In order to ensure a complete and accurate database, the NDRDI records information from several different sources: the Coroner Service, the acute hospital sector through the Hospital In-Patient Enquiry scheme, the Central Treatment List (CTL) and the General Mortality Register. Only deaths which were either directly or indirectly attributable to drug use are included in the analysis presented in this first NDRDI publication. 

 

Directly drug-related deaths (poisonings) are deaths in individuals directly due to the toxic effect of the consumption of a drug and/or other substance. Deaths arising from adverse reactions to prescribed medication are not included in the NDRDI. Indirectly drug-related deaths (non-poisonings) are deaths in individuals with a history of drug dependency or non-dependent abuse of drugs (ascertained from toxicology results, CTL, medical or coronial records) whether or not the drug use was directly implicated in the death.

 

Between 1998 and 2005, a total of 2,442 drug-related deaths were entered on the NDRDI database. Of these, 1,553 were poisonings and 889 were non-poisonings (Table 1). The annual number of drug-related deaths increased from 242 in 1998 to 400 in 2005.

 

Table 1   Poisonings and non-poisonings by year of death, 1998 to 2005 (N = 2,442)

 

 Two-thirds (1,047, 67%) of deaths by poisoning in the eight-year period were male and more than half were in people aged 20 to 40 years.  Over half (839, 54.0%) were due to two or more drugs and/or substances. Opiates (heroin, methadone, analgesics containing an opiate compound, and other unspecified opiates) were responsible for many of these deaths. Opiates accounted for 43% (305) of single-drug poisonings and were involved in 67.3% (565) of polysubstance poisonings.

 

Cocaine, alone or in conjunction with another drug, was implicated in 100 deaths by poisoning over the period, an increase from five in 1998 to 34 in 2005.  

 

Prescription and over-the-counter medications were implicated in many of the deaths by poisoning. Benzodiazepines played a major role in polysubstance poisonings, and were involved in 30% of all deaths by poisoning. 

 

Overall, alcohol in conjunction with another drug or substance was involved in one-quarter (380, 24.5%) of all deaths by poisoning. This is an underestimation of the total number of alcohol-related deaths as cases of poisoning by alcohol alone are not included in this analysis.

 

Since 2003, the annual number of deaths by poisoning outside Dublin has surpassed the number reported in Dublin (city and county), illustrating that drug use is now a nationwide issue.3

 

Calculating indirectly drug-related deaths allows, for the first time, the illustration of the total burden of mortality related to drug use in Ireland. The number of deaths indirectly related to drug use increased over the period, from 64 in 1998 to 168 in 2005. This may be an underestimation of the true figures, as details of drug using history are not always recorded in cases of death indirectly related to drug use. The number of non-poisoning deaths increased steadily over the reporting period both inside and outside Dublin.

 

The number of non-poisoning deaths reflects the increasing numbers of people in the population who are consuming drugs, taking risks, developing dependencies, or who have developed other illnesses associated with drug use.  

 

This report may be downloaded from the publications section of the HRB website at www.hrb.ie.

 

1. Lyons S, Lynn E, Walsh S and Long J (2008) Trends in drug-related deaths and deaths among drug users in Ireland, 1998 to 2005. HRB Trends Series 4. Dublin: HRB.

2. Department of Tourism Sport and Recreation (2001) Building on experience: National Drugs Strategy 2001–2008. Dublin: Stationery Office.

3. National Advisory Committee on Drugs and Public Health Information and Research Branch (2008) Drug use in Ireland and Northern Ireland 2006/2007. Drug prevalence survey: Regional Drugs Task Force (Ireland) and Health and Social Services Board (Northern Ireland) results. Bulletin 2. Dublin: NACD.

The Health Research Board published the first analysis of data from the National Drug-Related Deaths Index (NDRDI) in November 2008.which records cases of death by drug and alcohol poisoning and deaths among drug users and alcoholics. The NDRDI was established in September 2005 to comply with Action 67 of the current National Drugs Strategy.2 The aim of this action was to put in place a system for recording drug-related deaths to enable the State to respond in a timely manner, with accurate data, on drug-related deaths and deaths among drug users. 1 The NDRDI is an epidemiological database