Medical examiners participating in the federally sponsored Drug Abuse Warning Network (DAWN) program reported 8295 narcotic analgesic-related deaths in 1999, a 49% increase from the 3403 narcotic-related deaths reported in 1990 (Kissin et al., 2000). Heroin toxicity still accounts for nearly half of all narcotic-related deaths (42%), compared to one-third in 1990, and for 41.3% (4820/11,651) of all reported drug-related deaths. Toxicity from the other opiates occurred much less frequently than from heroin, although there have been some important changes since publication of the last edition of this book. Hydrocodone mentions have increased tenfold, and fentanyl, which did not rate a mention previously, was responsible for 53 of the deaths reported to the federal government. Table 5.1.1 lists the other agents that were included in the 1999 DAWN report.