Another record year for England and Wales drug deaths

There were 4,859 deaths related to drug poisoning registered in England and Wales last year, according to the Office for National Statistics (ONS) – the highest since records began almost 20 years ago and 6 per cent higher than in 2020. More than 3,000 of the deaths were recorded as drug misuse deaths.

As has been the case for the past nine years, the highest rate of drug misuse deaths was in the North East, where the rate remains ‘statistically significantly higher than all other regions of England’. Publication of the figures comes less than a week after Scotland recorded a fall of just nine drug deaths compared to 2020, following almost a decade of consecutive increases (

Just under half of all drug poisoning deaths in England and Wales involved an opiate, while – as was the case in Scotland – deaths involving cocaine have increased, with 8 per cent more than the previous year. With international cocaine production at record high levels ( the number of deaths involving cocaine in England and Wales is now seven times greater than it was a decade ago.

There were 28 per cent more deaths involving methadone than the previous year, and 13 per cent more involving benzodiazepines, while deaths involving pregabalin and gabapentin increased by 19 per cent and 13 per cent respectively. Deaths involving NPS, however, were up by almost 90 per cent – driven by rising numbers of deaths involving benzodiazepine analogues (‘street benzos’) like etizolam and flubromazolam.

As in previous years, rates of overall drug misuse deaths were highest among those aged 45 to 49. While death rates were up for both men and women, men continue to account for more than two thirds of registered drug poisonings.

David Bremner: ‘At a time of political uncertainty, these new statistics provide a loud and clear call, whatever your political allegiances.’

The figures were the result of ten years of austerity and year-on-year cuts, exacerbated by a pandemic which ‘hit the vulnerable particularly hard’, said Turning Point’s medical director David Bremner. ‘At a time of political uncertainty, these new statistics provide a loud and clear call, whatever your political allegiances. The government’s ten-year drug strategy announced at the end of last year and additional funding coming into services is helping to turn the tide but there is a way to go. We need sustained and coordinated action across health including mental health, housing and social care services in order to reduce the harm caused by drugs to individuals, families and communities. The government must continue to invest in these life-saving services.’ 

Mark Moody: ‘Only reasonable response is to redouble our efforts’

The only reasonable response to the figures was to ‘redouble our efforts to stop more people losing their lives to drugs’, agreed Change Grow Live CEO Mark Moody. ‘The government’s new drug strategy is a once-in-a-generation opportunity to change things for the better, and Change Grow Live will work with partners, policy makers and the people who use our services to make sure that happens.’

Deaths related to drug poisoning in England and Wales: 2021 registrations at – read the report here

More reactions from the sector…

Sadly, it will take many years for the number of deaths to change significantly but we believe that it can be done if drug deaths are treated as a health crisis rather than a criminal matter. For too long, treatment and support for people who use drugs has been side-lined and there needs to be a joined-up national approach to public health planning that ensures people can receive the care they need from all healthcare providers.

‘The £780 million drug strategy that was announced by the Government in December is a significant step forward and the first year’s funding is already making a difference but it is vital that there continues to be stable and sustained investment into treatment services.

‘We are working with people with lived experience to design better services and are striving to achieve an outstanding level of support across all of our centres.

It is not just about recovery though, steps must also be taken to reduce the harm faced by people who use drugs. Many of the deaths that are occurring are people who have used drugs for a long time and have underlying health issues as a result. Through measures such as increased provision of naloxone, easier access to safe needles and syringes, and testing and treatment for diseases such as hepatitis C, Humankind is focused on ensuring that people who use drugs face fewer risks.’

From a statement by Humankind


Niamh Eastwood, Release

‘It is an utter disgrace that we are again talking about record breaking drug deaths. Every single one of these tragedies could have been avoided with the wilful implementation of evidence-led, UK-wide policy reform. Drug deaths are a public health emergency across the UK that can and must be adequately addressed. Government inaction is a political choice.‘

‘Whilst the Government may be investing in drug treatment, drug deaths will continue to rise without commitment to serious policy reforms, eradicating the harms caused as a result of drug prohibition. The Home Office must allow overdose prevention facilities to be established immediately. We need safe supply of all controlled drugs, expanding substitute prescribing to other substances beyond opiates. Decriminalisation of drug possession – which would end the criminal sanctions for possession of drugs – must be core to any policy that seeks to protect the health and well-being of people who use drugs, from young people who are experimenting to those who use drugs to cope with trauma and mental health problems.’

Niamh Eastwood, executive director, Release


Kevin Flemen,

‘The ongoing increase in drug deaths featuring cocaine highlights why services must ensure their drug death prevention strategies also address stimulants.

‘OD has become shorthand for opiate OD and the responses, heavily orientated around naloxone roll-out, reflect this. For stimulant deaths we need to ensure other responses including screening for at-risk populations, identifying people who have already had potential cardiac episodes, training peers and professionals to be aware of risk factors and ensuring how to identify and respond to stimulant critical incidents.’

Kevin Flemen, KFx



Martin Blakebrough, Kaleidoscope

‘Drug Deaths once more show the sad reality of our UK government drug policy. Drug deaths are a public health emergency where radical action is required and an end to the ‘‘war on drugs’’. Instead we need a system where we actively encourage people into treatment and support. We need to do more to get people who use drugs to be listened to and get them to design services that they can engage with and are relevant to their needs. Peer 2 Peer naloxone has shown how we can invest in people with lived experience to make a real difference. Governments need to listen and enable change, not continue to pursue failed policies. 

‘In Wales we are trying to do things differently. We know the UK government policy doesn’t work. We know we can save lives. Looking at the evidence from successful programmes around the world, at Kaleidoscope we believe in the importance of treating substance use as a health issue, not a criminal justice issue. This focus in countries like Portugal has shown how over the long term a health-based focus improves outcomes in multiple areas – health, a reduced burden on the criminal justice system, and a reduced cost to society as a whole. Health-based enhanced harm reduction techniques are required here in Wales to help make a step change in outcomes.’

Martin Blakebrough, CEO, Kaleidoscope 




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