The main findings from this report include the following:
Based on the definition used for these statistics, 613 drug-related deaths were registered in Scotland in 2014, 86 (16 per cent) more than in 2013. This was the largest number ever recorded, and 257 (72 per cent) higher than in 2004 (paragraph 3.1.1). The underlying increases would be smaller if one took account of the effect of changes in the classification of drugs (paragraphs 3.1.4 to 3.1.6).
Males accounted for 74 per cent of the drug-related deaths in 2014 (paragraph 3.4.1).
In 2014, there were 213 drug-related deaths of people aged 35-44 (35 per cent of all drug-related deaths) and 157 drug-related deaths of 25-34 year olds (26 per cent) (paragraph 3.4.2).
The NHS Board areas which accounted for most of the 613 drug-related deaths in 2014 were:
Greater Glasgow & Clyde - 189 (31 per cent);
Lothian - 105 (17 per cent); and
Lanarkshire - 67 (11 per cent) - see (paragraph 4.1)
Using the annual average for 2010-2014, to reduce the effect on the figures of year-to-year fluctuations:
for Scotland as a whole, the average of 558 drug-related deaths per year represented a death rate of 0.11 per 1,000 population;
the NHS Board area with the highest rate was Greater Glasgow & Clyde (0.15);
the next highest rates were for Ayrshire & Arran and Tayside (both 0.11) - further details available in paragraph 4.3.
However, there is a narrower (in percentage terms) range of values when death rates are calculated using the estimated numbers of problem drug users (paragraph 4.9).
Comparing the annual average for 2010-2014 with that for 2000-2004:
the percentage increase in the number of drug-related deaths was greater for females (141 per cent) than for males (50 per cent) (paragraph 3.4.1);
the largest increase in numbers was for 35-44 year olds, the next largest was for people aged 45-54, and there was a fall in the number of drug-related deaths of people aged under 25 (paragraph 3.4.2); and
the NHS Board areas with the largest increases in the number of drug-related deaths were Lothian (up by 45), Greater Glasgow & Clyde (up by 38) and Lanarkshire (up by 33) (paragraph 4.2).
The standard basis for the figures for individual drugs for 2008 and subsequent years is 'drugs which were implicated in, or which potentially contributed to, the cause of death'. Of the 613 drug-related deaths in 2014:
heroin and/or morphine were implicated in, or potentially contributed to, the cause of 309 deaths (50 per cent of the total);
methadone was implicated in, or potentially contributed to, 214 deaths (35 per cent);
one or more opiates or opioids (including heroin/morphine and methadone) were implicated in, or potentially contributed to, 535 deaths (87 per cent);
benzodiazepines (e.g. diazepam) were implicated in, or potentially contributed to, 121 deaths (20 per cent);
cocaine, ecstasy-type drugs and amphetamines were implicated in, or potentially contributed to, 45, 14 and 22 deaths respectively; and
alcohol was implicated in, or potentially contributed to, 106 of the drug-related deaths (paragraph 3.3.3).
(The percentages add up to more than 100 because more than one drug was implicated in, or contributed to, many of the deaths.)
In 2014, heroin and/or morphine were implicated in, or potentially contributed to, far more deaths than in any of the previous three years, and almost as many as in 2008 (324). The corresponding figure for methadone was below those of the previous three years but was still higher than in 2008 (169). Opiates or opioids (including heroin/morphine and methadone) were implicated in 535 deaths: the highest ever number (there had been 524 in 2011 and 507 in 2008). However, the number for benzodiazepines was lower than in any of the previous six years. Due to a change in the method used to collect information about the substances that were found in the body (which is described in Section 2), 'individual drugs's figures for 2008 onwards cannot be produced on the same
basis as those for earlier years (paragraph 3.3.4).
Most drug-related deaths are of people who took more than one substance. Of the 613 drug-related deaths in 2014, there were just 60 for which only one drug (and, perhaps, alcohol) was found to be present in the body. There were 247 cases where only one drug (and, perhaps, alcohol) was believe to have been implicated in, or potentially contributed to, the cause of the death. The latter figure covers both the ‘only one drug found’ deaths and cases where one drug was implicated but other drugs were mentioned as being present but not considered to have had any direct contribution to the death (paragraph 3.3.9 to 3.3.11)
Annex E of this publication provides information about deaths which involved so-called 'New Psychoactive Substances' (NPSs). The definition used for the purpose of those figures is set out in first half of that Annex. On that basis, in 2014:
there were 62 deaths for which NPSs were implicated in, or potentially contributed to the cause of death. In 40 cases, the only NPSs present were benzodiazepines (usually etizolam, but sometimes diclazepam or phenazepam); in 17 cases, other types of NPS were present (e.g. mephedrone, MPA); there were five deaths for which both benzodiazepine NPSs and other types of NPS were present. Almost all of these deaths (55 out of 62) fall within the definition of ‘drug-related deaths’ that is used to produce the statistics that are given in the main body of this report – i.e. 55 out of 62 are included in the 613 drug-related deaths that are referred to earlier. In only a small proportion (7 out of the 62 deaths) were NPSs the only substances implicated in the death.
(paragraph E9)
there were 52 deaths for which NPSs were present but were not considered to have contributed to the death. In most cases (44 out of 52) the only NPSs present were benzodiazepines; almost all of the deaths (51 out of 52) were counted in the statistics in the main body of this report – i.e. 51 out of 52 are included in the 613 drug-related deaths referred to earlier (paragraph E11).
Figure 1: Drug-related deaths in Scotland, 3- and 5-year moving averages, and likely range of values around 5-year moving average
