Summary

In this bulletin, data on deaths among people who were homeless and who died in 2022 are presented, along with a summary of deaths that occurred from 2019 to 20221. The data were collected using the National Drug-Related Deaths Index (NDRDI) methodology.  

Number of deaths and type of accommodation

• There were 124 deaths among people known to be homeless at the time of death in 2022. This equates to more than 10 deaths per month in 2022.
• Of the 124 deaths, 63 (50.8%) were among people who were homeless and in temporary or crisis accommodation, and 16 (12.9%) were among people who were without accommodation such as sleeping rough.
• More than one in four (25.8%) people were in highly insecure, substandard or unstable accommodation.

Demographics

• Most (80.6%) deaths occurred among males.
• The median age of those who died was 46.0 years (47.0 years for males and 40.5 years for females).
• Most (57.3%) of the deceased lived in Dublin (city and county).

Substance use

• Most of the deceased (83.9%) had a history of substance use.
• Cocaine (72.4%) was the most common drug used by those with a history of drug use, followed by heroin (53.9%), alcohol (47.4%), and benzodiazepines (31.6%).
• Of those with a history of substance use, 61.5% were known to have alcohol dependence or problem use of alcohol.
• Of the 40 people who used drugs only (excluding alcohol), the majority (87.5%) had a recorded history of polydrug use.
• One in five (27, 21.8%) of the deceased had ever injected drugs, with 10 people injecting at the time of death.

Co-morbidities

• One in five (20.2%) of the deceased had a history of blood borne virus; this was most commonly a diagnosis of hepatitis C, which was recorded for 16.1% of the deceased.
• Mental health issues were known to have been present for 37.9% (47) of those who died.
• Two in five (41.1%) of the deceased were known to have ever accessed substance use treatment.
• One in five (21.0%) of the deceased were receiving opioid agonist treatment (OAT) in the form of methadone substitution, at the time of death.

Place of death

• Over one half (56.5%) of the incidents leading to death occurred in Health Service Executive (HSE) health regions Dublin and North East and Dublin and Midlands.
• The most common (57.3%) county of incident was Dublin (city or county).
• Specific accommodation for people who are homeless was the location of the incident in 33 deaths (26.6%), with a further 36 incidents (29.0%) occurring in a public place, public building, or derelict building.

Poisoning deaths

• Over a third (45, 36.3%) of deaths among people experiencing homelessness were due to poisoning: 38 (84.4%) were among males and seven (15.6%) were among females. The median age of those who died by poisoning was 43.0 years.
• The most common drug groups implicated in poisoning deaths were opioids (73.3%), benzodiazepines (57.8%), cocaine (55.6%), and alcohol (either alone or as part of polysubstance poisoning) (24.4%).
• Methadone (street or prescribed) (57.8%) was the most common specific drug implicated in poisoning deaths.
• Polysubstance poisoning accounted for seven in ten (71.1%) poisoning deaths. The proportion of polysubstance poisonings was the same among males and females.

Non-poisoning deaths

• There were 79 (63.7%) non-poisoning deaths: 62 (78.5%) were among males, and 17 (21.5%) were among females. The median age of those who died was 48.0 years.
• Six in ten (60.8%) non-poisoning deaths were classified as medical, with four in ten (39.2%) classified as traumatic.
• The most common medical cause of death was cardiovascular conditions, while the most common traumatic cause of death was falls.

Deaths among people with no recorded history of substance use

• There were 20 (16.1%) deaths among people who were homeless and who had no recorded history of drug or alcohol use. The median age of this group was 55.5 years.
• Most of these deaths were non-poisoning deaths, most commonly due to medical causes.