Statistical bulletin: Deaths Related to Drug Poisoning in England and Wales, 2012

Given the latest statistics that have recently been published surrounding National Drug Related Deaths. There is most definitely a need Naloxone, a life saving medication to be rolled out to every member of our community who may be at high risk or may be witness to a high risk situation where an immediate response could make the difference between the life or death of an individual. The following statistics show that over half the reported deaths (52%) were related to opiates of some form or other. And that, in fact, 63% in males aged between 30-39 involved an opiate. 

Statistical bulletin: Deaths Related to Drug Poisoning in England and Wales, 2012

Key findings

  • There were 1,706 male drug poisoning deaths (involving both legal and illegal drugs) registered in 2012, a 4% decrease since 2011.
  • Female drug poisoning deaths have increased every year since 2009, reaching 891 in 2012.
  • The number of male drug misuse deaths (involving illegal drugs) decreased by 9% from 1,192 in 2011 to 1,086 in 2012; female deaths decreased by 1% from 413 in 2011 to 410 in 2012.
  • The highest mortality rate from drug misuse was in 30 to 39-year-olds, at 97.8 and 28.9 deaths per million population for males and females respectively in 2012.
  • The number of deaths involving heroin/morphine fell slightly in 2012 to 579 deaths, but these remain the substances most commonly involved in drug poisoning deaths.
  • The number of deaths involving tramadol have continued to rise, with 175 deaths in 2012 – more than double the number seen in 2008 (83 deaths).
  • Mortality rates from drug misuse were significantly higher in Wales than in England in 2012, at 45.8 and 25.4 deaths per million population respectively.
  • In England, the North West had the highest mortality rate from drug misuse in 2012 (41.0 deaths per million population).
  • All figures presented in this bulletin are based on deaths registered in a particular calendar year, and out of the 2,597 drug-related deaths registered in 2012, 1,358 (just over half) occurred in years prior to 2012.

Summary

This bulletin presents the latest figures from the Office for National Statistics (ONS) on deaths related to drug poisoning (involving both legal and illegal drugs) and drug misuse (involving illegal drugs) in England and Wales for the last five years. Figures from 1993 are available to download, and are discussed in the commentary to provide context to the latest (2012) data.

Figures presented in this bulletin are for deaths registered each year, rather than deaths occurring each year – see the ‘Impact of registration delays on drug-related deaths’ section below for more information. Figures are presented by cause of death, sex, age, substance(s) involved in the death, and area of usual residence of the deceased.

Mortality rates for 2002–11 have been recalculated using revised mid-year population estimates which take account of the 2011 Census. These may differ from previously published figures (see Background note 13).

There were 2,597 drug poisoning deaths (involving both legal and illegal drugs) registered in 2012, and as in previous years, the majority (just over two-thirds) of these deaths were in males. There were 1,706 male deaths from drug poisoning in 2012, a decrease of 4% since 2011, and the lowest since 1995. The equivalent number of female deaths rose to 891, an increase of 1% since 2011, and the highest since 2004.

In 2012 males aged 30 to 39 had the highest mortality rate from drug misuse (97.8 deaths per million population), followed by males aged 40 to 49 (85.9 deaths per million population). The male mortality rates in these two age groups were significantly higher than the rates in all other age groups and much higher than females of any age.

As with males, the highest rates for females were among those aged 30 to 39 and 40 to 49 (28.9 and 28.7 deaths per million respectively), and these rates were significantly higher than the rates in other age groups.

Over half (52%) of all deaths related to drug poisoning involved an opiate drug, and in men aged 30 to 39, nearly two thirds (63%) of drug-related deaths involved an opiate. In 2012, as in previous years, the most commonly mentioned opiates were heroin and/or morphine, which were involved in 579 deaths.

Deaths involving heroin/morphine decreased in 2012, but deaths involving another opiate – tramadol – have continued to rise. There were 175 deaths involving tramadol in 2012 – more than double the number recorded in 2008 (83 deaths). In addition, deaths involving new psychoactive substances (sometimes referred to as ‘legal highs’) such as mephedrone have increased sharply in the last year from 29 deaths in 2011 to 52 deaths in 2012. But the number of deaths from new psychoactive substances are still much lower than the number of deaths from heroin/morphine.

For the first time this bulletin presents analysis of geographical variations in mortality rates from drug misuse. This analysis showed that in 2012 rates were significantly higher in Wales than in England (45.8 and 25.4 deaths per million population respectively). In England, the North West had the highest mortality rate from drug misuse in 2012 (41.0 deaths per million population).

Get all the tables for this publication in the data section of this publication .

Introduction

Drug use and drug dependence are known causes of premature mortality, with drug poisoning accounting for nearly one in eight deaths among people in their 20s and 30s in 2012. Drug-related deaths occur in a variety of circumstances, each with different social and policy implications. Consequently, there is considerable political, media and public interest in these figures.

This bulletin covers accidents and suicides involving drug poisonings, as well as deaths from drug abuse and drug dependence, but not other adverse effects of drugs (for example anaphylactic shock). Drug poisoning deaths involve a broad spectrum of substances, including legal and illegal drugs, prescription drugs (either prescribed to the deceased or obtained by other means) and over-the-counter medications. Some of these deaths may also be the result of complications of drug abuse, such as deep vein thrombosis or septicaemia resulting from intravenous drug use, rather than an acute drug overdose.

The figures presented in this bulletin are for deaths registered each year, rather than deaths occurring each year. Almost all drug-related deaths are certified by a coroner, and due to the length of time it takes to hold an inquest, just over half of drug-related deaths registered in 2012 will have actually occurred prior to 2012 – see the ‘Impact of registration delays on drug-related deaths’ section below for more information.

Get all the tables for this publication in the data section of this publication .

Policy context

In December 2010 the Coalition Government launched a new drug strategy entitled ‘Reducing demand, restricting supply, building recovery: supporting people to live a drug-free life’ (Home Office, 2010). This strategy highlights preventing drug-related deaths as one of the key outcomes that recovery-oriented services should be focused on. In 2011 a new initiative was launched in eight pilot areas in England, trialing payment by results for providers of treatment services for people with drug and/or alcohol problems. The Department of Health is funding a three year independent evaluation of these pilots, which is being led by the University of Manchester.

Patterns of drug use change over time. For instance, in recent years people have been taking new psychoactive substances, including so-called ‘legal highs’. In response to this, the Government’s 2010 drug strategy outlined the introduction of a system of temporary 12-month bans on newly emerging substances. The Advisory Council on the Misuse of Drugs (ACMD) can then evaluate the harm caused by the substance and advise whether there should be a permanent ban.

In February 2013, the Welsh Government published the Substance Misuse Delivery Plan 2013–2015 (Welsh Government, 2013), which included the specific target of ‘reducing the number of substance misuse related deaths and non-fatal overdoses / alcohol poisonings in Wales’. To support this, new proposals to undertake rapid case reviews for both fatal and non-fatal poisonings have been developed and will be formally consulted on next month.

Get all the tables for this publication in the data section of this publication .

Uses made of this data

The figures contained in this statistical bulletin are used by a range of public bodies, such as Public Health England (PHE), the Department of Health (DH) and the Welsh Government to evaluate the effectiveness of various drug strategies.

In April 2013, the key functions of the National Treatment Agency for Substance Misuse were transferred into PHE, and they have linked ONS data on drug-related deaths with data from the National Drug Treatment Monitoring System (NDTMS), to investigate the timing of drug-related deaths in relation to treatment history. This research will also examine risk factors associated with these deaths and carry out area-based comparisons.

The Welsh Government and Public Health Wales are linking ONS data to information on the distribution and coverage of the National Take-Home Naloxone (THN) programme. This will be used to evaluate whether the THN program is having an impact on the number of drug-related deaths in Wales, and also to identify hotspots and areas requiring further focus.

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) combines data for England and Wales from the ONS drug poisoning database with data from Scotland and Northern Ireland to publish UK figures, allowing comparisons to be made with other European countries. The latest EMCDDA report shows that the drug-related mortality rate in the UK was the fourth highest in Europe (EMCDDA, 2013). However, caution should be applied when making international comparisons, because of differences in definitions and the quality of reporting.

ONS drug poisoning data are also used by academic researchers. For example, analysis of this data by the Centre for Suicide Research at the University of Oxford revealed that there was a major reduction in deaths involving co-proxamol following its withdrawal in 2005, with no evidence of an increase in deaths involving other analgesics, apart from oxycodone (Hawton et al, 2012). Updated data on deaths involving co-proxamol and other analgesics are shown in Reference Table 6a.

Get all the tables for this publication in the data section of this publication .

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