The latest figures from the National Drug-Related Deaths Index (NDRDI) show that a total of 736 deaths in Ireland during 2016 were linked to drug use.1,2 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 as a result of trauma, such as hanging, or medical reasons, such as cardiac events, among people who use drugs.

Key findings of the report are:

• Prescription drugs contribute to the majority of poisonings and were implicated in 258 or three in every four poisonings during 2016.
• Taking a cocktail of drugs (polydrugs) continues to be a significant factor in poisoning deaths.
• Alcohol remains the main drug implicated in poisoning deaths, alone or with other drugs.
• Hanging is the main cause of non-poisoning deaths.

In the 13-year period from 2004 to 2016 inclusive, a total of 8,207 drug-related deaths were recorded by the NDRDI. Of these deaths, 4,597 (56%) were due to poisoning and 3,610 (44%) were non-poisoning deaths.

There were 736 deaths in 2016, similar to the number reported in 2015 (735) (see Table 1). Many of these deaths were premature, with one-half of all deaths in 2016 aged 42 years or younger. Three in four (549) of all deaths in 2016 were male. In 2016 alone, 21,300 potential life years3 were lost because of drug-related deaths.

Deaths in 2016 among people who inject drugs

People who were injecting at the time of the incident that led to their death represented 5% (34 deaths) of all drugs-related deaths in 2016. The majority were male, involved opiates (85%) and two-thirds (65%) occurred in Dublin city.

Poisoning deaths in 2016

The annual number of poisoning deaths decreased slightly from 365 in 2015 to 354 in 2016 (see Table 1). As in previous years, the majority (69%) were male. The median age of those who died was 42 years.

Key findings of poisoning deaths in 2016:

• The number of deaths involving alcohol increased by 18% from 112 in 2015 to 132 in 2016. Alcohol was implicated in over one in every three poisoning deaths (37%) and alcohol alone was responsible for 16% of all poisoning deaths.
• Opiates were the main drug group implicated in poisonings; methadone was implicated in almost one-third (29%) of poisonings, while heroin-related deaths decreased for the third year in a row from 96 deaths in 2014 to 72 in 2016.
• Prescription and/or over-the-counter drugs were implicated in 7 in every 10 (73%) poisoning deaths.

• • Benzodiazepines were the most common prescription drug group implicated. Diazepam was the most common benzodiazepine-type drug and was implicated in one in four (96; 27%) of poisonings
  • Methadone was the most common single prescription drug, implicated in 103 (29%) of poisonings.
  • Pregabalin (an anti-epileptic drug also prescribed for neuropathic pain and generalised anxiety disorders) was implicated in 65 deaths in 2016, an increase from 49 deaths in 2015 with a persistent rise from 14 deaths in 2013.

• Cocaine-related deaths decreased from 45 in 2015 to 41 in 2016.

Polydrug poisonings in 2016

Taking a cocktail of drugs (polydrugs) can increase the risk of fatal overdose. The majority of poisoning deaths (62%) in 2016 involved polydrugs, with an average of four different drugs taken.

• 58% (77) of deaths where alcohol was implicated involved other drugs, mainly opiates.
• 88% (91) of deaths where methadone was implicated involved other drugs, mainly benzodiazepines.
• 81% (58) of deaths where heroin was implicated involved other drugs, mainly benzodiazepines.
• All diazepam-related deaths (96) involved other drugs.

Non-poisoning deaths in 2016

The number of non-poisoning deaths increased slightly with 382 deaths in 2016 compared with 370 in 2015. Non-poisoning deaths are categorised as being due to either trauma (172 deaths) or medical causes (210 deaths).

• The main causes of non-poisoning deaths categorised as trauma were hanging (93; 24%) and those categorised as medical were cardiac events (56; 15%).
• Three in every four (75%) people who died as a result of hanging had a history of mental health problems.
• The median age for deaths due to medical causes has increased from 38 years in 2004 to 46 years in 2016, which may indicate an ageing cohort of people who use drugs in Ireland.

1    Health Research Board (2019) National Drug-Related Deaths Index 2004 to 2016 data. Dublin: Health Research Board. https://www.drugsandalcohol.ie/30174/

2    A number of infographics that outline key data are also available for download as well as tables outlining breakdown by county and DATFA (Drug and Alcohol Task Force Area). For further information, visit: www.drugsandalcohol.ie/30174 and www.hrb.ie/publications

3    Potential life years lost was calculated by looking at the age of individuals who died in 2016 and what their life expectancy would have been based on their year of birth.