Transcript Presentation-standard

Drug-related deaths
Phil Conley
Health Improvement Programme Manager
September 2015
ONS headlines
• 2014 figures published 3 September 2015
• There were 3,346 drug poisoning deaths registered in England and Wales in
2014, the highest since comparable records began in 1993.
• Of these, 2,248 (or 67%) were drug misuse deaths involving illegal drugs.
• Deaths involving heroin and/or morphine increased by almost two-thirds
between 2012 and 2014, from 579 to 952 deaths.
• Deaths involving cocaine increased sharply to 247 in 2014 – up from 169
deaths in 2013.
• In England there was a 17% rise in the drug misuse mortality rate.
• 21% increase last year.
2
Age-standardised mortality rate for drug-related deaths,
by sex, deaths registered in 1993 to 2014
3
Age-standardised mortality rates for selected substances, England
and Wales, deaths registered between 1993–2014
Rate per million population
7
Benzodiazepines
6
5
4
Cocaine
3
2
Amphetamines
1
New Psychoactive Substances
0
4
Percentage of drug-related deaths mentioning (i)
one substance alone and (ii) alcohol, 1993-2014
%
80
70
Mentioning one substance
60
50
40
30
20
10
0
5
Mentioning alcohol
Age-specific mortality rate for drug misuse deaths
registered in 1993 to 2014, England and Wales
6
Regional variation
•
Highest rates in NE and NW /
lowest in London (half).
•
England 17% increase
includes small falls in Y&H
and EM (Wales decreasing
and -16% this time).
7
Greater Manchester
Crude mortality rate for deaths related to drug misuse, by local authority,
deaths registered between 2006 and 2014
8
Possible causes?
9
•
Year of death/reporting issue? – PHE analysis of 1999-2013 ONS data and NDTMS
match suggests not.
•
Push towards recovery and people leaving treatment before ready? – PHE analysis
found little change in the proportion of opiate deaths where the individual had recently
been in treatment (i.e. within one year). NB Treatment is a protective factor with
majority of opiate deaths (60%) in 2011 had not been in treatment since at least the
start of 2007
•
Heroin drought and then return …
•
... at higher strength/purity?
Possible causes?
• Lack of naloxone coverage?
• Older, iller drug users more susceptible to OD / compromised health e.g.
community acquired pneumonia reported as DRDs?
• More poly-drug (and alcohol) use?
• NPS
•
Availability/use – e.g. more chem-sex / more GHB/GBL deaths
•
Coroners switch to labs better at detecting NPS
• Increased prison release and post-prison deaths?
• Not learning the lessons – confidential inquiry coverage?
• Austerity?
• Thoughts / Possible solutions?
10
Naloxone - a relaxing of the rules
• 1 October 2015, new legislation - no need for the usual Prescription Only
Medicine requirements, just a requirement that the supply is suitably
recorded
• People employed or engaged in drug treatment services will be able to
supply from:
•
Specialist drug treatment services
•
Primary care drug services
•
Needle and syringe programmes, including those provided from pharmacies
•
A pharmacy providing supervised consumption of opioid substitute medication
•
Outreach workers would be able to carry stocks of naloxone and supply it to drug
users
• Staff can supply individuals. The law does not list these so they could be a
drug user, carer, friend, family member, hostel manager or an individual
working in another facility where there may be a risk of opioid overdose
11