There were 5,565 deaths related to drug poisoning registered in England and Wales in 2024, according to the latest ONS figures – up from 5,448 the previous year, and the highest number since records began in 1993.
Just under half of all drug poisoning involved an opiate or opioid, while almost 200 involved a nitazene – nearly four times the number in 2023. Of the 5,565 deaths, 3,736 were identified as drug misuse.
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The highest death rate was among people aged 40-49, with the average age of drug misuse deaths 45 for males and 48 for females. Men accounted for two thirds of drug poisoning deaths overall. As has been the case for the past 12 years, the North East had the highest death rate while the East of England had the lowest. The largest increase in drug poisoning deaths was in London, however – from 500 to 662.
Deaths involving cocaine were up by 14 per cent, to 1,279 – the 13th consecutive increase. Cocaine has been the second-most commonly used drug in England and Wales after cannabis for a decade now, with three quarters of cocaine-related deaths occurring among men.
Other ‘significant’ drugs included on death certificates were pregabalin (617 deaths), diazepam (302), amphetamine (111), fentanyl (60) and ketamine (60). Delays in registration of the deaths mean that more than half of the fatalities included in the current statistics occurred in previous years, ONS points out.
A recent study by King’s College London estimated the true number of opioid-related deaths in England and Wales to be more than 50 per cent higher than official figures, as ONS relies on the information provided on death certificates and does not have access to toxicology results or post-mortem reports.
This means it cannot determine the substances involved if the death is the result of polydrug use and has been recorded with ‘ambiguous terms such as “multidrug overdose”’, the researchers pointed out (https://www.drinkanddrugsnews.com/opioid-related-deaths-more-than-50-per-cent-higher-than-official-figures-say-kings-college-researchers/).
While Scotland’s latest figures, which were published last month, saw a 13 per cent fall since 2023, the country still has the highest drug-related death rate in Europe (https://www.drinkanddrugsnews.com/thirteen-per-cent-fall-in-scottish-drug-deaths/).
‘With the rise in synthetic opioids and contaminated drugs, the drug supply is becoming more complex and dangerous,’ said With You CEO Simon Phillips. ‘The government must continue to invest in high quality treatment that anyone can access. We urge the government to make it easier for drug checking services to operate in local communities, continue to expand naloxone provision and explore the introduction of drug consumption rooms.
We can’t keep watching people die while proven interventions sit on the shelf. The government can address this public health crisis by concentrating on saving lives now, helping people recover over time, and addressing the root causes for the future. This requires coordinated action.’
The statistics were ‘a devastating reminder of the scale of the challenges we face’, said Change Grow Live chief executive Mark Moody. ‘Over half of all drug-related deaths now involve more than one drug, and the 30 per cent increase in cocaine-related deaths we saw in 2022-23 was not an anomaly.’
Despite the ‘scale and complexity’ of the issue drug treatment and recovery had not been referenced in the government’s recent ten-year health plan, he pointed out. Drug use didn’t happen in isolation – ‘it’s linked to housing instability, poverty, poor mental health, and an overwhelmed justice system. Tackling these broader issues will take time, but without urgent action now, drug-related deaths will continue on the same trajectory, with more lives lost, more families shattered, and more communities left behind.’
‘These deaths are preventable,’ added Turning Point’s chief operating officer Clare Taylor. ‘With the correct support, education and engagement we know it is possible to reduce the harm caused by drugs. Synthetic opioids continue to flow into the market. We would like to see continuing efforts to increase availability of naloxone, a life-saving medication which can reverse the effects of an opioid overdose.’
As in previous years the fatality rate didn’t ‘hit our communities equally’, stressed Phoenix Futures chief executive Karen Biggs. ‘In England there is a marked North-South divide; the North East of England has had the highest rate of drug related deaths for the last 12 years. The South West saw the biggest reduction. Men in their 40s who use opiates continue to die at a higher rate than other age groups.’
The North-South divide was clearly visible in access to residential treatment, she added. ‘Of the 12 local authority areas in the North East of England more than half didn’t fund any residential treatment for people using opiates – just 263 people in treatment for opiate use were funded, 0.4 per cent of the opiate users in community treatment.
The local authorities in the North East of England are not alone in excluding people from residential treatment, but as a region they are amongst the worst in Europe. Residential treatment is the oldest form of drug treatment with a strong evidence base for people with multiple needs and opiate users. Despite that we see the number of opiate users being referred to residential treatment continue to decline.’
What was ‘truly alarming’ was the sharp rise in deaths involving nitazenes, said Cranstoun’s director of new business and services, Megan Jones. ‘This is not just a statistic, it is a major warning sign. With delays in recording, the true scale is likely to be even worse. We have been sounding the alarm about this public health emergency for a number of years now, and we need to see much swifter and decisive action.’
Deaths related to drug poisoning in England and Wales: 2024 registrations at https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrelatedtodrugpoisoninginenglandandwales/2024registrations