Drug deaths among opioid users more than trebled in past decade, research finds

Drug-related deaths among Scots who were dependent on opioids more than trebled between 2011 and 2020, according to new research.

In a large-scale study involving almost 50,000 people over a decade, researchers at Glasgow Caledonian University determined drug-related deaths for those not receiving treatment were three-and-a-half times higher than those in treatment.

Although those in treatment had a lower death rate, the death rate for those receiving opioid agonist therapy (OAT) has increased in the past 10 years.

OAT is when people with an opioid dependency are prescribed a substitute, such as methadone.

Death rates increased across all age groups, bolstering the evidence that the rise in drug-related deaths (DRD) in Scotland is not due to addicts getting older.

The researchers have called for increased opioid agonist treatment – but warned treatment alone will not solve Scotland’s overdose epidemic.

The study is the largest of its kind ever conducted in Scotland, with the 50,000 people making up the majority of people who use drugs in Scotland.

It is understood by researchers that heroin remains the most widely-used opioid in Scotland.

The study has also been recognised as one of the largest conducted internationally.

Dr Andrew McAulay (pictured), a principal investigator on the study, said: “This was one of the largest studies of its kind ever conducted, covering a period where Scotland’s DRD rates had reached globally high levels and been labelled a ‘public health emergency’.

“We found that DRD rates among people prescribed OAT in Scotland more than trebled between 2011 and 2020 and are among the highest ever recorded.

“Our results confirmed the protective effect of OAT, with DRD rates almost three-and-a-half times higher among those who were not in treatment.”

Dr McAulay, who is also a reader in public health for Glasgow Caledonian University’s ReaCH, added: “However, unlike in many other countries, we found that DRD risk for people on OAT also increased over time, highlighting that OAT on its own is not enough to address Scotland’s DRD epidemic and other interventions, such as take-home naloxone, drug consumption rooms and drug checking services, are necessary.

“Addressing the socioeconomic inequalities which are driving drug dependence should also be prioritised.

“Finally, we found that DRD rates increased over time across all age-groups, supporting evidence that the increase in DRDs in Scotland is not mainly due to an ageing cohort.”

The study was conducted by experts from Glasgow Caledonian University, Public Health Scotland, the University of Bristol, Scottish Drugs Forum, and Glasgow Alcohol and Drug Recovery Services.

Study co-author Professor Matthew Hickman, a professor in public health and epidemiology at the University of Bristol, said: “This study is a very important contributor to the global evidence on the prevention of drug-related deaths.

“Compared to other countries and global reviews, Scotland is both at the upper end of community levels of drug-related mortality and the protective effect of drug treatment in reducing mortality risk.

“A critical next step is to estimate how many lives have been saved by current interventions in Scotland to inform public and policy debate on what other interventions are required to reverse trends in drug-related deaths.”

The research paper, entitled “Mortality among individuals prescribed opioid-agonist therapy in Scotland, 2011-2020: a national retrospective cohort study”, has been published in The Lancet Public Health.

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