Transcript Slide 1

Drug-related deaths in England:
latest data
Martin White, Alcohol, Drugs and Tobacco Division, Public Health England
Headline figures and notes around data
• Drug-related deaths in England have increased by 16% between 2012 and
2013, following several years of decreases
• Drug misuse deaths have increased by 21% (1,492 to 1,812), and account
for the large majority of the increase in drug-related deaths
• ONS have refreshed the drug misuse deaths data series historically to take
into account additions to controlled substances (in particular tramadol), but
this has little effect on overall trend
• Main driver of overall increase is a jump in heroin deaths – accounts for 58%
of total increase in drug misuse deaths
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Drug-related deaths in England: latest data
Headline figures
All drug poisonings
Drug misuse (new)
Drug misuse (old)
3000
2500
2000
1500
1000
500
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
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Drug-related deaths in England: latest data
Opioid deaths
• Published data refers to five types of opioid – large increases for three
• As in previous years, the most mentioned drug on death certificates was
heroin – 32% increase in 2013 (579 to 765) – following two years of reduced
numbers
• Significant increase in codeine deaths (from 73 to 130)
• Tramadol deaths continue to increase – up from 175 in 2012 to 220 in 2013
• Deaths where ‘other opiates’ mentioned rose from 172 to 237 – this is likely
not to be other opiates in the main but rather unspecified, i.e. just ‘opiate’
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Drug-related deaths in England: latest data
Opioid deaths
Heroin
Methadone
Codeine
Dihydrocodeine
Tramadol
Other opiate
1,200
1,000
800
600
400
200
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
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Drug-related deaths in England: latest data
Other substances
• Mentions of benzodiazepines on death certificates increased in 2013 by 20%
(from 284 to 342) – however benzos usually mentioned with an opioid
• Cocaine deaths increased by 22% in 2013, following a similar increase in
2012, but following an earlier decline
• Amphetamine deaths have increased in the last two years, having fallen
beforehand – this is mainly explained by increases in MDMA deaths and a
series of deaths involving PMA
• NPS deaths increased slightly in 2013 but remain relatively low – definition
includes GBL
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Drug-related deaths in England: latest data
Other substances
Cocaine
Amphetamines
NPS
Benzodiazepines
400
350
300
250
200
150
100
50
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
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Drug-related deaths in England: latest data
Gender and age
•
The jump in 2013 is as a result of a jump in drug misuse deaths among men – deaths
among women have also increased but this follows a general upward trend
Male
Female
1,600
1,400
1,200
1,000
800
600
400
200
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
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Drug-related deaths in England: latest data
Gender and age
•
Drug misuse deaths in England and Wales have increased in 2013 in all age groups
except the oldest and youngest
Under 20
20–29
30–39
40–49
50–69
70 and over
600
500
400
300
200
100
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
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Drug-related deaths in England: latest data
Underlying cause of death
•
Although intentional self-poisonings classed as drug misuse continue to increase, the
jump in 2013 is due to an increase in accidental poisonings
Mental and behavioural
Accidental poisonings
Intentional poisonings
1600
1400
1200
1000
800
600
400
200
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
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Drug-related deaths in England: latest data
Regional variation
All regions saw increases from 2012 to 2013, with the greatest in the South East
(statistically significant) and West Midlands and relatively little in the North West
Age-standardised mortality rate
2012 rate
2013 rate
% increase
70
40%
60
35%
30%
50
25%
40
20%
30
15%
20
10%
10
5%
0
0%
South
East
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West
Midlands
North
East
Drug-related deaths in England: latest data
East
East of London Yorkshire South
Midlands England
and The West
Humber
North
West
% increase between 2012 and 2013
•
Summary and further considerations
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•
Large increase in 2013 – may or may not represent a change in trend but statistically
significant (i.e. beyond ‘noise’)
•
Published data from ONS points towards the sudden jump being driven by accidental
poisonings, with heroin as the main drug mentioned, among men, replicated across
age groups and across regions
•
However, the published data is limited in terms of testing theories about the causes of
the increase as we cannot cross-reference between tables or with treatment data
•
For this reason, and also in order to match with treatment data to establish timing of
death in relation to treatment, PHE are working with ONS to get row-level data for 2013
– we expect to have this fairly soon
Drug-related deaths in England: latest data