This publication is the first in a series from the Drug Misuse Research Division of the Health Research Board. Each issue of this new series will provide a comprehensive, objective and reliable review of specific drug-related issues in Ireland. The data presented in this publication describe what is known about drug-related deaths and deaths among drug users in Ireland between 1990 and 2002. The analysis presented is based on data reported to the General Mortality Register, and on ad hoc studies that extracted data from the coroners’ records, the Central Treatment List, and the HIV/AIDS surveillance system, and on an epidemic investigation.1 

The main findings are:

• Between 1990 and 1994, there was a small but steady increase in the number of drug-related deaths, from 7 to 19, reported by the General Mortality Register in Ireland (Figure 1). Between 1995 and 2000, there was a substantial increase, from 43 to 119, and in 2001 there was a considerable decline (to 88) in the number of drug-related deaths. In 2002, the number of drug-related deaths increased marginally (to 91) when compared to 2001 .  

Figure 1 Number of direct drug-related deaths in Ireland, by national and by European definition, reported by the CSO, 1990 to 2002 (unpublished data from the vital statistics)

·         According to data from the General Mortality Register, almost all drug-related deaths between 1991 and 1994 occurred in Dublin (Figure 2). Between 1995 and 2000, there was a substantial increase in drug-related deaths in Dublin, from 39 to 90, and a steady increase outside the Dublin area, from 4 to 29. In 2001, there was a sharp decrease in the number of drug-related deaths in Dublin (to 55) and a continued increase outside Dublin (to 33 in 2001 and 35 in 2002). These data follow trends in treated problem opiate use.

Figure 2 Number of direct drug-related deaths in Ireland, by national and by European definition and by place of death, reported by the CSO, 1990 to 2002 (unpublished data from the vital statistics)

• From 1998 to 2001, the annual numbers of opiate-related deaths extracted by Byrne2 from the Dublin coroners’ records were consistently higher than those reported by the General Mortality Register. These variations may be related to differences in the definition of opiate-related deaths applied in each case. The General Mortality Register considers opiate-related deaths to be those occurring as a direct result of opiate use, while Byrne investigated all the coroners’ cases that tested positive for opiate use and so included a broader range of opiate-related deaths.
•  Opiate-related deaths account for the largest proportion of deaths among drug users in Ireland. The review of coroners’ cases found that polysubstance use was common among drug users who had died.
•  According to both the General Mortality Register and Byrne’s review of coroners’ data, 2, 3 those who died as a result of drug use were older than their counterparts in treatment, indicating an increased risk with age. As expected, more men than women died.
•  Following a review of the Dublin coroners’ cases, Byrne reported that 13 per cent of drug-related deaths were associated with imprisonment or recent release from prison.
•  Injecting drug use is associated with infection and subsequent mortality.
•  Deaths as an indirect result of drug use are not systematically documented and have been assessed only in small-scale studies in Dublin. The findings of these studies indicate an underestimate in opiate-related deaths but provide little information on other drug-related deaths. A system is required to document drug-related deaths and deaths among drug users.   

1. Long J, Lynn E and Keating J (2005) Drug-related deaths in Ireland, 1990–2002. Overview 1. Dublin: Health Research Board.

2. Byrne R (2001) Opiate-related deaths investigated by the Dublin City and County Coroners 1998 to 2000. Dublin: University of Dublin, Addiction Research Centre.

3. Byrne R (2002) Opiate-related deaths investigated by the Dublin City and County Coroners 1998 to 2001, Briefing No 2. Dublin: University of Dublin, Addiction Research Centre.