The Office for National Statistics maintains a dedicated database of drug poisoning deaths in England and Wales since 1993. Drug poisoning deaths are extracted from the national deaths database using specific International Classification of Disease codes for the underlying cause of death. As well as the data supplied in the cause of death section of the coroner’s death certificate, the database also contains textual information, which coroners supply voluntarily to ONS. This may include more detailed information about the drugs involved.

Both newspapers reported the main statistics correctly, but the broadsheet provided a possible explanation for the figures, including a comment from a member of DrugScope concerning the substantial rise in cocaine use and the apparent lack of Government treatment interventions for cocaine users. The tabloid linked the failure to meet the target for cutting drug related deaths to the downgrading of cannabis, suggesting that this was the reason for the surge in all illegal drug use between 2003-2004. The tabloid article included a comment from a Conservative party spokesman who criticised the Government’s “chaotic and confused” approach to the drugs problem and a member of the Europe Against Drugs campaign who spoke about cannabis as a gateway drug. Both the broadsheet and the tabloid news items focussed on the rise in drug use since 2003 and the Government’s failure to meet their target of a 20 per cent reduction in drug related deaths however, they reported that the figures from the Office for National Statistics showed a 9 per cent decrease in the number of deaths from drug use overall.

The Office for National Statistics states that although routinely collected mortality data provides the most complete dataset on deaths related to drug poisoning in England and Wales, it must be interpreted with caution as information on the death certificate is not recorded for epidemiological purposes and measurement of deaths related to drug misuse alone does not provide information about the reasons behind the trends identified. Also, if the coroner does not consider a particular drug to be relevant it is not included on the death certificate. Approximately 10 per cent of drug poisoning deaths have no specific information about the drug(s) taken. Inconsistency in the way toxicological examinations are carried out by coroners can also mean that some deaths involving drugs of misuse may not be identified. Neither newspaper mentioned these limitations, but used the ONS statistics to prove that drug use had “rocketed” between 2003-2004 and according to the tabloid article to suggest that this is due to the Government’s reclassification of cannabis.

Title, Authors and Source?

Morgan O., Griffiths C., Toson B., Rooney C., Majeed A., Hickman M (2006) Trends in deaths related to drug misuse in England and Wales 1993-2004. In Health Statistics Quarterly No 31. Office for National Statistics, London.

Available from: http://www.statistics.gov.uk/downloads/theme_health/HSQ31.pdf

What were the study objectives?

To report trends in deaths related to drug misuse in England and Wales from 1993 to 2004, looking particularly at the period between 1999 and 2004, for which there was a Government target to reduce these deaths by 20 per cent.                                               

What was the nature of the evidence?

ONS defined deaths relating to drug misuse as deaths where the underlying cause was poisoning, drug abuse or drug dependence and where any of the substances involved were controlled under the Misuse of Drugs Act (1971). They calculated directly age-standardised

mortality rates using the European standard population as the reference population. Age standardisation makes allowances for differences in the age structure of populations, which means that results can be compared over time and between sexes. ONS calculated age-specific rates for two periods: 1993–1998 and 1999–2004. They calculated years of life lost (YLL) for death before 55 years old, standardised to the European standard population. YLL is useful for highlighting causes of death that affect younger people. It measures the number of years a person would have lived if they had not died prematurely. Therefore taking 55 as the threshold for premature death, a person who dies at 45 will contribute 10 years of life lost. ONS also calculated age-standardised rates of years of life lost per 10,000 population. This represents the rate of years of life lost if the population of England and Wales had the same population structure as the European standard population. They assessed achievement of the Government’s target by calculating the percentage change in the number of deaths between 1999 and 2004.

What were the findings?

Between 1993 and 2004 there were 12,687 deaths related to drug misuse among males and 3,401 deaths among females. Age-standardised mortality rates for males increased from 24 to 52 per million between 1993 and 2000, subsequently declining to 37 per million in 2003 and rising again to 42 per million in 2004. Between 1999 and 2004, the percentage reduction in deaths related to drug misuse was 9 per cent, less than the Government target of 20 per cent. Heroin / morphine was the most commonly mentioned substance, involved in almost half of deaths related to drug misuse among males and over a quarter of deaths among females.

What were the conclusions?