Drug deaths in England and Wales up again

England and Wales have yet again recorded their highest ever number of drug-related deaths, according to the latest figures from the Office for National Statistics (ONS).

There were 4,561 deaths related to drug poisoning registered in 2020, a 3.6 per cent increase on 2019’s figure of 4,393 (DDN, November 2020, page 4). Last week also saw Scotland once again record its highest ever figure at 1,339. 


Drug Related Deaths by age 2021Two thirds of the poisoning deaths were related to drug misuse, with the highest rate in the 45-49 age range. As in previous years, the North East had the highest rate of deaths, and men accounted for more than two thirds of overall deaths. While just under half of fatalities involved an opiate, the number of deaths involving cocaine was up by almost 10 per cent to 777 – more than five times the figure from a decade ago. The rate of drug poisoning deaths in England and Wales has now increased every year since 2012. 

Deaths involving benzodiazepines were up by more than 19 per cent to 476, while deaths involving pregabalin rose by more than 40 per cent to 344 and gabapentin by 32 per cent to 118. The vast majority of deaths mentioning these substances, however, involved other drugs – primarily opiates. While Wales recorded its lowest rate of drug misuse deaths since 2014, ONS states that death registration delays as a result of COVID-19 ‘could be affecting’ the latest figures. 

‘Drug-related deaths have been on an upward trend for the past decade,’ says ONS. ‘The reasons behind this are complex and differ by drug type. The overall trend is driven primarily by deaths involving opiates, but also by an increase in deaths involving other substances like cocaine. Across Europe, rates of deaths involving heroin or morphine have been increasing, while the number of new heroin and morphine users has fallen. This indicates higher rates of death among existing long-term drug users.’ Recent trends in taking drugs like gabapentinoids or benzodiazepines alongside heroin or morphine may also increase the risk of overdose, it adds. 

‘Such an increase in the number of drug-related deaths demonstrates the need for us to take action now,’ said Change Grow Live chief executive Mark Moody. ‘Drug-related deaths are preventable, not inevitable, and now is the time for change. The recommendations made to government in the Dame Carol Black review offer a once-in-a-generation opportunity to change things for the better, but only if they are implemented in their entirety.’ No single organisation had the solution, and any national drug strategy ‘must be led by the voices of the people who are most affected’, he stated. 

The figures were ‘tragic and concerning’, added With You’s executive director of services, Jon Murray. ‘For many people drug use is a reaction to their environment so it’s no surprise that drug-related deaths are highest in the most deprived areas of the country. Too many people who need treatment aren’t accessing it, and too many people are unaware of the potential harms of their drug use. These figures are unacceptable but we are hopeful that change is possible. We are calling on the government to respond to today’s statistics by bringing serious political commitment to this issue and ensuring the appropriate financial investment is made in the upcoming Comprehensive Spending Review to action the recommendations of Dame Carol Black’s review.’ 

More reactions from the sector

Many of those deaths could have been prevented if more people were able to readily access treatment. More people would come into treatment if a wider range of treatment options were available across England. The announcements of additional funding in England this year have been welcome. However they have been too little too late for the people whose deaths have been recorded in this report. We still see more people dying in the north of England than in the south. The stigmatising explanations for the rate of death being in the older age group doesn’t excuse that people in long term addiction aren’t being able to access the long term help they need to reduce risk. 

No longer can the government claim they don’t know what to do to address the continued increase in deaths. The Dame Carol Black review has set out clearly and in excruciating detail what is needed for a whole system change to drug treatment. This is not a time to pick and choose from her 32 recommendations. This is a time to listen to the experts, take the advice asked for, and invest in treatment. Only then will we ensure vital healthcare for people who use drugs is available ( in line with clinical guidance) to everyone in the country, regardless of where they live or how much money they have. To do anything else is to deny the heartbreak of the thousands of families who have experienced a loss due to a treatable condition.

Karen Biggs, chief executive, Phoenix Futures

We are now experiencing a crisis that will only continue to escalate without significant intervention from the state. With an issue as complex as addiction, so dependent on social environment, the reasons behind the crisis are multitude. Substance misuse treatment has a strong evidence base for reducing mortality, so there can be little doubt that a huge reduction in funding for treatment is likely to have played a role, as well as the lack of clear government action on such a cross-cutting issue.  

Thankfully, there are some encouraging signs the government has heard the calls of our field and is prepared to listen. Dame Carol Black’s independent review has revealed the inadequacy of the state’s response to drugs, which cost the UK almost £20bn each year. Substance misuse treatment budgets have represented less than just four per cent of those costs, despite each £1 spent creating £3.50 in social returns. Dame Carol has therefore recommended investment of almost £1.8bn into treatment over the next five years, which will create £6.5bn in benefit and – most importantly – prevent over 3,000 people from dying from opiate overdose.

The government’s initial response has endorsed Dame Carol’s ‘whole-system approach’ by announcing a new Joint Combatting Drugs Unit, local and national outcomes frameworks and commissioning quality standards. As a field we must be ready to do whatever it takes to support the change we all want to see. All eyes are now on the political decision-making shaping the Spending Review, which must unlock the resource to stem the tide. Without it, there is little hope on the horizon of the crisis abating.

Peter Keeling, campaigns officer, Collective Voice 

The public health crisis that we are all experiencing as a result of COVID-19 has exposed how structural inequalities have contributed to high deaths rates due the virus, we have seen the same thing in drug related deaths for the last decade. It is no surprise that in areas of deprivation, where austerity has destroyed social safety nets, we are witnessing the highest levels of drug related deaths linked to drug dependency. Investment in these communities, adequate housing, restoring benefits to a decent level, along with drug policy and harm reduction initiatives can save lives.

Niamh Eastwood, executive director, Release

Deaths related to drug poisoning in England and Wales: 2020 registrations at www.ons.gov.uk


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