This update presents figures from the National Drug-Related Deaths Index (NDRDI) on deaths due to poisoning by alcohol and/or other drugs, and deaths among drug users, in the period 2004–2011. The figures in this update supersede all previously published figures.

Key findings
Poisoning deaths in 2011:
• The number of poisoning deaths increased from 338 in 2010 to 365 in 2011.
• Almost two thirds of these deaths were male; males account for the majority of deaths since 2004.
• The median age for those who died was 39.
• Alcohol was involved in 37% of poisoning deaths in 2011, more than any other drug, despite a small drop on the overall number of deaths where alcohol was implicated. Alcohol alone was responsible for 17% of poisoning deaths.
• More than half of poisoning deaths involved more than one drug (polydrug use).
• There was a notable increase (28%) in the number of poisoning deaths as a result of polydrug use, rising from 168 in 2010, to 215 in 2011.
• The drugs most implicated in polydrug use are alcohol, diazepam, methadone and anti-depressant medication.
• Methadone was implicated in 113 deaths in 2011, rising from 60 deaths in 2010.
• Benzodiazepines were implicated in 166 deaths - an increase of 61% on the 2010 figure of 103 deaths.
• Heroin related poisonings continue to decline from 72 in 2010 to 60 in 2011.
• Cocaine deaths have fallen from a peak of 66 deaths in 2007 to 23 in 2011.

Commenting on the findings, Dr Lyons, Senior Researcher at the Health Research Board, says,‘It is disappointing to see an increase in poisoning deaths in 2011, as the three preceding years all recorded an overall decrease in these deaths. Alcohol, alone or in combination with other drugs, continues to be one of the main reasons for poisoning deaths.

Also of concern is that the number of deaths involving prescription medication has increased considerably between 2010 and 2011, mainly diazepam, methadone and other benzodiazepines. Our data shows that it is the use of these medications together that is frequently contributing to the death. This demonstrates the need to continue to highlight the dangers associated with polydrug use in harm reduction initiatives at local, regional and national level.

The reason for the rise in the numbers of deaths involving methadone in 2011 also needs more investigation, although it does reflect similar trends in Scotland and to a lesser extent England and Wales for the same time period. What we do know is that 68% of those who died, where methadone was implicated, were not in opiate substitution treatment at the time of their death. This is notable as there is clear evidence(*) which indicates that having access to drug treatment, including opiate substitution treatment, is one of the major factors in reducing drug-related deaths’.

Non-poisoning deaths in 2011:
(Non-poisoning deaths are deaths among drug users that may be indirectly attributed to their drug use.)
• There were 17 fewer non-poisoning deaths in 2011 than in 2010. This is the second year that these deaths have reduced.

Deaths due to trauma:
• Trauma deaths fell from 122 in 2010 to 117 in 2011.
• 71% of these deaths were among people under the age of 39.
• 86% of these deaths were male, following a trend of previous years.
• Hanging was the most common cause of death (65 people or 56%) and road traffic collisions (14 people or 12%).

Deaths due to medical causes:
• The number of deaths due to medical causes continued to decrease since 2009, with 125 deaths in 2011.
• 60% were aged between 30 and 49 years and the three quarters of these were men.
• The most common medical causes of death were cardiac events (44 people or 35%) and liver disease (27 people or 22 %).
‘
The decrease in non-poisoning deaths is overshadowed by the large proportion of hangings occurring in 2011. This finding, in conjunction with the frequency that benzodiazepines and anti-depressant medication are implicated in poisoning deaths, would indicate that a proportion of both poisoning and non-poisoning cases may have had mental health problems, as well as problem drug use issues. The evidence in this report supports the need for increased awareness of people with mental health issues attending addiction services.

This report clearly highlights the key factors that are influencing drug-related deaths in Ireland. The evidence produced by the NDRDI can be used to raise awareness in order to target actions to reduce the burden of premature death caused by problem alcohol and other drug use here in Ireland', says Dr Lyons.