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Drug-related deaths in Scotland in 2007

Annex B Some other definitions of drug-related deaths

B1. Other bodies may use other definitions for other purposes: this annex gives some examples.

B2 First, there is a "wide" definition which is used by the Office for National Statistics (ONS) to provide figures for deaths from drug poisoning. It covers the following cause of death categories (the relevant codes from the International Classification of Diseases, Tenth Revision [ICD10], are given in brackets):

• deaths where the underlying cause of death has been coded to the following sub-categories of ‘mental and behavioural disorders due to psychoactive substance use’:
  • opioids (F11);
  • cannabinoids (F12);
  • sedatives or hypnotics (F13);
  • cocaine (F14);
  • other stimulants, including caffeine (F15);
  • hallucinogens (F16);
  • volatile solvents (F18); and
  • multiple drug use and use of other psychoactive substances (F19).
• deaths coded to the following categories:
  • accidental poisoning (X40 – X44);
  • intentional self-poisoning by drugs, medicaments and biological substances (X60 – X64);
  • assault by drugs, medicaments and biological substances (X85); and
  • event of undetermined intent, poisoning (Y10 – Y14).

The main differences between this "wide" definition and the one which was used to produce the statistics given in this paper (which is the "baseline" definition for the UK Drugs Strategy) are:

• the first part of the "wide" definition also includes deaths coded to "volatile substances" (F18);
• the second part of the "wide" definition is not restricted to cases where a drug listed under the Misuse of Drugs Act (1971) was known to be present in the body at the time of death.

As a result, the "wide" definition produces figures which are markedly higher than those of the UK Drug Strategy definition.

B3. Second, there is the definition used by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) for its "general mortality register". The rules for this definition refer to particular codes for the underlying causes and the types of substance involved, and (in some cases) specify the combinations that must occur for a death to be counted under this definition. It produces figures which are broadly similar to those of the UK Drug Strategy definition, but which cover deaths which involved the use of a different (albeit overlapping) range of drugs: so some deaths which are counted under the EMCDDA definition are not counted under the UK Drug Strategy definition, and vice versa.

B4. Because GROS has details of all the deaths which were registered in Scotland, it can produce figures using the ONS "wide" definition and the EMCDDA "general mortality register" definition, as well as using the definition of the "baseline" for the UK Drug Strategy. These are given in Table X. As the table and Figure 2 show, the numbers produced using the three definitions tend to rise and fall in broadly similar ways, and so all three definitions give similar impressions of the long-term trend, although they differ regarding the numbers of deaths in each year.

B5. The Scottish Crime and Drug Enforcement Agency (SCDEA) uses a different definition. In Autumn 2007, GROS compared some of the details of the drug-related deaths (in terms of the "baseline" UK Drug Strategy definition) in 2006 that were held by GROS and the deaths that were recorded in an SCDEA database of drug-related deaths. The results may be summarised as follows:

• 321 deaths were counted by both GROS and SCDEA;
• 100 deaths were counted by GROS but not by SCDEA. These included:
  • 14 deaths occurring in December 2005 which were not registered until 2006;
  • 28 definite suicides;
  • 19 probable suicides (classified as "events of undetermined intent");
  • 8 cases coded to "accidental overdose";
  • 29 cases coded to "drug abuse".
• 53 cases were counted by SCDEA but not by GROS. These comprised:
  • 13 deaths occurring in December 2006 which were not registered until 2007 - most (if not all) of which will be included in the GROS figures for 2007;
  • 21 deaths for which drugs (whether named or unspecified) were recorded in the GROS database - but either the drugs mentioned were not covered by the "baseline" definition or the deaths were coded to causes other than drug abuse or drug overdose;
  • 19 deaths which had no mention of drugs in the GROS database (13 were coded to "unascertained" cause of death). Returns from Procurators Fiscal were still outstanding for several of these when the GROS database for 2006 was closed at the end of June 2007. SCDEA recorded the involvement of heroin or methadone in 15 deaths, so it is likely that some of them would have been counted in GROS's figures for drug-related deaths had all the relevant information been available before its database for 2006 closed.

B6. Other organisations may interpret the term "drug-related deaths" in other ways.

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