name meth, Tina and crystal. Most of us have heard of methamphetamine from the news. What most people don’t realize is that methamphetmine use is skyrocketing. We are in the midst of an opioid epidemic, which are often followed by a stimulant epidemic.

Meth, classified as a CNS Stimulant, is in the same category of drugs like cocaine and Adderall. Since it’s use is increasing, it is important for us to focus our enforcement efforts to include methamphetamine and not just heroin and fentanyl.

#3 Cocaine

Cocaine is a CNS Stimulant that increases the pulse, dilates the pupils and makes the user hyperactive. Cocaine use, like methamphetmine, has been on the rise for the last few years. However, the reason for this is more of a political one. I wrote about this some time ago. Specifically, there is an increase in cocaine production in Columbia, which is the U.S.’s number one supplier of cocaine.

The increase in cocaine production is so dramatic that we have not seen an increase like this in 20 years. The reason for the increase in production is a pending peace accord with Columbia’s rebel group “Revolutionary Armed Forces of Columbia”, or FARC. As part of the peace accord, FARC will renounce drug trafficking and farmers will receive subsidies from the government to replace their coca fields with traditional crops. Unfortunately, these farmers are increasing their production so that they can receive more money from the government once the subsidies take effect.

Now Americans are facing the brunt of this huge increase. Cocaine ultimately killed over 11,000 of our citizens.

#2 Heroin

Heroin, a Narcotic Analgesic, has been the top of the list for decades. But a new deadlier drug has bumped it from the top of the list. Don’t fool yourself, heroin is still around and causing us a lot of problems. Most of America’s heroin is coming from Mexico, although most people falsely believe it is coming from Afghanistan.

Heroin is going to cause the user to have constricted pupils, a slow pulse and they will be lethargic and on the nod. However, once the drug wears off and the addict goes into withdrawals, they will have the opposite affects. You may see dilated pupils, a fast pulse and they will appear to have the flu.

#1 Fentanyl

Fentanyl has been causing us problems for some time, so it is no surprise that it jumped to the top of the list. Fentanyl has claimed the lives of over 18,000 people in a single year. The cartels have seen the value in fentanyl. Instead of maintaining a field of poppies that have to be cultivated, protected and shipped to a lab, the cartels are just setting up Fentanyl labs. Fentanyl can be made for as little as $3,800 and can be easily shipped to the United States. One kilo of fentanyl is the equivelant of 50 kilos of heroin. So, it makes economic sense for the cartels to make the switch. The market also demands it. Users on the street are now seeking out fentanyl as their primary high.

Other Drugs on the List

These are just the top five drugs killing our citizens. Here is the rest of the list.