National drug related death database (Scotland)
Analysis of deaths occurring in 2017 and 2018

About this release

This release by Public Health Scotland (PHS) presents information from the National Drug-Related Deaths Database (NDRDD) for Scotland on deaths which occurred in 2017 and 2018, with trend data from 2009. Data from the NDRDD provides detailed information on drug-related deaths in Scotland, highlighting potential areas for intervention. Information is provided on deaths involving controlled drugs which were classed as either non-intentional (accidental, or of undetermined intent) or intentional (deaths by suicide).

On 8th November 2022 a revision was made to the Publication Summary and Report. An error in the presentation of figures was identified and this has now been corrected. The percentage of people who died an opioid-related death and who were prescribed an Opioid Substitution Therapy (OST) at the time of death should be 22% in 2009, 51% in 2017 and 51% in 2018 (not 21%, 42% and 41% respectively, as reported previously).  This error in presentation did not impact any other data or charts.

Main points

The NDRDD includes 1,209 deaths which occurred in 2018, of which 1,154 were classed as non-intentional (in 2017, 899 of 956 deaths were non-intentional).

The following main points focus on non-intentional deaths which occurred in 2018:

• The mean age of people who had a drug-related death increased from 35 years in 2009 to 42 years in 2018. The percentage of drug-related deaths which occurred among women increased from 21% in 2009 to 27% in 2018.
• The most common substances found present at post-mortem in 2018 were heroin or morphine (51%), methadone (51%) and etizolam (51%). The presence of etizolam (a benzodiazepine-type 'Novel' Psychoactive Substance or 'Street benzo') has increased markedly since it was first detected (<1% in 2012).
• Opioids (heroin/morphine, methadone or buprenorphine) were implicated in 77% of deaths in 2018. Among people in this group, 51% were prescribed an Opioid Substitution Therapy drug (for example, methadone) at the time of death. This percentage has increased from 22% in 2009.
• Around half of all people who died were in contact with drug treatment services in the six months prior to death (48%). This percentage has increased since 2009 (34%).
• Among people who had a drug-related death, prescribing of gabapentin or pregabalin (medications prescribed for epilepsy or chronic pain, which have been reported to enhance the effects of opioids) in the three months prior to death increased from 5% in 2009 to 28% in 2018.

The figure shows the presence of six specific drugs at post mortem across the time series from 2009-2018. Heroin, methadone and etizolam were the most commonly found drugs at post mortem. The presence of etizolam has has increased since 2012 whereas the presence of diazepam has decreased since 2012.

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Most Common Substances Present at Post-mortem (NDRDD: 2009-2018)

Background

The definition of a drug-related death is based on the UK-wide definition used by National Records of Scotland (NRS) for national reporting. Summary statistics on drug-related deaths registered in 2017 and 2018 were previously published by NRS.

The NDRDD collects information collated by NHS Board Data Collection Co-ordinators from a variety of data sources (e.g. police sudden death reports, pathology reports, GP and other clinical notes), and facilitates detailed analysis of these deaths with the aim of providing further insights into the lives of those who died.

Further information

The next release of this publication will be winter 2023/24.