Types of drug-related deaths
The straight answer is that we do not know exactly how many drug-related deaths there are in the UK. This is because it depends on what definition of drug-related deaths is used, which is not a simple question. For example, these could include
- people who are dependent on drugs and overdose
- suicides by overdose, of people who have no previous history of using drugs
- accidental poisoning or overdose
- ecstasy-related deaths where people have died from overheating through dancing non-stop in hot clubs, rather than from the direct effect of the drugs
- deaths associated with cigarette smoking
- deaths from accidents where people are drunk or under the influence of drugs
- murders and manslaughters where people are drunk or under the influence of drugs
- deaths from driving while drunk or intoxicated
- deaths from AIDS among injecting drug users
- deaths which had nothing to do with the presence of a drug in the body, but were a result of ill-health caused in part by drug use.
- Cause of death is recorded on death certificates but doctors may not mention drugs, even where drugs might be involved.
Despite these difficulties there are estimates of the possible number of deaths associated with different drugs:
England and Wales
According to the ONS publication: Deaths related to drug poisoning in England and Wales: 2020 registrations, published in August 2021
- In 2020, 4,561 deaths related to drug poisoning were registered in England and Wales (equivalent to a rate of 79.5 deaths per million people); this is 3.8% higher than the number of deaths registered in 2019 (4,393 deaths; 76.7 deaths per million).
- Among males, there were 109.7 drug poisoning deaths registered per million in 2020 (3,108 registered deaths), compared with 49.8 deaths per million among females (1,453 deaths).
- Two-thirds (or 2,996) of registered drug poisoning deaths in 2020 were related to drug misuse, accounting for 52.3 deaths per million people.
- Rates of drug-misuse death continue to be elevated among those born in the 1970s, with the highest rate in those aged 45 to 49 years.
- The North East continues to have the highest rate of deaths relating to drug misuse (104.6 deaths per million people); London had the lowest rate (33.1 deaths per million people).
- Approximately half of all drug poisoning deaths registered in 2020 involved an opiate (49.6%; 2,263 deaths); 777 deaths involved cocaine, which is 9.7% more than 2019, and more than five times the amount recorded a decade ago (144 deaths in 2010).
According to drug related deaths statistics published in Scotland in July 2021: Drug-related Deaths in Scotland in 2020: In 2020, there were 1,339 drug-related deaths registered in Scotland. This was 5% more than in 2019 and the largest number since records began in 1996. Deaths have increased substantially over the last 20 years – there were 4.6 times as many deaths in 2020 compared with 2000.
- In 2020, males were 2.7 times as likely to have a drug-related death than females, after adjusting for age.
- The average age of drug-related deaths has increased from 32 to 43 over the last 20 years.
- In 2020, 63% of all drug-related deaths were of people aged between 35 and 54.
- In 2020, after adjusting for age, people in the most deprived areas were 18 times as likely to have a drug-related death as those in the least deprived areas. That ratio has almost doubled in 20 years, from around 10 times in the early 2000s.
- Greater Glasgow and Clyde had the highest age-standardised drug-related death rate of all health board areas (30.8 per 100,000 population for the 5-year period 2016-2020), followed by Ayrshire and Arran (27.2) and Tayside (25.7).
- Greater Glasgow and Clyde had the largest increase in its drug-related death rate, from 8.9 per 100,000 population in the period 2000-2004 to 30.8 per 100,000 population in 2016- 2020. Tayside and Ayrshire and Arran had the next biggest increases.
- Dundee City had the highest age-standardised drug-related death rate of all local authority areas (43.1 per 100,000 population for the 5-year period 2016-2020), followed by Glasgow City (39.8) and Inverclyde (36.7).
- Dundee City had the largest increase in its drug-related death rate, from 5.9 per 100,000 population in the period 2000-2004 to 43.1 per 100,000 population in 2016-2020.
Inverclyde and Glasgow City had the next biggest increases.
- In 93% of all drug-related deaths, more than one drug was found to be present in the body.
- Of all drug-related deaths in 2020, the following substances were implicated:
- opiates/opioids (such as heroin/morphine and methadone) – 1,192 deaths (89% of the total);
- benzodiazepines (such as diazepam and etizolam) – 974 (73%);
- gabapentin and/or pregabalin – 502 (37%);
- cocaine – 459 (34%)
- In recent years there have been large increases in the numbers of deaths where the following substances were implicated:
- ‘street’ benzodiazepines (such as etizolam), from 58 in 2015 to 879 in 2020;
- methadone, from 251 in 2015 to 708 in 2020;
- heroin/morphine, from 345 in 2015 to 605 in 2020;
- gabapentin and/or pregabalin, from 131 in 2015 to 502 in 2020;
- cocaine, from 93 in 2015 to 459 in 2020
- Scotland’s figures imply a drug-death rate that is over three and a half times that of the UK as a whole. It is also higher than that reported for any other EU country. (However, countries differ in how deaths are recorded and coded, and there may be under-reporting in some cases)
Reducing drug related deaths
The Scottish Drug Deaths Taskforce was set up in July 2019 by the Minister for Public Health and Sport, supported by the Cabinet Secretary for Justice to develop a programme of actions to meet Scotland’s unique drug deaths challenge, ensuring that the evidence of what would work most effectively is assessed and acted upon, and that stakeholders amongst the critical agencies involved in the challenge are engaged in the application of best practice. You can read their latest report (June 2021) here
Updated August 2021