Drug deaths in England have been rising for the last nine years, reaching a record high of 4,532 in 2021. This is the highest level since records began in 1993 and are proportionally almost double the rate in 1993. Drug deaths include deaths from fatal accidents, suicides, drug dependence, alcoholism, and complications. Nearly two-thirds of these deaths are related to drug misuse.
These include deaths from drug dependence, fatal accidents, suicides, and complications involving drugs. Drugs accounted for include both prescription drugs, over-the-counter drugs such as paracetamol, and illicit drugs. We will look at the drugs which contribute most to this increase in death rates, but also at factors that contribute to drug use and access to alcohol or drug addiction treatment.
Which Drugs Contribute Most to Increased Death Rates?
Opiates have consistently contributed most to drug deaths, accounting for 2,066 of all drug deaths in 2021. There has been a relatively stable population of heroin users over the years, the opiate responsible for the most deaths. With an aging population of heroin users, we can expect further deaths and health complications as more people suffer from the effects of long-term heroin use.
However, while opiates are responsible for the highest number of drug-related deaths and have increased one-and-a-half times from 1,306 to 2,066 in the last ten years, cocaine deaths are increasing at a much more alarming rate. Since 2011, cocaine deaths have increased seven-and-a-half times from 105 to 791. Many people are therefore linking the record drug deaths to an increase in cocaine-related deaths.
The natural response to seeing increased drug death rates is to assume that there has been an increase in drug misuse. However, the latest data from ONS from 2020 has suggested that there has been no change in the overall level of drug use. In fact, while drug deaths increased overall from 1995 to 2013, the proportion of people who had taken drugs in the last year decreased. It is only since 2013 that we have seen an increase, though it is still lower than the misuse in 1995.
However, over the last five years, there has been a sharp increase in the number of people taking cocaine. This seems to be driven by men under thirty taking powder cocaine. There is also a new population of younger crack cocaine users. Powder cocaine is generally thought of to be safer than crack cocaine; it is less potent, so it is not as addictive. However, powder cocaine is still a very addictive drug and can cause overdoses. Most people who use powder cocaine use it occasionally. However, the use of it is a risk factor for crack cocaine use.
While increasing death rates due to cocaine are consistent with this increase in cocaine use, it is also thought to be affected by the purity of cocaine. From 2013, the worldwide production of cocaine increased drastically, causing more competition among UK suppliers. This led to the quality of powder and crack cocaine increasing. If you are used to taking less potent cocaine, taking your usual dose with a more potent batch could cause you to overdose or lead to other adverse effects, increasing your risk of death through accidents or overdose.
Other Contributing Factors
Narrowing down the deaths to a particular drug gives us an idea of drug trends; however, it does not really get to the root of why there are record numbers of drug-related deaths. The real question is why people are taking drugs to the extent that they are dying. Part of this is thought to come down to austerity measures. Drug misuse and death are closely linked to poverty and deprivation. The Conservative governments from 2010 to 2019 have used the term austerity throughout their time in office. Part of reducing public spending and increasing taxes has been the decrease in funding for addiction treatment. Austerity measures increase the risk that people misuse drugs, and cutting funding reduces the means for seeking treatment.
Additionally, those who take drugs face a lot of stigmas, which are thought to be the greatest barrier to seeking addiction treatment. The stigma surrounding addiction means that those with substance use problems are likely to feel shame and guilt about their substance use. Addiction is a brain disease, but stigma makes it out to be a moral failing of the individual. Tackling the stigma surrounding addiction is vital in making sure that people are comfortable talking about substance use and getting help if they need and want it.
Due to this stigma, the agency of those who take drugs is often taken away from them. They may be coerced into rehabilitation, and policies and programs restrict their treatment based on their actions. For example, support for people who use drugs is often dependent on their sobriety. You will receive a job and housing if you can prove that you are not taking drugs. This creates a barrier for people, and while this approach may help some people, it hinders many others.
What Can We Do?
Harm reduction is an approach that aims to keep those who use substances alive and as healthy as possible. Rather than requiring people to maintain abstinence to receive support, those who use this approach recognize that people who take drugs have agency and should be in control of their decisions. Most people who take drugs do not have problematic use, but even if you use drugs once recreationally without information about safer drug use, you could overdose. Harm reduction includes teaching people about safer drug use and providing the means for it, such as through needle exchanges and access to naloxone, a drug that rapidly reverses the effects of an opioid overdose. This approach has been shown to be effective as it builds trust with people who take drugs, and many will even choose to seek treatment as it is given as an option rather than an obligation. Opiate and cocaine use may be directly responsible for the record drug death rates, but austerity measures, treating drug users like criminals, and restricting access to treatment and dignified support are arguably huge indirect reasons that drug death rates are so high.