Introduction

Latest data from the National Drug-Related Deaths Index (NDRDI) show that there were 343 drug poisoning deaths in Ireland in 2022, representing an 8% decrease on 2021 figures.1 The NDRDI bulletin presents data on deaths in 2022, with key trends for the period 2013–2022. It describes the number of deaths and mortality rates, as well as the circumstances of deaths, including poisoning drugs implicated, location, place, and context of deaths, and characteristics of the deceased. Trends must be interpreted in the context of the COVID-19 pandemic and related public health measures from March 2020. 

Background

A drug poisoning (overdose) death is a death due to the toxic effects of one or more substances on the body, which may include illicit drugs such as cocaine, or prescribable drugs such as diazepam (Valium). Since 2005, the NDRDI has provided national data on drug poisoning and other drug-related deaths in order to inform measures to reduce deaths and other drug-related harms.

The NDRDI’s main data source is closed coroner files, accessed via the Coroner Service. The NDRDI also includes data from the General Mortality Register via the Central Statistics Office, the Hospital Inpatient Enquiry system via the Healthcare Pricing Office, the Central Treatment List, and the Primary Care Reimbursement Service via the Health Service Executive.

Number of deaths

An upward trend in the number of deaths peaked in 2020 with 446 deaths, the highest number ever recorded (Figure 1). The NDRDI reported year-on-year decreases in the number of poisoning deaths from 2021 to 2022. A similar pattern was observed in some other countries and appears as a phenomenon of the COVID-19 pandemic period. It may reflect an acceleration of deaths among especially vulnerable people in 2020. In Ireland, there was a large increase in deaths among females in that year (Table 1).

Three-year moving averages were examined to gain further insight into trends. Where there are annual fluctuations and extremes in numbers, moving averages can provide a better indication of long-term trends than can be gained by examining differences between two individual years. Having been relatively stable through 2015/2017, the moving average number of deaths increased before plateauing over 2020/2021, followed by a small decrease in 2022 (Figure 1).

Overall, the number of deaths in 2022 appears as a return to pre-pandemic levels. Moreover, the number of deaths in 2022 represents a 6% increase on 2013 and an 11% increase on 2016.

Figure 1: Number of drug poisoning deaths, and three-year moving averages, NDRDI 2013–2022

Table 1: Number of drug poisoning deaths by sex, NDRDI 2013–2022*

*Data presented in this bulletin supersede all previously published NDRDI data

Figure 2: Three-year moving average age-standardised mortality rates (ASMRs) for drug poisoning deaths, by sex, NDRDI 2013–2022

Mortality rates

Age-standardised mortality rates (ASMRs) were calculated to enable rates to be compared by year while accounting for differences in population age and structure. The ASMR for drug poisoning deaths in 2022 was 6.7 deaths per 100,000 standard population, compared with 6.9 in 2013, and 6.8 in 2017. Moving average ASMRs increased after 2014/2016, and stabilised over 2020/2021, before decreasing slightly in 2022 (Figure 2). Overall, mortality rates in 2022 also appear to reflect a return to the pre-pandemic trends, rather than a downward shift that will continue.

Characteristics of the deceased

Males were in the majority, accounting for 68% (232) of drug poisoning deaths in 2022 and at least three in five deaths in every year (Table 1). In 2022, the median age was 45 years for males and 46 years for females.

Poisoning drugs implicated

In 2022, opioids (65%), benzodiazepines (48%), cocaine (34%), and antidepressants (27%) were the most common types of drugs implicated in poisoning deaths. Methadone (street/prescribed) (36%) was the most common individual drug, while the main illicit drugs were cocaine (34%) and heroin (27%). Most (81%) deaths had prescribable drugs implicated, such as diazepam (29%), alprazolam (28%), and pregabalin (18%). In most (78%) poisoning deaths, more than one drug was implicated.

The NDRDI recorded decreases in opioids, benzodiazepines, cocaine, and gabapentinoids/antiepileptics between 2020 and 2022. Nevertheless, each of these drug types was implicated in more deaths in 2022 than in 2013. The largest 10-year increase was for cocaine (a 259% increase), followed by gabapentinoids/antiepileptics (a 250% increase), mainly due to pregabalin. Methadone increased 31% over the 10-year period, while heroin decreased 11%.

Circumstances of deaths

Two in five (43%) poisonings occurred in Dublin; most (70%) poisonings occurred in a private dwelling; and many (47%) people were alone at the time.

In 2022, almost eight in ten (78%) of the deceased had experienced substance misuse or dependency; two in five (41%) had received substance use treatment; and three in ten (31%) were in treatment (mainly opioid agonist treatment, 27%) at the time of death.

In 2022, almost one in four (23%, 80) of the deceased were known to have ever injected drugs, similar to the 2013 findings (24%). Of those, two in five (40%, 32) were injecting at the time of death (a decrease from 60% in 2013). In 2022, one-half (50%) of those injecting at the time of death were alone at the time.

Alcohol-related poisonings

The NDRDI recorded 155 alcohol-related poisoning deaths in 2022, of which 67 involved alcohol-only and 65 involved alcohol in combination with one or more other drugs.2 The number of alcohol-only deaths remained fairly stable over the period, while alcohol in combination decreased by 22% between 2013 and 2022.

Conclusion

Despite recent decreases in the number of drug poisoning deaths in Ireland, there has been an upward trend in the number of deaths from 2013. However, drug poisoning deaths are preventable deaths. The NDRDI will continue to monitor trends and provide data to inform policy and other measures to reduce drug deaths and other harms of drug use.

1    Kelleher C, Riordan F and Gopalakrishnan A (2025) Drug poisoning deaths in Ireland in 2022: Data from the National Drug-Related Deaths Index. HRB StatLink Series 28. Available from
https://www.drugsandalcohol.ie/44591. Additional online E-appendices are available at: https://www.drugsandalcohol.ie/44591

2    Data on alcohol-only poisoning deaths and data on all alcohol-related poisoning deaths are presented in the online E-Appendices available from: https://www.hrb.ie/wp-content/uploads/2025/12/Tables-Drug-poisoning-deaths-2022.pdf or https://www.drugsandalcohol.ie/44591