Intravenous injection of opiates is most used: by comparison with injection, "dragon chasing" (heating of heroin on a piece of foil), and madak and "ack ack" (smoking of cigarettes containing tobacco mixed with heroin powder) are only 40 percent and 20 percent efficient, respectively. One study of British heroin addicts found a 12-fold excess mortality ratio (1.8 percent of the group dying per year). Most heroin deaths result not from overdose "per se", but combination with other depressant drugs such as alcohol or benzodiazepines.