21 August 2012

Scots drugs deaths increase by 563% & 623%, but for who?

Last week, the General Register Office for Scotland published its grim annual statistics on the number of drug-related deaths in Scotland in 2011. BBC Newsnicht took the findings for its topic last night, focussing on the much-increased incidence of the drug methadone being implicated in deaths.  I don't know about you, but I often find big data shots like this are difficult to digest.  On the telly, the demands of brevity make for fleeting graphics, glossed issues and compressed conversations.  The statistical releases themselves are a remorseless parade of cross-referenced columns, less than easily navigated.  I thought it might be of interest, therefore, to pull out some of the information published by the government statisticians, and re-render it in more easily intelligible forms. 

Obvious questions include: how many people are dying? Is the number increasing or decreasing? Chipping below the total number of deaths, are there changes in the gender and the age groups of those who are dying? Of the dizzying array of noxious and intoxicating substances out there for sampling, which ones are most implicated in most deaths, and how have these figures changed over time? I hope to provide sketchy, preliminary answers to all of these questions, but first, the total butcher's bill.  The General Register Office statistics cover the last fifteen years, during which period...

Like a great many of the statistics which have interested me in the past - imprisonment, homicide, suicide - Scottish men represent the overwhelming majority of recorded drug-related deaths.  Since 1996, the number of men dying has more than doubled (from a low of 179 deaths in 1997, to a high of 461 in 2008).  For women, by contrast, a look across the same period shows that a 1997 low of 45 deaths has increased to a high of 155 last year, with an upwards spike in 2008 which has seen over 100 women die drug-related deaths each year to date.

And showing increases between 1996 and 2011, by gender.

And women...

Feckless, raving, drug-addled youth. It's a familiar image, likely reinforced by the coverage given to some tragic instances of very young folk, perishing. The statistics, by contrast, show a rather different picture.  Fifteen years ago, the overwhelming majority (77%) of those who died drugs-related deaths were aged under 35, 35% of them before their twenty fifth birthdays.  Over fifteen years, however, that picture has rapidly altered.

Under 35s now make up just 41% of 2011 drug deaths.  Last year, fewer under 25 years olds died than 45 - 54 year olds.  To my eye, most startling over the decade and a half has been the huge increase in the number of 35 to 44 year olds dying, from just 32 deaths in 1996, to last year's high of 212: an increase of 563% in just fifteen years.  Although starting from a lower base, the increase in the number of 45 - 54 year olds was even greater, climbing over 623% during the period from just 13 deaths in 1996 to the current high of 94.  Despite some people's expectations, drug deaths amongst under 25 year olds are one of the few age strands which has been showing a consistent downward tendency these last four years. 


Seeing such substantial changes, the obvious question to ask is, "why"? Confounded tricky question it is too, and a few tentative cautions and hypotheses are probably beyond the scope of this (already substantial) blog. I may well come back to it anon, but until then, speculative discussion in the comments is positively encouraged. 

So what sorts of drugs are implicated in the ongoing rise in the number of Scottish drugs deaths, and how has this changed over time? On a statistical note, more than one drug may be reported per death, and should not be added to give total deaths. I'll be using the data generated by pathologists on the "drugs which were implicated in, or which potentially contributed to the cause of death".  The report also includes data on "other drugs which were present but which were not considered to have had any direct contribution to the death", for those interested in the cocktail of substances found in the systems of those who died.  

Like the changing chart on the age of those who died, the profile of the drugs which killed them has changed substantially over time, with volatile spikes, falls, troughs.  Statistics are not published on all of the sorts of substances which may rob a man of his life - the data is selective, and I'm sure you've heard of most of the drugs depicted.  

So that's how things have changed over time.  What of last year? What substances are proving a contemporary challenge? As the Newsnicht report focussed on, methadone looms large. 

Given the issues I've looked at so far - differences in gender, differences in age groups - I wondered whether the drugs implicated in deaths would differ substantially between men and women, and between older and younger victims.  First, let's compare genders.  It's worth emphasising again, these are all of the drugs which pathologists recorded as "implicated in, or which potentially contributed to the cause of death" appear in these charts. It would be possible, for example, for a fatally over-intoxicated unfortunate to have every single one of these substances in (probably his) system.  The Office publishes a separate chart on all those drugs deaths where only a single one of these substances (and "perhaps alcohol" too) were found in the deceased's system.

And women:


In reading these graphs, it is worth recalling that male deaths substantially outnumber female deaths, and so you can't read across from the percentages given.  While, for example, a greater percentage of women than men are dying with methodone knackering their systems, methodone is implicated in a greater number of male deaths (75 deaths to 200).  It's an elementary point, but worth keeping in mind.  Now.  What about age? The youngest cohort, whose under 25, constituting 9.9% of drugs related deaths recorded in 2011.  Substances "implicated in, or which potentially contributed to" their deaths were as follows:

Taking them in order of youthfulness, next, the 25 - 34 year olds, who made up 32.5% of those dying last year as a result of drug use.

35 to 44 year olds, 36.3% of deaths last year:

Second to last, the 45 to 54 year olds, who made up 16% of recorded deaths in 2011.


And finally, the oldest cohort, of over 55s, who made up just 6.2% of 2011's total.

So there we have it. Is it entirely what you expected? As we often find, quantitative data like this poses more riddles than it solves, even before we start asking thorny questions about causation, or trying to explain changes in the statistics and analysing what the devil we might do, to try to decrease the numbers of folk needlessly dying. I should also add, the report itself includes various other pieces of data which I've passed over for reasons of brevity.  Conspicuous by its absence is a geographical perspective on the national totals.  You can find further breakdowns by NHS Board area and council area respectively between 2001 and 2011. 


  1. Increase in older people dying could be continued drug use through age, either occasional or ongoing.

    Most 40-50 year olds would have been exposed to rave culture and the expansion of drug use to something altogether more social.

    The availability of drugs now makes it a simple matter for well off older folk to occasionally dip their toe, sometimes with tragic consequences.

  2. Yes I was going to make a similar point. The 35-44 year olds are the 25-34 year olds who dodged the bullet. Then it caught up with them.

    I don't think there are actually that many people who die because of dipping their toe now and then. I think it is habitual users and if you are a habitual user sooner or later it will get you.

  3. Anonymous, Indy,

    Interestingly, that was precisely what one of my hard scientist friends suggested when we were chatting about this over lunch yesterday. Unfortunately, it's impossible to tell if it's true on the basis of these figures - we'd need a longitudinal study of drugs-users to be sure.

  4. Groundskeeper Willie22 August 2012 at 11:16

    How many people are employed, directly or indirectly in the whole illegal drugs industry, ie those on the supply side (criminals) and those on the prevention/law enforcement/ treatment side?

    How much is the industry worth?

    Does anyone know?

  5. I make the same point with murder as for drug related deaths - in that with medical advance in the ever improving ability to resuscitate both, this may mask or certainly affect the true nature of incidence - real or potential. It would be interesting to know the number of drug overdose survivors to obtain a more complete picture of drug usage and it's 'population' of users. Death rates alone will not necessarily give the actual picture.
    I recall a pathologist telling me that many of his post mortem results indicated a fatal overdose often resulted from newly released prisoners returning to their previous level of drug intake having ignored their lowered drug adaption while in prison(?) and in effect taking an overwhelming amount when reverting to habit. The consequential and co-existing morbidity of long-term drug users must also play a significant role in their premature deaths and may frequently be the precipitating factor.

  6. I can only give a personal viewpoint.
    Back in the late '70's, early '80's, there was no work for many Scots young men. An alternative culture gave young men something to do with their lives. The drug lifestyle meant that many young men could have a sense of purpose to their lives. Silly, i know.
    Most of the guys i knew then are all dead, or on the way. London was the lure for most of them. The comfort blanket of heroin destroyed many of my friends.
    When there is no hope, blanking out the present is often the best choice.
    Vote YES in 2014.


  7. Juteman, Clarinda,

    Two rather different perspectives: I appreciate them both. Interesting (and in Juteman's case, profoundly sad).

  8. Groundskeeper Willie,

    I've read various estimations, both for the policing and justice cost, and for the trade in drugs themselves. Combined, we're likely talking about billions. In 2002, Joseph Rowntree suggested that policing cannabis in England and Wales alone cost "at least £50 million a year".

  9. I agree that my post was profoundly sad.
    Unfortunstely, i 'm already seeing Trainspotting pt. 2 happening.
    Take my home city of Dundee. It is a high tech city, with lots of opportunities for university graduates in the sciences. Mostly for folk from outwith the city.
    For locals, without a degree, it's a choice between call centres or supermarkets.
    There is nothing for the majority of 'blue collar' workers in the middle.
    The only folk making money in Dundee without s degree are drug deslers.
    Vote YES in 2014

  10. The report states that the vast majority of these deaths result from accidental poisoning (overdose). If prevention of drug-related deaths is the objective then eliminating the accidental has to be key because it would more than half the number of drug-related deaths. The effects of long-term drug abuse would then be the major cause of drug-related deaths.

    I would like to know why Scotland’s per capita consumption of cocaine is the highest in the world, and why it leads the UK in the consumption of the other main illegal drugs. Alongside tobacco and alcohol, I would say that such obvious risk-taking is otherwise nationally uncharacteristic.

    Progressive beaconism precludes criminalising addicts.

  11. Groundskeeper Willie23 August 2012 at 23:41

    It seems that the answer to the problem is for Scotland to leave the UK.

  12. Health is devolved but misuse of drugs is reserved. Constitution aside, in light of the overlap between the two, drug deaths in Scotland would be easier to address if both were devolved.

  13. It's economic powers that need to be devolved, not drugs mis-use. Give folk hope, and drug mis-use will drop.
    Vote YES in 2014.

  14. Juteman, independence reaches parts of me that devolution does not.

    I’m arguing that tackling drug abuse in Scotland would be easier if Scotland controlled its own:

    Misuse of drugs
    Financial and economic matters
    Social security

    With those powers, the political will and the right policies, a significant reduction in Heroin, Methadone, Diazepam, Temazepam and alcohol-related abuse and deaths is achievable. We may also be able to make a dent in the number of cocaine, amphetamine and ecstasy-related deaths although I find it conceivable that there use could remain static or even increase.

    Not all drug abuse is economically driven. Across the world some people will get high while living normal lives. We shouldn’t fret about that or criminalise them for doing so.

    Off topic. I’m angry and embarrassed by the inhumane and vindictive treatment of Stephen Gough by Scottish police and the criminal justice system. This madness has been going on for ten years and has cost a lot of money.

  15. I meant Independence, Graham, and agree with everything you say.
    In a system where alcohol is legal, it's hypocritical to criminalise other 'party' drugs.

  16. I note that cannabis is responsible for 0% of deaths in any age group, yet it is criminalised while alcohol, for all the deaths it causes, is not. Madness.