Public Health England Trends in Drug Use 1999-2014

The complete report is linked to Below the Executive Summary

Executive summary
This report presents year-by-year data on drug misuse deaths in England from 1999 to 2014. The Office for National Statistics (ONS) reported a 17% increase in drug misuse deaths registered in England in 2014, following an increase of 21% in 2013.
Public Health England, DrugScope and the Local Government Association held a national summit on drug-related deaths in January 2015, leading to a published report on the main points of the discussion at the summit and the publication of the first trends report by PHE using ONS data in July 2015. This report is an update to incorporate the most recent ONS data.
Presented by year of death, the updated analysis suggests that there was an increase of at least 17% in the number of drug misuse deaths between 2012 and 2013. Data for 2013 is assumed to be an undercount of the actual number occurring in that year as not all deaths in 2013 will yet have been registered. Provisional data for 2014, which will be significantly incomplete, suggests a further increase.
Across the period studied, opiates are the type of substance most frequently mentioned in drug misuse deaths, consistently mentioned in over four-fifths of deaths. The most commonly mentioned opiate drug is heroin, followed by methadone and tramadol. There was an increase of at least 21% in opiate deaths in 2013.
Alcohol was mentioned in combination with illicit drugs in just over one third (36%) of drug misuse deaths in 2012, a proportion that has remained similar in recent years.
Benzodiazepines are the most commonly mentioned non-opiate drug in drug misuse deaths (16% in 2012) and there was an increase of at least 21% in benzodiazepine deaths in 2013. Benzodiazepines are rarely the only drug mentioned in a death.
Mentions of cocaine and amphetamines have risen since around 2010, having fallen markedly before this. Drug misuse deaths where a new psychoactive substance (NPS) was mentioned continued to rise in 2012 (4% of drug misuse deaths), but provisional figures for 2013 suggest a fall, in contrast to the overall rise in drug misuse deaths.
Among heroin deaths, there is a clear long-term trend towards increased mentions of other substances alongside heroin, including alcohol, benzodiazepines and methadone, indicating increasingly complex poly-substance deaths.
The median age at drug misuse death has increased from 32 in 1999 to 41 in 2012. The majority of drug misuse deaths are among men (72% in 2012), although there is a long- term trend of increasing numbers among women.

4

Trends in drug misuse deaths in England, 1999 to 2014

Over three-quarters of drug misuse deaths in 2012 were accidental poisonings. The remainder are classed as suicide and involve relatively high proportions of women, people from older age groups and mentions of opiates other than heroin and methadone.
An update of the matching undertaken between the ONS data and community treatment data from the National Drug Treatment Monitoring System (NDTMS) for 2007–2014 suggested a continuation of known trends:

•   the majority of individuals who suffered opiate misuse deaths in 2012 had not been in treatment since at least the start of 2007
  
•   there was little change in the proportion of opiate misuse deaths where the individual had recently been in treatment (ie, within one year), although there was a slight increase in the proportion where the individual was currently in treatment
  In addition, the updated matching found that the substantial increase in opiate misuse deaths in 2013 was slightly more pronounced for those with recent treatment compared to those who had not had treatment in the past year.
  PHE continues to investigate the trends around drug misuse death, including setting up a national expert group to lead a national inquiry in 2016. Five local events around England will review what is known nationally about DRDs, what local areas can tell us and what can be done to prevent deaths. The national group will then consider the findings alongside other relevant intelligence and publish conclusions and recommendations on what else needs to be done.
  Driven by the findings of the inquiry and by what we already know about drug misuse deaths and their prevention, PHE will:
  

•   now consider what additional advice and support we can provide to local authority commissioners and drug treatment providers
  
•   support improvements in local drug death review processes in 2016–17
  
•   continue to support local areas to further improve access to treatment, which
  appears to have a continuing protective effect
  
•   continue to provide commissioners with advice on provision of the opioid
  antagonist naloxone, following the legislative change to allow drug services to
  more easily supply naloxone
  
•   through the 2016 update to the clinical guidelines for drug misuse and drug
  dependence, cover many of the factors involved in drug-related deaths, such as
  smoking behaviour and supervised consumption of opioid substitute medicines
  
•   in 2016–17, improve the collation, analysis and dissemination of intelligence on
  the adverse health effects of a range of drugs 
  

http://www.nta.nhs.uk/uploads/trendsdrugmisusedeaths1999to2014.pdf