Drug deaths at highest level since records began – and experts say it's going to get worse

Drug related deaths in England and Wales have increased for the 13th year in a row, with 5,448 people losing their lives. But experts warn we are still only seeing the start of the UK’s synthetic opioids crisis, and that drug users are being abandoned by the state.

Almost half of the deaths from drug poisoning involved opioids, while cocaine deaths increased by 30.5% year-on-year – up to 1,118 fatalities and an increase of 10 times since 2011.

The 5,448 figure is the highest since records began in 1993 and represents an 11% increase on 2022.

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However, there are warnings the statistics are just the “tip of the iceberg” when it comes to deaths from nitazenes and synthetic opioids. Almost two-thirds of the deaths included in the figures from the Office for National Statistics (ONS) happened before 2023, owing to delays in coroners’ courts.

“A lot of the deaths related to nitazenes and other synthetic opioids are yet to hit the system”, said Dr Steve Brinksman, medical director of the drugs charity Cranstoun, adding that widespread testing for nitazenes only began towards the end of 2023. “People might use these stats and say it’s not that bad a problem. But actually there’s a massive lag.

“Next year, it’s going to be worse, and we need to be doing something about it now. We need to be getting people into treatment.”

Drug deaths in England and Wales, by numbers:

• 93.0 deaths per million people – up from 84.4 per million in 2022
• The rate of drug deaths in England and Wales has risen every year since 2012
• Those aged 40-49 the likeliest to die from drug misuse
• North East had the highest regional rate of deaths, while London had the lowest

Big Issue has been investigating the impact of nitazenes – a powerful synthetic opioid hundreds of times more potent than heroin, which has been linked to 284 deaths in the UK.

Paramedics’ use of naloxone, a life-saving drug used to reverse opioid overdoses, increased by 50% since January 2023, according to data obtained by Big Issue. 

As the crisis mounts, little is known about the scale of the deaths – or about those who have died. In Birmingham, 21 deaths happened in the space of three months, all among people who had taken the same type of nitazene.

“We’ve got a slight handbrake on at the moment. As the supply of heroin coming through the Afghan-produced areas goes, I expect synthetics to surge,” Brinksman said. “We’ve got a small window of opportunity.”

The increase in deaths led to calls for the government to change its approach to drugs, with Niamh Eastwood, executive director of Release, saying it was time for the government to decriminalise drug possession and increase the number of drug consumption rooms and checking facilities.

“This public health crisis is turning into a health catastrophe. Across England and Wales, those using drugs have been intentionally abandoned by the state. A growing number of adulterants within the drug supply have meant that drug supplies are more toxic than ever; more and more people are unknowingly exposed to new and dangerous substances, with limited access to resources to stay safe,” said Eastwood.

“This government has a chance to save lives through policy reforms if it acts with urgency now.”

The rise in cocaine deaths came off the back of a massive increase in the drug’s availability, Brinksman added.

“Lots of people now wouldn’t dream of going to the pub on a Friday or Saturday night without having a bit of coke,” Brinksman said. “The use has gone up massively so the deaths have gone up.”

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