"DRUG-RELATED DEATHS": DEFINITION

Further to the debate on what does or does not count as a "drug-related death", Peter O'Loughlin gives the authoritative definition, as below.

In 2000, the advisory Council on the Misuse of Drugs (ACMD) published a report, Reducing Drug Related Deaths (1) that fed into the 10-year strategy. In addition to several recommendations about the prevention of drug misuse deaths, the ACMD recommended that a better system for the surveillance of drug misuse deaths was needed.

In response to this recommendation, a technical working group was set up consisting of experts across government, the devolved administrations, coroners, toxicologists and drug agencies. The working group reviewed the system for collecting data on drug related deaths and proposed an indicator for the surveillance of deaths related to drug misuse.

“The definition of the indicator is, deaths where the underlying cause is poisoning, drug abuse or dependence and any of the substances controlled under the Misuse of Drug Act (1971) are involved”.

The definition was accepted by the DoH (2) and still stands today.

In view of the foregoing, I reject the subsequent NTA claim that my questions posted on this site are rhetorical - the NTA has both a duty and obligation to respond to them.

REFERENCES:

1.  Advisory Committee on the Misuse of Drugs (2000) Reducing Drug Related Deaths. The Stationery Office:  London.

2. Department of Health (2001) The Government Response to the Advisory Council on the Misuse of Drugs Report into Drug Related Deaths, The Stationery Office London 

Comments

[Drugs Epidemiologist]

It is worth pointing out that at present there are at least four different definitions of 'acute' or 'direct' drug-related deaths used within the UK for both national and international purposes.

For a definitive exploration of how drug-related deaths can be defined, please see Corkery (2008).

Corkery, J. (2008). ‘UK drug-related mortality – issues in definition and classification.’ Drugs and Alcohol Today. June, 8(2):17-25.

[Kevin Molloy]

Does this not rather demonstrate that your earlier point was misconstrued. ie the "drug poisoning" figures you referred to in your earlier article would,presumeably, include substances such as papacetomol, which is not included in the phrase "AND any of the substances controlled under the misuse of drugs act" in the definition you quote above.

It is the word "and" which is key. Had it said "or" your point may have been correct, but as it is I cannot see how I can agree with you.

[Peter O'Loughlin]

In their posting dated 28th February, the NTA included the following statement.

“What Peter has taken issue with is the claim that “drug-related deaths have gone down in recent years. That claim is based on the drug-related deaths figures for England cited by the ONS in its report, Deaths Related to Drug Poisoning in England and Wales, 2003-7, published in Health Statistics Quarterly 39”.

I have taken issue with the claim that “drug related deaths have gone down in recent years” because it is a false claim, as the table taken from the Health Statistics Quarterly 39 (HSQ 39) and reproduced below proves.

Number of deaths related to drug misuse:
2003 1,432
2004 1,495
2005 1,608
2006 1,573
2007 1,604.

Apart from the fact that these are identical to the figures provided by the NTA in their initial response to my article, it is self evident that with the exception of 2006 that the only drop in “deaths related to drug misuse”, occurred in 2005. With the exception of that year, 'drug related deaths' - even within that very narrow area, and on which the NTA base their false claim - have been increasing, not reducing.

The official UK definition of drug related deaths is “deaths where the underlying cause is poisoning, drug abuse or drug dependence and where any of the substances controlled under the Misuse of Drugs Act (1971) are involved”.

The only difference between abuse and misuse is one of semantics, as reference to the criteria of the former in DSM 1V, and the latter in ICD-10, are virtually identical.

The UK definition makes it abundantly clear that any death where any controlled substances is involved, is a ‘drug related death’. It is therefore apparent that the NTA claim is false not only on the figures they selected in their attempt to justify it, but also within the UK definition that they actually referred to, in their response, but wrongly attributed to the ONS.

Whilst judging from their last response it would seem the NTA are now eager to draw a veil over their claim, they have some explaining to do. It is also apparent that what they chose in that response to describe as ‘rhetorical questions’ are anything but rhetorical.

[Peter O'Loughlin]

Thank you for your contribution Kevin.

The answer to your question is No. The figures I quoted are confined to heroine, morphine, methadone,cocaine, ecstasy, cannabis, and GHB.

It is not me who has misconstrued.