Rate of drug poisoning deaths up again
Earlier this week(19 December 2023) the Office for National Statistics published the annual drug-deaths statistics. These are officially called Deaths related to drug poisoning in England and Wales: 2022 registrations and are published four months later than last year’s edition. As you will have seen from coverage in the mainstream media, the number and rate of drug-related deaths continue to rise and it is tragic to report that 4,907 people lost their lives to drugs in 2022, the highest number on record.
Key findings
The majority of deaths related to drug poisoning are registered following a coroner’s inquest and the text on the coroner’s death certificate is used to code all of the substances involved in the death.84.4 deaths per million people, this is similar to the rate recorded in 2021 (84.0 deaths per million, 4,859 deaths); the age-standardised mortality rate for deaths related to drug poisoning has risen every year since 2012 after remaining relatively stable over the preceding two decades.
Drug misuse deaths
Deaths classified as drug misuse must meet either one (or both) of the following conditions:
- The underlying cause is drug abuse or drug dependence,
- Any of the substances involved are controlled under the Misuse of Drugs Act 1971.
Information on the specific drugs involved in a death is not always available, therefore figures on drug misuse are underestimates. Of the drug-poisoning deaths registered in 2022, 3,127 were identified as drug misuse. This represents 63.7% of drug poisonings. If we exclude deaths where no information was available on the drug(s) involved (1,240 deaths), then 85.3% of drug-poisoning deaths were drug misuse. Other key facts include:
The rate of death relating to drug misuse in 2022 was 53.9 deaths per million people. The male rate of drug misuse deaths was 76.7 deaths per million in 2022 (2,178 registered deaths) and the female rate was 31.9 deaths per million (949 deaths).
Rates of drug misuse deaths continue to be elevated among those born in the 1970s, often referred to as “Generation X”, with the highest rate in those aged 40 to 49 years.
Just under half of all drug-poisoning deaths registered in 2022 involved an opiate (46.1%; 2,261 deaths), while 857 deaths involved cocaine, which is 2.0% more than 2021 and represents the 11th consecutive annual rise.
The North East continues to have the highest rates of deaths relating to drug poisoning and drug misuse (133.9 deaths per million people and 81.7 per million, respectively); London had the lowest rate for drug poisonings (56.6 deaths per million people), and the East of England had the lowest rate for drug misuse (37.2 per million).
Deaths by substance
You can see the trends in which substances have been related to deaths from 1993 to 2022 in the chart above. For deaths registered in 2022, a total of 2,261 drug-poisoning deaths involved opiates; this was 1.9% higher than in 2021 (2,219 deaths). Opiates were involved in just under half (46.1%) of drug-poisoning deaths registered in 2022, increasing to 61.7% when we exclude deaths that had no drug type recorded on the death certificate. Heroin and morphine (often indistinguishable in toxicology testing) continued to be the most frequently mentioned opiates with 1,256 drug-poisoning deaths mentioning either one of these substances in 2022.
There were 857 deaths involving cocaine registered in 2022, which was 2.0% higher than the previous year (840 deaths) and more than seven times higher than in 2011 (112 deaths). In 2022, males accounted for 78.4% of the deaths involving cocaine (672 males compared with 185 females). This is the 11th consecutive year that cocaine-related deaths has risen.
Increase in polydrug use
There has been an increase in the number of drugs typically recorded on the death certificate. The average number of drugs (where this information was available) has been gradually increasing since 2010, after being relatively stable for the preceding two decades. For each year from 1993 to 2011, the average had been either 1.4 or 1.5 drugs per death. For deaths registered in 2022, the average had risen to 2.0 drugs mentioned per death.
Drugs such as benzodiazepines and gabapentinoids are increasingly seen alongside heroin and other opiates. Polydrug use increases the risk of serious complications, including overdoses. Increasing polydrug use may have contributed to the rise in drug-related deaths over the past decade.
Whenever I present these grim statistics, I try to remember that each death represents a personal tragedy and a world of grief for people’s family and friends.
Thanks to Alexander Grey for kind permission to use the header image in this post which was previously published on Unsplash
