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Almost 100% increase in drug-related deaths leading up to peak in 2020

Drug-related deaths have increased by almost 100% in the last 10 years in Northern Ireland with the peak coming during 2020 – the year of the Covid outbreak.

The Northern Ireland Statistics and Research Agency (NISRA) has today (Wednesday) published figures for deaths in Northern Ireland due to drug-related causes between 2012 – 2022.

Figures show there were 154 drug-related deaths registered in 2022.

While this represents a decrease of 59 (27.7%) from the 213 drug-related deaths registered in 2021, it is important to note that registration-based figures build in delays arising from system wide processes which can drive annual fluctuations in the series.

Every death reported to the Coroner is carefully considered and is influenced by several factors specific to each case. These include whether the Coroner orders a post mortem, whether an inquest is required, the complexity of each case, and the number of cases reported to and being investigated by the Coroner at any point in time.

Since 2012, NI has seen deaths due to drug-related causes rise by 98% from 110 to a peak of 218 in 2020 and to 213 in 2021.

The 2022 total (154) represents a 40% increase on the number of drug deaths registered a decade ago.

The majority (82.5%) of all drug-related deaths in 2022 were classed as drug misuse deaths (where the underlying cause is drug poisoning, drug abuse or drug dependence or where any of the substances controlled under the Misuse of Drugs Act (1971) are involved).

Of the 154 drug-related deaths registered in Northern Ireland in 2022, over two-thirds (69.5%) were men.

The figures show that the three-year average age-standardised drug-related death rate from 2020 – 2022 was 10.5 deaths per 100,000, a decrease of 5.5% on the 2019-2021 figure of 11.2 deaths per 100,000.

The comparative figure for drug misuse averaged 8.3 deaths per 100,000 between 2020 and 2022, a decline of 6.8% on the 2019-2021 average rate of 9.3 deaths per 100,000. Prior to this, the three-year average for both drug-related deaths and drug misuse has been steadily increasing since 2012.

Looking at the number of deaths by age, the 25-34 and 35-44 age groups together accounted for 55.8% of all drug-related deaths in 2022.

The 25-34 age group had both the highest crude drug-related death rate and highest crude drug misuse death rate in 2022, at 19.2 per 100,000 population and 18.7 per 100,000 population respectively.

Each year over half of drug-related deaths have involved an opioid. Between 2020 and 2022, an average of 118 drug-related deaths each year had an opioid mentioned on the death certificate. Heroin and morphine were the most frequently mentioned opioids.

The next most commonly mentioned type of drug was benzodiazepines, appearing on 95 death certificates on average between 2020 and 2022. Drug-related deaths involving pregabalin have risen consistently since its first appearance in these statistics in 2013. The annual number of deaths involving this controlled substance rose from 1 between 2011 and 2013, to an average of 67 between 2020 and 2022.

The number of registered drug-related deaths which involved a psychoactive substance (that is all substances that have been controlled under the Psychoactive Substance Act 2016 – this includes drugs that may also have since been classed under the Drug Misuse Act) has seen a sharp increase in recent years, from 12 between 2017 and 2019 to an average of 50 between 2020 and 2022. Flubromazolam, flualprazolam and etizolam were the drugs mentioned most often in this category.

Over two-thirds (68.8%) of drug-related deaths in 2022 involved two or more drugs. In contrast, in 2012 60.0% of drug-related deaths involved two or more drugs. While cocaine is not the most frequently mentioned drug on death certificates in 2022, it has emerged as the predominant substance mentioned in deaths involving only one drug in 2022, constituting 9.1% of total drug-related deaths and 35.0% of single-drug deaths.

The number of deaths where alcohol is mentioned on the death certificate of drug-related deaths has been declining over the last decade. In 2012 the proportion of drug-related deaths involving alcohol was 31.8%, falling to 17.6% in 2022.

Statistics show that there continues to be markedly higher numbers of drug-related deaths in areas of deprivation across Northern Ireland. The 20% most deprived areas accounted for 44.5% of drug-related deaths and 44.4% of drug misuse deaths between 2018 and 2022, compared to 7.6% drug-related and 7.2% drug misuse deaths in the 20% least deprived areas over the same period.

Belfast LGD had the highest age-standardised rate of drug-related deaths in 2022. (14.3 deaths per 100,000 population) while Causeway Coast & Glens LGD had the second highest age-standardised rate in 2022 at 10.7 per 100,000 population.

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