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Understanding and preventing drug-related deaths

The report of a national expert working group to investigate drug-related deaths in England

This report presents the independent findings, conclusions and recommendations of an expert group supported by Public Health England and the Local Government Association. The expert group investigated drug-related deaths in England with the aim of understanding recent rises in deaths and helping local areas to prevent future premature deaths.

The report is based on two meetings of the group, which heard a range of evidence, supported by commissioned data analysis and informed by five stakeholder events around the country. Across these local events, around 400 stakeholders helped gather intelligence on local thinking and practice in relation to drug-related deaths.

The group’s findings are based on their synthesis of this evidence and their individual experience and expertise, as clinicians, academics or service users.
The report is intended primarily for commissioners and providers of specialist services for people who use drugs. Its recommendations are also applicable locally for clinical commissioning groups, NHS and other health, social care, criminal justice, employment and housing and homelessness services, and coroners; and nationally for Public Health England, NHS England, government departments, the Office for National Statistics, the Care Quality Commission and the Chief Coroner.

There were two consecutive rises in registrations of drug-related deaths (DRDs) in England reported in 2014 (21%) and 2015 (17%), to the highest figures yet seen (ONS 2014 and 2015). Due to the typical delays in registering deaths, the increasing trend in DRDs actually started around early 2013.

Although these rises (which were chiefly in deaths associated with heroin use) could, in part, have been driven by a ‘cohort effect’ – from older, iller heroin users dying in increasing numbers – this did not completely explain the recent sudden increase in deaths.

Deaths also occurred across different age groups from different types of drug use in increasing numbers. There is also considerable geographical variation in the drug misuse deaths figures, with some regions and local areas showing large increases, but others seeing little change or slight falls.

Public Health England, with the Local Government Association, therefore convened a national inquiry to better understand the causes of the rises and how to reduce future premature deaths.