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In relation to the whole range of problems which can happen to those who use drugs, death is by far the least likely outcome, but one which, not surprisingly, attracts most attention and causes most concern. Like all data about illegal drug use, information about deaths comes from a variety of sources that combine to present a patchy and incomplete picture. Hence this is a highly simplified overview of what we know about deaths from drug use and how these compare to deaths caused by alcohol and tobacco.
VII.I Drugs, alcohol and tobacco
The claim is often made in defence of drug use that far fewer people die from it than drinking or smoking. This is hardly surprising given that there are many more users of alcohol and tobacco and that the effects often result from a lifetime of use. What is more significant is the percentage of deaths in relation to the estimated total population of users. Below are calculations mainly based on heaviest use within the three categories on the assumption that these people are most at risk of dying.
Opiate deaths
In 1999, around 754 people died through opiate use. If we use a rough estimate of 250,000 opiate users in the UK as the base, we have a percentage of 0.003 per cent bearing in mind that not all those notified will be in the high risk category for overdose, i.e., those who inject.
Tobacco deaths
From information supplied by ASH, mortality from smoking is around 110,000 people per annum out of an estimated total adult smoking population (16 plus) of 12 million. It is not possible to sift out the heavy and upward category from the available ONS status and in any case, no safe level for smoking has been established hence all smokers are included. This gives a percentage rate of 0.9 per cent.
Alcohol deaths
Estimates for alcohol deaths vary widely from 5000 - 40,000 per annum. ONS figures for England and Wales cite only 3679 deaths from \"alcohol-related causes\" (excluding road traffic accidents which would add another 500 fatalities). But using a methodology for calculating excess mortality as applied to cigarette smoking, one study has calculated the figure at 28,000 while the highest by the Royal College of General Practitioners estimates the figure at 40,000 (1986). For consumption, ONS estimates a total drinking population in Great Britain from \"fairly high\" to \"very high\" as around 8.4 million. Thus the mortality percentage even at the highest calculation of 40,000 would be 0.5 per cent.
Ecstasy
As a final comparison the percentage rate for ecstasy would be about 0.00005 per cent on the basis of:
. 32 ecstasy-related in 1999 for Scotland, England and Wales;
. a rough estimate of 600,000 regular users (based on 2 per cent of the population having use in the last year in the 2000 British Crime Survey).
However these figures are calculated, it is clear that related to the user-base, deaths associated with ecstasy are rare.
VII.II England and Wales
The following represents the ONS (office of national statistics) data of the total number of deaths from drug use involving the following drugs in England and Wales from 1995 to 1999 (excluding suicides and undetermined poisonings), which vary as indicated. The figures are based on the International Classification of Diseases, 9th revision (ICD 9). No differentiation is made as to whether the underlying cause of death was drug dependence, accidental poisoning/overdose, related to the drug use or whether one or more drug was implicated - resulting possibly in some double counting.
Drug-related deaths in England and Wales 1995 to 1999
Cocaine
227
Amphetamine 213
Ecstasy 78
Opiates 4,743
Alcohol 200,000 - 400,000.
Tobacco
one million plus
Source: ONS, Deaths related to drug poisoning: England and Wales, 1995-1999. Health Statistic Quarterly, Spring 2001
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