Drug-related deaths worst ever (again)

There were 4,392 deaths related to drug poisoning in England and Wales in 2019, the highest ever total.

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Big rise in cocaine-related deaths

Yesterday (14 October 2020), the Office for National Statistics released its annual report on drug-related deaths in England and Wales. The number of deaths due to drug poisoning have risen again for the seventh year in a row, although the increase is smaller than in recent years. Almost half of all drug related deaths involved opiates such as heroin and morphine. However, cocaine deaths rose for the eighth consecutive year to their highest level. The data in this release relate to deaths registered in 2019 and therefore do not cover deaths that occurred during the coronavirus pandemic. It is important to note that there will be a number of additional deaths not yet officially recorded (via inquests that have been delayed for instance) and the true figure will be even higher. 

Key findings

The headlines from the 2019 figures are:

  • 4,393 deaths related to drug poisoning were registered in 2019 in England and Wales, equivalent to an age-standardised mortality rate of 76.7 deaths per million people; this is similar to the rate in 2018 (76.3 deaths per million) when there were 4,359 registered deaths.

  • Among males, there were 104.7 drug poisoning deaths registered per million in 2019 (2,968 deaths), and the female rate was 49.1 deaths per million (1,425 deaths); neither rates were statistically significantly different to those in 2018.

  • Males accounted for two-thirds of drug poisoning deaths in 2019, or 2,968 of 4,393 registered deaths, consistent with previous years.

  • Two-thirds (or 2,883) of registered drug poisoning deaths were related to drug misuse, a small fall since 2018 but not statistically significant, accounting for 50.4 deaths per million people in 2019.

  • The North East had a statistically significantly higher rate of deaths relating to drug misuse than all other English regions (95.0 deaths per million people); East of England had the lowest rate (33.6 deaths per million people).

  • Since the 2018 registration year, there were no statistically significant changes to age-standardised rates of any specific drug mentioned on the death certificate, though deaths involving cocaine increased for the eighth successive year, by 7.7% for male deaths and by 26.5% for female deaths.

  • New analysis by deprivation shows that, in the last decade, rates of drug poisoning deaths have been higher in the most deprived areas of England and Wales compared with the least; this is particularly the case among those aged in their forties where rates reach peaks that are at least 5.5 times higher in the most deprived areas.

Concerning trends

There are a number of worrying trends highlighted in the ONS report which has the full title: Deaths related to drug poisoning in England and Wales: 2019 registrations — Deaths related to drug poisoning in England and Wales from 1993 to 2019, by cause of death, sex, age and substances involved in the death. I summarise these trends briefly in the section below.

  • The rate of female drug-related deaths is rising. Males accounted for more than two-thirds of drug poisonings in 2019 (2,968 male deaths compared with 1,425 female deaths), consistent with previous years. The male age-standardised rate decreased to 104.7 deaths per million males in 2019, down from 105.4 in 2018. Conversely, the female age-standardised rate has increased for the 10th consecutive year to 49.1 deaths per million females in 2019, up from 47.5 deaths in 2018. 
  • Two thirds of drug poisonings are because of drug misuse. Drug misuse accounts for 70.2% of male and 56.1% of female drug poisonings.
  • 40-49 year olds are most at risk. figures continue to show that the age at which most people died from drug misuse has increased over time: for the first decade of our data time series 20- to 29-year-olds had the highest rates (between 1993 and 2002), 30- to 39-year-olds then had the highest rates between 2003 and 2015, and more recently 40- to 49-year-olds have had the highest rates.
  • Rates of drug misuse death have a marked north-south divide with the North East, North West and Yorkshire and Humber regions having the three highest rates.
  • Opiates are involved in just under half (49.2%) of drug poisonings registered in 2019, increasing to 62.4% when we exclude deaths that had no drug type recorded on the death certificate. As such, trends over time tend to resemble that of all drug poisonings. Heroin and morphine continued to be the most frequently mentioned opiates with 1,329 drug poisoning deaths mentioning either one of these substances in 2019.
  • Cocaine deaths rise for the 8th consecutive year. In 2019, a total of 708 registered drug poisoning deaths involved cocaine, over double the number in 2015 (when there were 320 deaths) and over six times higher than in 2011 (when there were 112 deaths).
We have, as yet, no idea on what the impact of COVID-19 will be on drug misuse deaths this year but many of us await next year’s figures with some trepidation.

 

Thanks to Matthew Macquarrie for use of the header image, originally published on Unsplash.

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