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Opioids, the leading factor in drug-related deaths in Wales.

Published: 11 July 2024

Latest figures from Public Health Wales show that opioids contributed to more deaths in Wales in 2022-23, than any other substance. There were 125 opioid deaths, 64 involving heroin or morphine and the remaining 61 deaths involved at least one other opioid such as methadone, codeine or tramadol.

However, more people than ever before are carrying naloxone, a life-saving drug that can reverse the effects of opioid poisoning. Naloxone was used in 303 overdose events in Wales last year, helping to prevent many deaths. The number of people carrying naloxone has increased year on year since it was first introduced in 2009. In the year 2022-23, over 6 thousand take home naloxone kits were provided.

Opioids represent the most common substance group recorded in drug misuse deaths in Wales. In 2022, 61 per cent of deaths involved an opioid (n = 125). Of the 125 opioid deaths, 64 involved heroin/morphine. The remaining 61 deaths involved at least one other opioid such as methadone, codeine or tramadol.

The number of deaths in which cocaine was a contributing factor rose again for another year running. In 2022, the presence of cocaine was recorded in 52 deaths, representing 26 per cent of all drug misuse deaths, the third highest after opioids and Benzodiazepines (30 per cent of drug deaths).

There has been a large increase in the number of deaths involving cocaine over the last three years. There has also been an increase in reported cocaine related hospitalisations and more individuals presenting for treatment within substance misuse services.

There have also been more deaths where cocaine was the only substance listed and a decrease in the number of deaths where cocaine was used in combination with other substances. Common substances listed alongside cocaine are heroin/morphine and other opioids. Drug deaths as a result of multiple substances (poly drug use) remained high at 126 deaths.

Most drug misuse deaths occurred in those in the over 50-year age group, making up 25 per cent of all drug deaths (n = 45) in 2022. There were 13 drug deaths in people under the age of 25.

Since 2003, Wales has maintained a higher rate of drug misuse deaths than England, with the exception of three years (2004, 2014 and 2020). In Wales in 2022 there were 71 drug deaths per million population. Rates in England in 2022 were 53 per million population. Rates of drug misuse deaths have increased in both countries over the past two decades.

Drug misuse deaths were over 5 times higher amongst those living in the 20 per cent most deprived areas compared with the 20 per cent least deprived areas in Wales.
The local authority with the highest rates in 2022 were Swansea (14.3 deaths per 100,000 population) and Neath Port Talbot (13.3 deaths per 100,000 population) (see Figure 37). The lowest rates were observed in Monmouthshire (2.3 deaths per 100,000 population), Flintshire (2.8 deaths per 100,000 population) and Carmarthenshire (3.1 deaths per 100,000 population).

Rick Lines, Head of the Substance Misuse Programme, for Public Health Wales said:

“The number of deaths from drug-related causes remains unacceptably high in Wales. These deaths are tragic and preventable and take a toll on families and communities across the country. It is however encouraging to see that more opioid drug deaths are being prevented by the use of Naloxone and that this vital life-saving medication is being carried by more people in Wales than ever before. Naloxone can be ordered for free in Wales by calling Dan 24/7 or by visiting their website.”