Trends in drug misuse deaths in England 1999-2014
This month (April 2016) Public Health England (PHE) published a new report on trends in drug misuse deaths in England over the last 15 years.
PHE is paying increased attention to drug misuse deaths because of a worrying recent increase:
The Office for National Statistics (ONS) reported a 17% increase in drug misuse deaths registered in England in 2014, following an increase of 21% in 2013.
The number of men whose death was officially caused by drug misuse is approximately the same now as it was 15 years ago, although the last two years have seen a sharp increase. The number of women whose death was officially caused by drug misuse has doubled over the same period:
The report’s key findings are set out below:
- Across the period studied, opiates are the type of substance most frequently mentioned in drug misuse deaths, consistently mentioned in over four-fifths of deaths. The most commonly mentioned opiate drug is heroin, followed by methadone and tramadol. There was an increase of at least 21% in opiate deaths in 2013.
- Alcohol was mentioned in combination with illicit drugs in just over one third (36%) of drug misuse deaths in 2012, a proportion that has remained similar in recent years.
- Benzodiazepines are the most commonly mentioned non-opiate drug in drug misuse deaths (16% in 2012) and there was an increase of at least 21% in benzodiazepine deaths in 2013. Benzodiazepines are rarely the only drug mentioned in a death.
- Mentions of cocaine and amphetamines have risen since around 2010, having fallen markedly before this. Drug misuse deaths where a new psychoactive substance (NPS) was mentioned continued to rise in 2012 (4% of drug misuse deaths), but provisional figures for 2013 suggest a fall, in contrast to the overall rise in drug misuse deaths.
- Among heroin deaths, there is a clear long-term trend towards increased mentions of other substances alongside heroin, including alcohol, benzodiazepines and methadone, indicating increasingly complex poly-substance deaths.
- The median age at drug misuse death has increased from 32 in 1999 to 41 in 2012. The majority of drug misuse deaths are among men (72% in 2012), although there is a long-term trend of increasing numbers among women.
- Over three-quarters of drug misuse deaths in 2012 were accidental poisonings. The remainder are classed as suicide and involve relatively high proportions of women, people from older age groups and mentions of opiates other than heroin and methadone.
Drug deaths and drug treatment
This is an update report which has looked carefully at the relationship between people dying through drug misuse and their treatment history. Some commentators have suggested that the emphasis on recovery in treatment services over the last five years has resulted in some long term drug users dropping out of treatment.
The report states that matching between the drug misuse death data collected by the Office of National Statistics (ONS) and community treatment data from the National Drug Treatment Monitoring System (NDTMS) for 2007-2014 suggested a continuation of two known trends:
- the majority of individuals who suffered opiate misuse deaths in 2012 had not been in treatment since at least the start of 2007
- there was little change in the proportion of opiate misuse deaths where the individual had recently been in treatment (ie, within one year), although there was a slight increase in the proportion where the individual was currently in treatment.
In addition, the updated matching found that the substantial increase in opiate misuse deaths in 2013 was slightly more pronounced for those with recent treatment compared to those who had not had treatment in the past year.
Given that opiates are mentioned in more than 80% drug misuse deaths:
it is to be hoped that the increased availability of naloxone (a drug which can reverse opiate overdoses) will have a positive impact which will be seen in next year’s figures.
See naloxone in action here.