Intended for healthcare professionals


Drug related deaths in England and Wales

BMJ 2016; 355 doi: (Published 17 October 2016) Cite this as: BMJ 2016;355:i5259
  1. John Middleton, president1,
  2. Sara McGrail, independent health policy specialist2,
  3. Ken Stringer, independent consultant in substance misuse2
  1. 1Faculty of Public Health, London NW1 4LB, UK
  2. 2Telford, Shropshire, UK
  1. Correspondence to: J Middleton, president{at}

A public health and primary care emergency

Figures from the Office for National Statistics published last month show that total drug related deaths in England and Wales increased by 65.7% and opioid related deaths by 107% between 2012 and 2015.1 These figures exclude deaths from bloodborne viruses and other conditions related to use of illegal drugs, so the actual mortality associated with drug use will be higher. In a report published the same day, Public Health England2 suggests contributors to the increase in deaths, including the rising age and increased physical frailty of drug users, interactions with other drugs and new psychotropics, and variations in the street purity and availability of opiates. Over half of the drug related deaths were among people who used opiates and had had no recent contact with drug services.

Public Health England suggests local and national actions to counter this public health emergency, including use of its updated prescribing guidelines, more extensive availability of naloxone, and a new Public Health Outcomes Framework indicator for drug related deaths. The report is silent, however, on systemic factors that may have …

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