Drug-related deaths in England and Wales have reached a record high, driven primarily by opiates, figures show.
There were 4,859 deaths related to drug poisoning registered in 2021 – a rate of 84.4 deaths per million people, the Office for National Statistics (ONS) said.
This is the ninth consecutive annual rise, up 6.2% from the previous year, and the highest number since records began more than a quarter of a century ago in 1993.
The ONS said the overall rising trend over the past decade has been driven primarily by deaths involving opiates, but also those involving other substances such as cocaine.
In the last year there have been “significant” rises from 2020 in deaths involving cocaine, methadone and new psychoactive substances.
The ONS said possible explanations for the rise could be that there is an ageing cohort of drug users experiencing the effects of long-term use and becoming more susceptible to a fatal overdose.
New trends involving taking specific drugs, such as benzodiazepines, alongside heroin and morphine may increase the overdose risk.
The figures cover drug abuse and dependence, fatal accidents, suicides and complications involving controlled and non-controlled drugs, prescription and over-the-counter medications.
Around half of the deaths registered in 2021 will have occurred in previous years due to death registration delays.
The figures show the rates of drug-related deaths have risen 81.1% since 2012, when there were 46.6 deaths per million people.
Of the deaths registered last year, 3,809 were due to accidental poisoning, while there were 927 instances of intentional self-poisoning.
There were 119 deaths arising from mental and behavioural disorders as a result of drug use, and four deaths following assault by drugs, medicaments and biological substances.
Almost two-thirds (3,060) of the deaths were related to drug misuse, and just under half (2,219) involved an opiate.
Some 840 deaths involved cocaine – up 8.1% from 2020 and more than seven times the number recorded a decade ago (112 deaths in 2011).
There were 663 deaths involving methadone registered in 2021, a 28.5% rise from the previous year (516 deaths).
A total of 258 deaths involving new psychoactive substances were registered, up 88.3% from the previous year (137 deaths).
People in the North East were more than three times more likely to die due to drugs misuse than people in the East (104.1 deaths per million versus 27.4 deaths per million).
And they were more than three times more likely to die from drug poisoning than people in London (163.4 deaths per million versus 47.6 deaths per million).
Rates of drug misuse deaths continue to be high among Generation X, who were born between the late 1960s and early 1980s.
Mike Trace, chief executive of the Forward Trust, said the rise in drug-related deaths comes amid people mixing substances, known as “poly drug use”.
He told the PA news agency: “I think the pandemic has made things worse. Most deaths are what we call deaths of despair – people who are lonely, they’re using drugs in situations where they don’t have support or other people to protect them. And that was definitely worse during the pandemic.
“So I think that does have an effect, and that’s what we have to bear down on. We need to provide much better support and inclusion to people who are living very isolated, marginalised lives.”
Mr Trace also hit out at the “tough language” of condemnation from politicians and other public figures about clamping down on people who use drugs.
He said: “That message is absolutely the opposite of what we should be saying to people who are struggling with drug addiction.
“We should be saying that society cares about you. Society offers help. And, you know, if you reach out for that help, then you can turn your life around and make things better.”
The charity Turning Point called for the Government to continue to invest in “life-saving” health, housing and social care services.
Dr David Bremner, group medical director and a consultant psychiatrist in addictions at the charity, told PA: “We need to ensure that the funding results in a reversal of these death rates at a pace that we would find acceptable if this was any other cause of death.
“If these were cancer deaths increasing at this rate, we would expect action at a certain pace that I believe we should expect the same for persons with addiction.”
The Local Government Association (LGA) said the annual rise is “very concerning”.
Councillor David Fothergill, chairman of the LGA’s community wellbeing board, said: “Many drug overdose deaths are preventable. Ensuring robust practices are in place, along with the policies or protocols to support those at the greatest risk, can prevent overdoses and subsequent fatalities.
“As well as this, we must support and expand the provision of naloxone, a drug that can reverse the effects of an opiate overdose, and provide overdose training for drug service users, drug users not in treatment, family and friends, hostel residents and others.”
A Government spokesman said: “Our landmark drug strategy will help rebuild drug treatment and recovery services to better support people through recovery, as well as tackling the criminal supply chains which fuel illegal drug markets.
“This will help to prevent nearly 1,000 deaths, deliver over 54,500 new treatment places – a 19% increase on current numbers – and support 24,000 more people into recovery from substance dependency.
“This funding is additional to the annual public health grant spend and builds on the £80 million put into treatment services in 2021 which worked to decrease drug-related deaths by helping services distribute more naloxone, which can help reverse opiate overdoses.”