Drug-related Deaths in Scotland in 2003

Summary of results

Recent trends (Table 1)

4. There were 317 drug-related deaths in 2003, 65 (17%) fewer than in 2002 but 73 (30%) more than in 1996. Within these totals, the number of deaths of known or suspected habitual drug abusers fell substantially, from 280 in 2002 to 216 in 2003. However, the number of deaths in this category is 23 % higher than in 1996. Between 2002 and 2003 there were only minor changes in the numbers of deaths coded to the other categories shown in Table 1.

Health board areas (Table 2 and Table 3)

5. Of the 317 deaths in 2003, 107 (34%) occurred in the Greater Glasgow Health Board area. Lothian with 40 (13%), and Grampian with 37 (12%), had the next highest totals. The Greater Glasgow total showed a large decrease, down from 126 in 2002 to 107 in 2003, that for Grampian fell from 47 to 37, while Lothian's total increased by 1 to 40. Of the other areas there were sizeable decreases for Ayrshire & Arran (down from 33 to 19), Forth Valley (down from 24 to 12) and Lanarkshire (down from 37 to 25).

6. Because of the relatively small numbers involved, particularly for some health board areas, and the possibility that more complete information has been reported in recent years, care should be taken when assessing the trends shown in Tables 1 and 2.

Age groups and sex (Table 4)

7. Most deaths (89%) were to persons aged under 45, with a quarter (25%) aged under 25. Of the 36 cases aged 45 and over, only 10 were known, or suspected, to be drug-dependent. Men accounted for 81% of the 317 drug-related deaths in 2003. Almost three-quarters (74%) of the male deaths were of known or suspected drug abusers compared to only 43% of the female deaths.

Types of drug involved (Table 5 and Table 6)

8. Tables 5 and 6 give information on the involvement of selected drugs, either alone or, more commonly, in combination with other drugs. Since the tables record individual mentions of particular drugs they involve double counting of some deaths. It is believed that for the overwhelming majority of cases where morphine has been identified in post-mortem toxicological tests its presence is a result of heroin use. The tables therefore show a combined figure for 'heroin/morphine'.

9. In 2003, the drugs listed in the Tables were known to be involved in 272 (86%) of the 317 deaths. Heroin/morphine was involved in 175 (55%) of the deaths; diazepam was involved in 153 (48%) of the deaths; and methadone was involved in 87 (27%) of the deaths. A wide range of drug combinations was recorded. Of particular note was the fact that diazepam was also mentioned in 95 (54%) of the 175 deaths involving heroin/morphine. The presence of alcohol was mentioned for 128 of the 317 drug-related deaths in 2003. The blood-alcohol level was not given for all cases but, where mentioned, it was often at a relatively low level.

10. Table 5 shows that, since 1996, there have been significant increases in the involvement of heroin/morphine, and to a slightly lesser extent diazepam, though the figures for 2003 both show a fall from the peaks recorded in 2002. Since 1996, there have also been marked increases in the smaller numbers involving cocaine and ecstasy. However, the number of deaths involving cocaine decreased slightly from 31 to 29 between 2002 and 2003, and the number involving ecstasy fell from 20 to 14. Between 1996 and 2000 there was a downward trend in the number of deaths involving methadone, but there has been a substantial increase since then, almost back to the 1996 level (100). The table also shows that the decline in the number of deaths involving temazepam was reversed in 2003 which recorded more than double the 2002 figure.

11. Table 6 shows some geographical differences in the reported involvement of certain drugs. For example, heroin/morphine was mentioned in a much larger proportion of the deaths in Greater Glasgow (60 out of 107) and Grampian (27 out of 37) than in Lothian (9 out of 40). However the pattern is reversed for methadone - only 40 out of 107 deaths in Greater Glasgow and 5 out of 37 in Grampian compared to 19 out of 40 in Lothian. The table also shows that diazepam was involved in almost two-thirds (72 out of 107) of the deaths in Greater Glasgow.