Mortality rate from drug misuse highest ever
Last Friday (9 September 2016), the ONS published details on drug-related deaths in England and Wales registered in 2015, the highest number ever recorded.
The report which charts a continued growing trend in drug-related deaths since 2012 makes for distressing and depressing reading.
The headline findings are:
- There were 3,674 drug poisoning deaths involving both legal and illegal drugs registered in England and Wales in 2015, the highest since comparable records began in 1993.
- Of these, 2,479 (or 67%) were drug misuse deaths involving illegal drugs only.
- The mortality rate from drug misuse was the highest ever recorded, at 43.8 deaths per million population.
- Males were almost 3 times more likely to die from drug misuse than females (65.5 and 22.4 deaths per million population for males and females respectively).
Deaths involving heroin and/or morphine doubled in the last 3 years to 1,201 in 2015, and are now the highest on record.
- Deaths involving cocaine reached an all time high in 2015 when there were 320 deaths – up from 247 in 2014.
- People aged 30 to 39 had the highest mortality rate from drug misuse (98.4 deaths per million population), followed by people aged 40 to 49 (95.1 deaths per million).
- In 2015, the mortality rate from drug misuse was significantly lower in England than in Wales (42.9 compared with 58.3 deaths per million population).
- Within England, the North East had the highest mortality rate from drug misuse in 2015 for the third year running (68.2 deaths per million population), while the East Midlands had the lowest (29.8 deaths per million).
- The mortality rate from deaths involving New Psychoactive Substances (NPS) — AKA legal highs — is very low compared with heroin and/or morphine (1.9 deaths per million compared with 21.3). However, NPS deaths have increased sharply over the last 5 years, with 114 deaths registered in 2015 (up from 82 deaths in 2014).
The table below shows the figures by substances mentioned on death certificates. As you can see, there have been large increases in the number of deaths related to heroin, methadone, cocaine, NPS, gabapentin and pregabalin.
Vanessa Fearn, the researcher and statistician compiling this report, in an interview for the BBC, indicated a range of reasons for this increase:
Ms Fearn said people receiving treatment for drug abuse were “older than they used to be”.
She added: “Deaths involving heroin and morphine have more than doubled since 2012, partly driven by a rise in heroin purity and availability over the last three years.
“Age is also a factor in the record levels of drug deaths, as heroin users are getting older and they often have other conditions, such as lung disease and hepatitis, that make them particularly vulnerable.”
The death rate among people aged 30-39 is now at a record high, at 98.4 deaths per million population.
And deaths in the 40-49 bracket are also at a record high, with 95.1 deaths per million.
Ms Fearn also said 2014 was a record year for heroin production globally, which might also be impacting on the current availability of heroin.
The figures showed that there were 320 deaths involving cocaine, up from 247 in the previous year.
Mortality rates relating to that drug have increased for four consecutive years, with most cocaine-linked fatalities occurring in men aged 30 to 49.
The figure for cocaine-related deaths will include some where it was taken in the form of crack cocaine, as it is not possible to separately identify crack from other forms of the drug at post-mortem, the ONS report said.
It added: “Since cocaine is often taken alongside heroin, it is likely that changes in the purity and availability of heroin, as well as increases in the purity of cocaine, are contributing to the rise in deaths involving cocaine in recent years.”
Given that cuts in public expenditure have started to impact on drug and alcohol treatment services, it seems we must fear that next year’s figures will be even worse unless the Department of Health and Public Health England make this issue a priority.
Its Public Health England that has caused this problem in the first place with its totally discredited outcome measure of ‘successful completion and not returned for 6 months’. At the same time the NHS CDTs are being replaced by cheaper recovery charities who are cheerfully discharging as many as possible in order to comply with the outcome measures. Most discharges are older users who do not want recovery, are not ready for it and cannot comply with group work and abstinence as the required goal of remaining in drug treatment. They need health input and as the CGL chief prescriber on the Wirral blithely stated in the recent BBC report on the Wirral, “we are not primary healthcare providers”. Well who is, these older drug users are being discharged and left to rot by the likes of CGL, Addaction and others.
Thanksfor your comment John. In my view, your analysis is indeed one of the main causes of these very sad deaths. The drugs field continues to struggle with promoting recovery as actively as possible with as many people as possible, while still doing effective harm reduction work with those who do not want to and/or do not feel able to try to live drug free. At the very least, since we know that relapse is integral to most people’s recoveries from drug dependence, we need to make re-engagement with treatment/health services as easy as possible.
I know plenty of addicts, and plenty of them relapse, it is part of the condition. If I discharged 100 from MMT, 50 would have relapsed in a week, another 40 in a month. Why do these agencies own figures report 40% to 50 % completion rates, sometimes higher. It has to be lies or creative blocking of returnees. You can hear them saying it, “come back in 6 months if things haven’t turned out well”, “your problem really is alcohol now not opiates”, “try NA first, then ring us back”. Dreadful.