The number of drug-related deaths in England and Wales rose by 6.5% in 2021, reaching the highest number since records began, official figures have revealed.

The Office for National Statistics (ONS) data, released on 3 August, showed 4,859 deaths related to drug poisoning were registered in England and Wales in 2021, the highest number since records began in 1993.

The report said the rate of drug-related deaths, recorded as 84.4 deaths per million in 2021, 'has increased every year since 2012 after remaining relatively stable over the preceding two decades'.

Among males, there were 115.1 drug poisoning deaths registered per million in 2021 (3,275 deaths), compared with 54.1 deaths per million among females (1,584 deaths).

Of the total deaths, the majority were from drug misuse - which means the underlying cause is drug abuse or dependence, or the drugs are illegal - accounting for 53.2 deaths per million people. The rate of drug misuse deaths were highest among born in the 1970s, with the highest rate in those aged 45 to 49 years.

Approximately half (45.7%) of all drug poisoning deaths registered in 2021 involved an opiate, while 840 deaths involved cocaine, which is 8.1% more than in 2020 and more than seven times the amount recorded a decade ago (112 deaths in 2011).

The north east continues to have the highest rate of deaths relating to drug poisoning and drug misuse (163.4 deaths per million people and 104.1 per million, respectively).

London had the lowest rate for drug poisonings (47.6 deaths per million people), and the east of England had the lowest rate for drug misuse (27.4 per million).

The report noted that rates of death involving heroin or morphine have been increasing across Europe, while the number of new heroin and morphine users has fallen. This indicates higher rates of death among existing long-term drug users, it said.

It suggested this could be because of:

  • There is an ageing cohort of drug users, likely to be suffering from the effects of long-term drug use and becoming increasingly susceptible to a fatal overdose
  • New trends in taking specific drugs, including gabapentinoids and benzodiazepines, alongside heroin or morphine, may increase the risk of an overdose
  • There may have been an increase in disengagement or non-compliance with opiate substitute therapy

However, the rise in deaths involving cocaine is likely to because of the increasing prevalence in cocaine use in England and Wales, as also seen across Europe.

This comes after a consultation in March found that almost all respondents believed that allowing pharmacists to provide a supply of ‘take-home’ naloxone without a prescription would help reduce overdoses and drug-related deaths.