More people died from drug poisoning in England and Wales in 2018 than in any other year since records began, with victims aged between 30 and 49 driving the surge in fatalities.

Deaths involving opiates have increased to their highest ever level, accounting for more than half of the 4,359 drug deaths in England and Wales last year. There was also a spike in deaths caused by cocaine, new psychoactive substances (formerly legal highs) and ecstasy, new figures from the Office for National Statistics (ONS) show.

Highest number of deaths

Two-thirds of the deaths were related to drug misuse which has a stark north-south divide in England, with the north-east having a far higher rate of such deaths than any other region. London had the lowest rate: 34.9 deaths per million compared to 96.3 deaths per million in the north-east.

The figures for England and Wales come after Scotland’s drug-related death toll reached a record high of 1,187, putting the country on par with the United States on fatalities per capita.

The drug deaths in England and Wales amount to a 16% increase from last year’s figures, the highest ever annual increase since the first records in 1993. Males accounted for more than two-thirds of all deaths.

“This equates to a statistically significant increase in the drug-poisoning rate, with 76.3 deaths per million people in 2018, compared with 66.1 deaths per million in 2017,” said Ben Humberstone, ONS’s deputy director for health analysis and life events.

Most drug-poisoning deaths had an underlying cause of accidental poisoning, accounting for 80% of male deaths and 67% of female deaths.

Male drug-deaths

The pattern is similar to previous years but the are numbers significantly greater: between 2017 and 2018, the male drug-poisoning rate increased from 89.6 per million males to 105.4. While the female rate increased for the ninth consecutive year to 47.5 million in 2018.

Since 2012, rates of drug-related poisoning have generally been on an upward trend in England and Wales, something that has previously been attributed to a rise in heroin deaths. Higher than average drug-related mortality rates have also been reported more widely across Northern Europe), including Scotland and Northern Ireland, over the last several years.

Last year, men aged between 40 and 49 had the highest age-specific drug misuse rate at 125.7 deaths per million people – a rate significantly higher than in 2017, when there was a rate of 102.8 deaths per million people in the same age group.

People in their 40s

“The rate of drug misuse has largely been increasing in each English region, and Wales since the time series began in 1993,” said Humberstone.

“Over the last decade, the rate of drug misuse has more than doubled in the north-east (46.3 deaths per million in 2008 increasing to 96.3 in 2018). Wales followed the north-east with the next biggest increase in its rate over the last 10 years with an 84% increase (39.2 deaths per million in 2008 increasing to 72.0 in 2018). London and the south-west saw the smallest change in this period.”

The deaths involved a wide range of substances including controlled, non-controlled and prescription drugs. Opiates, including heroin and morphine, were the most common, but deaths involving cocaine doubled between 2015 and 2018 to their highest ever level.

As well as deaths from drug abuse and dependence, figures include accidents and suicides.

Because of the length of time it can take for an inquest to be completed, around half of drug-related deaths registered in 2018 will have occurred in earlier years, and many 2018 deaths will not yet be included in the figures.


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