Main Points

The main findings from this report include the following:

• Based on the definition used for these statistics, 526 drug-related deaths were registered in Scotland in 2013, 55 (9 per cent) fewer than in 2012. This was the fifth highest number ever recorded, and 209 (66 per cent) more than in 2003 (paragraph 3.1.1.).
• Males accounted for 75 per cent of the drug-related deaths in 2013 (paragraph 3.4.1).
• In 2013, there were 184 drug-related deaths of people aged 35-44 (35 per cent of all drug-related deaths) and 137 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 526 drug-related deaths in 2013 were:
  • Greater Glasgow & Clyde - 138 (26 per cent);
  • Lothian - 90 (17 per cent);
  • Lanarkshire - 75 (14 per cent); and
  • Grampian - 50 (10 per cent) (paragraph 4.1).

Using the annual average for 2009-2013, to reduce the effect on the figures of year-to-year fluctuations:

• for Scotland as a whole, the average of 544 drug-related deaths per year represented a death rate of 0.10 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, Fife, Lanarkshire, Lothian and Tayside (all 0.10) further details available in paragraph 4.3.

However, there is a much 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 2009-2013 with that for 1999-2003:

• the percentage increase in the number of drug-related deaths was greater for females (139 per cent) than for males (53 per cent) (paragraph 3.4.1);
• the largest increase in numbers was for 35-44 year olds, the largest percentage increase was for people aged 45-54, and there was a fall in the number of drugrelated 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 Greater Glasgow & Clyde (up by 44), Lothian (up by 39) and Lanarkshire (up by 32) (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 526 drug-related deaths in 2013:

• heroin and/or morphine were implicated in, or potentially contributed to, the cause of 221 deaths (42 per cent of the total);
• methadone was implicated in, or potentially contributed to, 216 deaths (41 per cent);
• benzodiazepines (e.g. diazepam) were implicated in, or potentially contributed to, 149 deaths (28 per cent);
• cocaine, ecstasy and amphetamines were implicated in, or potentially contributed to, 45, 17 and 27 deaths respectively; and
• alcohol was implicated in, or potentially contributed to, 103 of the drugrelated 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 2013, heroin and/or morphine were implicated in, or potentially contributed to, the same number of deaths as in 2012 (221), and far fewer deaths than in 2008 (324). The corresponding figure for methadone was below that for 2012 (237) but was still higher than in 2008 (169). The number for benzodiazepines was also lower than in 2012 (196) and was at the same level as in 2008 (149). Because of 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’ 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 526 drug-related deaths in 2013, there were just 46 for which only one drug (and, perhaps, alcohol) was found to be present in the body. There were 193 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 2013:

• there were 60 deaths for which NPSs were implicated in, or potentially contributed to the cause of death. In 39 cases, the only NPSs present were benzodiazepines (usually phenazepam); in 19 cases, other types of NPS were present (e.g. AMT, BZP, PMA or PMMA); there were two deaths for which both benzodiazepine NPSs and other types of NPS were present. Almost all of these deaths (57 out of 60) fall within the definition of ‘drugrelated deaths’ that is used to produce the statistics that are given in the main body of this report – i.e. 57 out of 60 are included in the 526 drugrelated deaths that are referred to earlier. In only a small proportion (5 out of the 60 deaths) were NPSs the only substances implicated in the death. (paragraph E9)
• there were 53 deaths for which NPSs were present but were not considered to have contributed to the death. In almost all cases (51 out of 53) the only NPSs present were benzodiazepines; almost all of these deaths (52 out of 53) were counted in the statistics in the main body of this report – i.e. 52 out of 53 are included in the 526 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