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: 2018 registrations, published in August 2019
- There were 4,359 deaths related to drug poisoning in England and Wales in 2018, the highest number and the highest annual increase (16%) since the time series began in 1993
- The male drug poisoning rate has significantly increased from 89.6 per million males in 2017 to 105.4 in 2018; while the female rate increased for the ninth consecutive year to 47.5 per million females in 2018, the latest increase was not statistically significant compared to 2017.
- Two-thirds (or 2,917) of drug-related deaths were related to drug misuse, accounting for 50.9 deaths per million people in 2018.
- The North East had a significantly higher rate of deaths relating to drug misuse than all other English regions; London had the lowest rate.
- Between 2017 and 2018, there were increases in the number of deaths involving a wide range of substances, though opiates, such as heroin and morphine, continued to be the most frequently mentioned type of drug.
- Deaths involving cocaine doubled between 2015 and 2018 to their highest ever level, while the numbers involving new psychoactive substances (NPS) returned to their previous levels after halving in 2017.
According to drug related deaths statistics published in Scotland in July 2019: Drug-related Deaths in Scotland in 2018:
There were 1,187 drug-related deaths registered in Scotland in 2018, 253 (27 per cent) more than in 2017. This is the largest number of drug-related deaths in Scotland since the series began in 1996, and more than double the figure for 2008 (574).
- Males accounted for 72 per cent of the drug-related deaths in 2018.
- There were 442 drug-related deaths of people aged 35-44 (37 per cent of all drug-related deaths), 345 deaths in the 45-54 age-group (29 per cent) and 217 drug-related deaths of 25-34 year olds (18 per cent).
- The NHS Board areas with the most drug-related deaths in 2018 were:
- Greater Glasgow & Clyde – 394 (33 per cent);
- Lothian – 152 (13 per cent);
- Lanarkshire – 130 (11 per cent); and
- Tayside – 109 (9 per cent).
- Opiates or opioids, such as heroin, morphine and methadone, were implicated in, or potentially contributed to, 1,021 deaths (86 per cent of the total number in 2018). Benzodiazepines such as diazepam and etizolam were implicated in, or potentially contributed to, 792 deaths (67 per cent).
- Scotland’s figures imply a drug-death rate that is nearly three 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
In 2016 the Advisory Council on the Misuse of Drugs (ACMD) explored the substantial increases in the number of people dying in the UK where illicit drugs are reported to be involved. The largest increase was in deaths related to the misuse of opioids; 2,677 opioid-related deaths were registered in the UK in 2015.
Their report stated the following:
Through our brief review of the potential causes of recent trends in opioid-related death, the ACMD can assert … that the ageing profile of heroin users with increasingly complex health needs (including long-term conditions and poly-substance use), social care needs and continuing multiple risk behaviours has contributed to recent increases in drug-related deaths.
Other possible causes of recent increases include greater availability of heroin at street level, deepening of socio-economic deprivation since the financial crisis of 2008, changes to drug treatment and commissioning practices, and lack of access to mainstream mental and physical health services for this ageing cohort.
We found that although the current definition and measurement of opioid-related deaths across the UK is consistent and useful, there are weaknesses in current data collection methods that mean the trends over time can be difficult to interpret. Improving the processes of collecting information on opioid-related deaths would ensure that policy makers have better information to make better decisions to reduce deaths.The ACMD also recommends that governments fund independent research in order to provide a better understanding of the causes and drivers of trends in opioid-related deaths, as well as all other drug-related deaths.
Updated August 2019