The latest figures from the National Drug-Related Deaths Index (NDRDI) show that a total of 697 deaths in Ireland during 2014 were linked to drug use.¹ The NDRDI reports on poisoning deaths(also known as overdose), which are due to the toxic effect of a drug or combination of drugs, and on non-poisonings, which are deaths among people who use drugs as a result of trauma such as hanging, or medical reasons such as cardiac events.

In the eleven-year period from 2004 to 2014 inclusive, a total of 6697 deaths by drug poisoning and deaths among drug users met the criteria for inclusion in the NDRDI database. Of these deaths, 3,864 (58%) were due to poisoning and 2,833 (42%) were deaths among drug users (non-poisoning) (Table 1). There were 697 deaths in 2014, similar to the number reported in 2013 (698). Many of these deaths were premature, with half of all deaths in 2014 aged 39 years or younger. Three in four (523) of all deaths in 2014 were male.

Some of the key findings of the report are:

• Prescription drugs were implicated in 259 or three in every four poisonings during 2014.
• Two hundred and thirty-five (n=235) or two in every three people died in 2014 because they took a mixture of drugs, with an average of four drugs involved.
• Benzodiazepines were the most common drug group involved in polydrug deaths.
• Notwithstanding a small decrease in alcohol poisonings, alcohol is still implicated in one-in-three deaths and remains the single most common drug implicated in deaths over the reporting period 2004‒2014.
• Opiates were the main drug group implicated in poisonings.
• Hanging was the main cause of non-poisoning deaths. There was a 21% increase in deaths due to hanging between 2013 and 2014.

Table 1 Number of deaths, by year, NDRDI 2004‒2014 (N=6697)

Poisoning deaths in 2014

The annual number of poisoning deaths decreased by 11%, from 397 in 2013 to 354 in 2014 (Table 1). As in previous years, the majority (72%) were male. The median age of those who died was 39 years, again similar to previous years.

Figure 1                Infographic of prescription drugs implicated in deaths

Prescription drugs were implicated in 259 or three in every four poisoning deaths:

• Benzodiazepines were the most common prescription drug group implicated.
• Diazepam (a benzodiazepine) was the most common single prescription drug, implicated in 115 (32%) of all poisoning deaths.
• Methadone was implicated in more than a quarter of poisonings (n=98, 28%).
• Zopiclone-related deaths (a non-benzodiazepine sedative drug) increased by 41% from 51 in 2013 to 72 in 2014.

Alcohol continues to be the single most common drug implicated over the reporting period. Alcohol was implicated in one-in-three of all poisonings, and alcohol alone was responsible for 13% of all poisoning deaths.

Figure 2                Infographic of illicit drugs implicated in deaths

The number of deaths where illicit drugs were implicated increased:

• Heroin was implicated in one-in-four (n=90) deaths and 42% of these people were not alone at the time of the incident that led to their deaths.
• Cocaine-related deaths increased by 25% from 32 in 2013 to 40 in 2014.
• MDMA-related deaths continue to increase from less than 5 in 2010 to 15 in 2014.

Polydrug poisoning deaths

Polydrug use is a significant risk factor for fatal overdose. In 2004, 44% or 118 deaths were due to a cocktail of drugs, with an average of two drugs taken. In 2014, this had risen to 66% or 235 deaths, with an average of four different drugs taken (Figure 3):

• 59% of deaths where alcohol was implicated involved other drugs, mainly opiates.
• 92% of deaths where methadone was implicated involved other drugs, mainly benzodiazepines.
• 81% of deaths where heroin was implicated involved other drugs, mainly benzodiazepines.
• Almost all deaths (98%) where cocaine was implicated involved other drugs.

Figure 3                Evolution of polydrug poisonings, NDRDI 2004‒2014 (N=3864)

Non-poisoning deaths in 2014

The number of non-poisoning deaths increased by 14% from 301 in 2013 to 343 in 2014.Non-poisoning deaths are categorised as being due to either trauma (n=177) or medical causes (n=116).

• The main causes of non-poisoning deaths were hanging (27%) and cardiac events (15%).
• There was a 21% increase in deaths due to hanging between 2013 and 2014.
• More than two-thirds (67%) of people who died as a result of hanging had a history of mental health illness.

Ena Lynn

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1    Health Research Board (2016) National Drug-Related Deaths Index 2004 to 2014 data. Dublin: Health Research Board. www.drugsandalcohol.ie/26299

A number of infographics that outline key data are also available for download. www.drugsandalcohol.ie/26299 and www.hrb.ie/publications