Drugs — Remarkably Nontoxic

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Abstract
Data accumulated by the Boston Collaborative Drug Surveillance Program provide an estimate of the acute and long-term toxicity of most drugs used in adult medicine. When extrapolated to the entire American population these data suggest that adverse drug reactions in their totality yearly afflict millions of people, causing hundreds of thousands of hospitalizations, and deaths numbering in the tens of thousands. However, the rates and severity of adverse reactions to individual drugs are remarkably low in view of their pharmacologic properties. The high prevalence of drug-related morbidity and mortality primarily reflects extensive drug usage rather than the intrinsic toxic potential of particular drugs. (N Engl J Med 291:824–828, 1974)