Harm reduction database Wales: Drug related mortality (Annual report 2025)

Executive summary

Key findings and trends

Take-home Naloxone (THN) – HRD

• Since July 2013 THN has reportedly been used during 4,199 opioid drug poisoning events, each one a potential drug death – a fatal opioid poisoning was reported in only 1.3 per cent (n=53) events where THN was used
• In 2024, THN was reportedly used in 307 drug poisoning events, a 5.5 per cent increase on the previous year, with <5 deaths reported. The frequency of follow-on care, including ambulance attendance and hospitalisations, increased slightly
• The number of supply events and new individuals supplied have increased compared to 2023. The total number of THN kits provided in 2024 increased by 22.3 per cent, to 8,229 THN kits
• Regional variation remains in the provision and coverage of THN to those at risk of experiencing or witnessing an opioid drug poisoning event, with higher rates of kit provision observed in Powys and Swansea Bay
• Among new individuals supplied with THN in 2024, over half (53.9 per cent) were listed as family / partner / carers or professionals working with people at risk of opioid poisoning
• Amongst people who inject drugs and regularly access NSP services, 36.0 per cent only attend Pharmacy-based NSP services, where THN provision remains limited
• While THN provision in the community continued to increase in 2024, supply on release within prison settings has fluctuated substantially since 2014 when the programme began, making it difficult to identify consistent trends

Drug deaths in Wales – ONS

• In 2024, 417 deaths due to drug poisoning were registered in Wales, a 10.6 per cent increase from the previous year (n=377). Of these, 288 (69.0 per cent) were classified as drug misuse deaths. Drug deaths in 2024 are the highest ever recorded in Wales
• For the last decade, drug misuse deaths have been over five times higher among those living in the 20 per cent most deprived areas compared to the 20 per cent least deprived areas in Wales
• In 2024, the ratio of drug misuse deaths was 2.6:1 male to female, due to an increase in the proportion of female drug misuse deaths
• Most deaths occurred in those in the over 50 age group making up 34.4 per cent of all drug misuse deaths (n = 99) in 2024.
• There were 17 drug misuse deaths in people under the age of 25, accounting for 5.9 per cent of drug misuse deaths in 2024, an increase from 2023
• As in previous years, the most commonly reported substance group was opioids, reported in 200 deaths (69.4 per cent), of which 55.0 per cent involved heroin/morphine. Other substances commonly reported were cocaine, pregabalin, bromazolam, methadone, and diazepam.
• Poly-drug use was reported in 62.2 per cent (n=179) of drug misuse deaths.
• There remains considerable geographic variation in the age-standardised rates of drug misuse deaths across Wales, with local authority rates ranging from 2.8 to 21.2 deaths per 100,000 population

Fatal / non-fatal drug poisoning reviews – HRD

• Since implementation of the rapid review process on drug deaths in 2014, a total of 1,680 fatal and 1,637 non-fatal drug poisoning reviews have been conducted in Wales.
• 211 fatal drug poisoning cases were reviewed in 2024, representing 73.3 per cent of those deaths recorded by ONS
• In 85.7 per cent of cases with a known location of death, the drug poisoning incident occurred within a private residence, with the remaining 14.3 per cent of incidents occurring within a hostel facility or public place.
• 42.3 per cent of individuals were reported as living in non-secure housing or having no fixed abode (NFA) at the time of death. Where reported, 88.6 per cent (n=124) of deaths were pronounced at scene
• In 42.2 per cent of cases reviewed, no known contact was reported between the deceased and any local services health, social care, or criminal justice services in the 12 months prior to death (n=89). Of these, 60.7 per cent (n=54) were not known to any services. Very little information is available for these individuals
• Where any service contact was reported within 12 months prior to death, 95.1 per cent (n=116) had a history of mental illness or diagnosed psychiatric disorder
• Coroner’s findings were reported for 33.2 per cent of fatal cases reviewed in 2024, of which 92.9 per cent were confirmed to be related to drugs