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Wales' drug deaths a complex picture

Published: 19 October 2022

A complex and evolving pattern of drug use and availability is resulting in increased drug deaths in Wales, with two thirds of deaths in 2021 involving a combination of drugs, including alcohol and prescription medicines.  

A detailed analysis of drug trends and harm reduction interventions has been published by Public Health Wales. The annual report looks to deep dive into the drug related deaths across Wales and the UK reported by the Office of National Statistics every summer, which showed a record increase this year.

Rick Lines, Head of Substance Misuse at Public Health Wales said:

“Drug related mortality, specifically deaths related to use of illicit drugs including opiates and cocaine, as well as prescription medicines accessed through non-medical routes present real challenges to preventing deaths.

“Over the last five years, deaths involving cocaine have more than doubled.  Also concerning is the increase in deaths involving benzodiazepines, a class of sedative type drugs including diazepam (commonly known as “Valium”) either prescribed or obtained illicitly, which have also more than doubled in the last few years.

 “Premature deaths from drug use are preventable. Each drug related death has a considerable and long lasting impact upon the individual’s family, peers and communities. Whilst the impact of drug deaths are experienced by the whole socio-economic spectrum, they are more than five times more likely to occur in those living in the most deprived areas in Wales compared to the least deprived. 

“Wales operates a number of effective initiatives aimed at preventing or reducing drug deaths, including the national Take Home Naloxone programme and access to specialist substance misuse treatment. In the last year, Naloxone was used in 288 overdose events, with only 3 deaths reported.

“However, in light of the scale of drug deaths in Wales, evidence on the impact and influence of different level policies and practices, and their role as barriers or facilitators to reducing drug deaths, is required to inform change.”

Other key findings include:

  • As in previous years, the most commonly reported substance group was opioids, reported in 150 deaths (71 per cent), of which 93 per cent involved heroin/morphine. 
  • Other substances reported were diazepam, cocaine and methadone. Poly-drug use was reported in 62 per cent (n=131) of drug misuse deaths. 
  • In 2021, the ratio of deaths amongst males and females was around 3:1. Drug misuse deaths amongst females was the highest recorded in 2021, with 57 deaths. 
  • Most deaths occurred in those in the 40-44 year age group reported in 18 per cent of all drug deaths (n = 38) in 2021. 
  • There were 13 drug deaths in people under the age of 25. 
  • There remains considerable geographic variation in the age-standardised rates of drug misuse deaths across Wales, with rates ranging from 1.4 to 13.5 deaths per 100,000 population 
  • 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

Harm Reduction Database Wales: Drug related mortality, Annual Report 2021-22 takes a deep dive into ONS data and data from the Harm Reduction database Wales (HRD) fatal and non-fatal drug poisoning reviews. The HRD is designed to support health, social care, criminal justice and related service providers, planners, commissioners and policy makers to reduce drug related deaths in Wales.

Public Health Wales produces reports and information to influence national and international policy to ensure it is based on the best evidence to protect and improve health.

Those seeking to receive support for drug or alcohol related concerns can contact the Wales Drug and Alcohol Helpline on Freephone 0808 808 2234, by texting DAN to: 81066 or by visiting