|Death Registrations (Administrative data)
|Administrative data processing
|England and Wales
| Deaths related to drug poisoning in England and Wales
Suicides in the UK
Quarterly suicide death registrations in England
Deaths of homeless people in England and Wales
This quality and methodology report contains information on the quality characteristics of the data (including the European Statistical System five dimensions of quality) as well as the methods used to create it.
The information in this report will help you to:
understand the strengths and limitations of the data
learn about existing uses and users of the data
understand the methods used to create the data
decide suitable uses for the data
reduce the risk of misusing the data
The main figures presented are based on registration year rather than occurrence year; as most of the drug-related deaths (99.4% in 2019) are certified by coroners, the years reflect the date a death was certified as opposed to when the death happened.
Many deaths involve more than one type of drug and/or alcohol and it is not possible to tell which substance was primarily responsible for the death.
The figures include accidents and suicides involving drug poisonings, as well as deaths from drug abuse and drug dependence; they do not include other adverse effects of drugs (for example, anaphylactic shock), or other types of accidents (for example, a car crash) where the driver was under the influence of drugs.
Causes of death are coded using the International Statistical Classification of Diseases and Related Health Problems; due to changes in this (and the software used for coding) over time, the deaths by underlying cause data is not a consistent time series.
The Deaths related to drug poisoning in England and Wales statistical bulletin contains main findings and commentary on the latest years of data, with a time series of figures from 1993. Annual figures are broken down by cause of death, sex, age, place of usual residence of the deceased and the substance(s) involved in the death.
The output is compiled using a drug-related deaths database that Office for National Statistics (ONS) developed to facilitate research into deaths related to drug poisoning. The drug-related deaths database is extracted from the national mortality database for England and Wales. Deaths are included if the underlying cause of death is regarded as drug-related, according to the National Statistics definition (see Concepts and definitions section).
ONS mortality data (including data on drug-related deaths) come from the information collected when a death is registered. Information about the underlying mortality data, including details on how the data are collected and coded are available in the User guide to mortality statistics. The majority of deaths related to drug poisoning are registered following a coroner’s inquest and the text on the coroner’s death certificate is used to code all of the substances involved in the death.
Uses and users
There is widespread policy, professional and public interest in the deaths related to drug poisoning and drug misuse. Main users of the data include:
the Department of Health and Social Care and Public Health England
other devolved health administrations
public health observatories
local and health authorities
Figures provide evidence to inform decision making and policy monitoring at a national and local level; this can save lives through enabling policymakers and support services to target their resources most effectively. Table 1 provides detail on how users use this data.
|Public Health England
|Public Health Outcomes Framework
Feeds into the substance misuse strategy
|Public Health Wales and Welsh Government
|Individual level drug data is provided to monitor the impact of the national substance misuse strategy in Wales
|Data used to support the government’s Drug strategy 2017
|Drugs, Alcohol and Justice Cross-Party Parliamentary Group
|ONS presents latest evidence on drug deaths
|Advisory council for the misuse of drugs (ACMD)
|Uses drug deaths data to make recommendations to government on the control of dangerous or otherwise harmful drugs
|European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)
|Along with Scottish and Northern Ireland drug poisoning data, published by the National Records of Scotland and the Northern Ireland Statistics and Research Agency,
Download this table Table 1: Uses and users of deaths related to drug poisoning in England and Wales..xls .csv
Strengths and limitations
Deaths related to drug poisonings, including drug misuse deaths, are compiled using information supplied when deaths are registered, which gives complete population coverage.
Figures are presented in England and Wales from 1993 onwards.
Coding for cause of death is carried out according to the World Health Organisation (WHO) ICD-9 and ICD-10, based on internationally agreed rules.
We report two statistical measures – age-standardised rates and age-specific rates: age-standardisation is undertaken using the European Standard Population 2013, it weights data according to its age structure, thereby enabling populations with different age structures to be compared validly.
The main figures presented are based on death registration year rather than death occurrence year, this provdes timely and consistent time series but makes it more difficult to evaluate sudden changes in the drug-related deaths.
There is no internationally agreed definition of what constitutes a drug-related death; figures cannot be compared with those produced by other organisations.
More than half of all drug poisoning deaths involve more than one drug and sometimes also alcohol, and it is often not possible to tell which substance was primarily responsible for the death.
ONS data cannot shed any light on other types of short-term harm associated with drug use (for example, social or psychological), the long-term damage that using such substances may cause, or the numbers of surviving individuals using such substances.
The ONS does not have access to post-mortem reports or toxicology results, so the accuracy of figures on deaths related to drug poisoning depends on the information provided by the coroner on the death certificate.
Due to this variation, the findings relating to specific substances should be interpreted with care. In particular, figures on the number of deaths involving New Psychoactive Substances (NPSs) should be treated with caution because these types of drugs are constantly evolving and it may not always be possible to identify new substances during post-mortem investigations.
It is our best practice not to calculate rates based on small numbers, as they are imprecise and susceptible to inaccurate interpretation; rates based on fewer than 20 deaths are marked with a “u” to warn users that their reliability is low; for reliability, age-standardised rates are not calculated for when there are fewer than 10 deaths, while age-specific rates are not calculated when there are fewer than three deaths.
There are two recent improvement in the data processing of drug related deaths.
In 2019 we made improvements to the statistical program used to search individual records for information on drugs and other substances. The new statistical program is more efficient, and has reduced the level of error, when compared with its predecessor.
Deaths where the only identified controlled substance is found within a compound analgesic or cold remedy is not included in the definition of drug misuse as they are likely to contain relatively small quantities of any controlled substance. In 2020, this approach has been aligned with that of the National Records of Scotland (NRS) and a new set of compound analgesics, such as Pholcodine and “Codeine and brompheniramine maleate”, are added to our drug lookup.Back to table of contents
Statistics on deaths related to drug poisoning can be accessed free of charge.
Provisional release dates are announced on the GOV.UK release calendar up to 12 months in advance and final dates at least four weeks in advance. This enables equal access to these statistics for all users and signposts the location of the statistics on our website.
It is not possible to publish the drug-poisoning database in its entirety, as it contains confidential data. National and regional level figures are available in the bulletin and variables such as age are grouped to protect confidentiality. More detailed tables, including figures for lower geographies, different age groups and substances not mentioned in the bulletin, are available on request (subject to legal frameworks, disclosure control, resources and agreement of costs, where appropriate). Information describing the limitations of data in these more detailed tables is provided with each individual request.
In addition, researchers can apply to access the individual record data contained on the drugs database, by becoming an approved researcher. For more information, please contact the mortality analysis team using the contact details at the beginning of this report.
Feedback from users is invited in the statistical bulletin with the inclusion of a standard statement within the background notes: ‘We welcome feedback from users on the content, format and relevance of this release’. Regular attendance of ONS researchers at user group meetings and conferences also ensures feedback is received, as well as meetings with key stakeholders. To add, contact with users via ad-hoc requests provides steer on breakdowns and analysis that are not currently in the bulletin.
Useful links to Office for National Statistics (ONS) drug-related analysis
Useful links to external drug-related analysis
Useful links to other related publications
OtherBack to table of contents
Contact details for this Methodology
Telephone: +44 01633 455952