The Scottish Government

« Previous | Contents | Next »

Listen

Chapter 2: Profile of the study population

What is in this chapter? This section of the report describes the demographic profile of the study population. It also presents trends in drug related deaths in Scotland during 1996-2003.

Where did the information come from? Demographic data on drug-related deaths in 2003 and trends in characteristics of drug deaths during 1996-2003 were sourced from the GROS database. Deprivation categories were available from NHS returns to ISD on 218 of the 317 cases of drug-related death. There were 317 drug related deaths in Scotland in 2003 registered by the General Register Office for Scotland ( GROS).

Cause of death

Cause of death by ICD-10 drug-related death category and gender for the sample are set out in Table 2.1. Definitions of drug-related deaths based on ICD-10 criteria are provided in Appendix 1.

Table 2.1: Drug related deaths by ICD-10 category and gender (n=317)

Source: GROS (2004)

The majority (68%) of cases were considered to have died as a result of 'drug abuse', i.e. 'mental and behavioural disorders due to psychoactive substance use' ( ICD-10) or (more commonly known as) fatal drug overdose. Suicides comprised 13% of the total number of deaths.

Demographics

The demographic characteristics of the population are set out in Table 2.2. The majority of cases were male (81%). Mean age of the group was 32.7 years, range 16 to 82 years). Over one third of the group (39%) was aged between 25 and 34 years.

Table 2.2: Demographic characteristics of cases of drug related death in Scotland in 2003 (n=317)

Day of death

Table 2.3 shows the distribution of drug deaths by day of death. One third (35%) died on a weekend day.

Table 2.3: Drug related deaths by day of week (n=317)

Social deprivation

The Carstairs index (Carstairs and Morris 1991) for social deprivation classifies postcode areas on a scale of one to seven with 1 being the most affluent areas of the country and 7 being those most socially deprived. Deprivation categories (depcats) of cases of drug related death (n=218; excludes cases with unknown depcat scores) were compared with those for the general population (in parentheses) in Scotland (Table 2.4).

Table 2.4: Percentage of drug-related deaths (n=218 ¹) and of general population, Scotland by deprivation category

¹ Excludes 99 (31%) cases of drug related death whose depcat scores were unknown
²One death of unknown depcat therefore excluded from this analysis

For most health board areas, distribution of drug deaths by depcat score broadly reflected the general population's distribution. Of note Greater Glasgow was the only area to have more than half its total percentage of drug deaths in the most deprived category (category 7) - this finding reflected the high proportion of the local general population in the same category. Nationally, there was a lower proportion of drug related deaths in the most affluent regions (categories 1 and 2) compared with the general population (6.5% vs. 20%) and a higher proportion of cases (42% vs. 18%) in the most deprived regions (categories 6 and 7). However, it must be noted that in 31% of drug related deaths, deprivation category was unknown.

Trends in and characteristics of drug-related deaths in Scotland, 1996-2003

The majority of the 2,331 drug-related deaths recorded in Scotland during 1996-2003 were aged 15-54 years (96%: 2,240/2,331). Restricting to this age group, drug-related deaths in Scotland increased from 234 in 1996 to 301 in 2003. Three out of four deaths involved either heroin/morphine (1,209; 54%) or methadone (620; 28%). Figure 2.1 shows the trends in heroin/morphine, methadone and other drug-related deaths in Scotland during 1996-2003. Deaths involving heroin/morphine increased two-fold from 82 in 1996 to 164 in 2003 (representing a 13.8% yearly increase), whereas those involving methadone reduced from 99 in 1996 to 55 in 1999 and 86 in 2003 (representing a 0.4% yearly decrease). Other drug-related deaths ( i.e. those without heroin/morphine or methadone detected) remained relatively stable, with a 3% yearly increase, during 1996-2003.

Tables A2.1 - A2.3 ( Appendix 2) show the characteristics of and the annual change in (a) all drug-related, (b) heroin/morphine-related and (c) methadone-related deaths among persons aged 15-54 years in Scotland during 1996-2003. The majority (79%) of all drug-related deaths were considered to have died from either drug abuse or accidental poisoning, 9% from intentional self-poisoning and 12% were undetermined as to accidental or intentional. A significantly higher proportion of methadone (55%) compared to heroin/morphine (45%) related deaths occurred at the weekend, defined as Friday, Saturday or Sunday; although, the number of deaths at the weekend involving methadone have decreased during 1996-2003 by 3.5% per year. The annual number of drug-related deaths increased at a significantly higher rate among persons aged 35-54 years compared to those aged 15-24 years (16.0% vs 0.3% yearly increase, respectively).

The annual increase in all drug-related deaths was higher in health-board areas (except for Lothian and Tayside) outwith Glasgow. In Lothian and Tayside, approximately half of drug-related deaths involved methadone, although these deaths reduced by 11.2% and 19.3% per year, respectively, during 1996-2003 (Table A2c). The annual increase in heroin/morphine-related deaths was significantly higher in other health-board areas (except Lothian) compared to Glasgow; the percentage of heroin/morphine-related deaths in Glasgow reduced from 70% in 1996 to 37% in 2003. A substantial proportion (57%) of drug-related deaths involved benzodiazepines and 38% involved alcohol. The number of drug-related deaths involving cocaine, although only representing 5% of the total, increased from 3 in 1996 to 28 in 2003.

Figure 2.5: Trends in heroin/morphine, methadone and other drug -related deaths among persons aged 15-54 years in Scotland, 1996-2003

Key points

• Most Scottish drug related deaths in 2003 were male, and in their early 30s (mean age of 32.7 years).
• The majority (68%) of drug related deaths in Scotland were accidental fatal overdoses. Suicides comprised 13% of the total.
• Trends in drug related deaths in Scotland from 1996 to 2003 were complex and showed a great deal of heterogeneity over time in relation to geographical distribution and the involvement of heroin/morphine or methadone.
• Drug-related deaths involving heroin/morphine had increased at a significantly higher rate than those involving methadone in Scotland during 1996-2003 (13.8% vs -0.4% per year, respectively). In Glasgow however, deaths involving methadone increased at a higher rate (average 9.7% per year) than deaths involving heroin (which increased at an average 6.5% per year).
• Drug-related deaths involving heroin/morphine had increased at a significantly higher rate out-with the main urban centres of Glasgow and Lothian during 1996-2003. Overall, there were twice as many deaths involving heroin/morphine as methadone. However, the ratio of heroin/morphine : methadone overdose deaths varied considerably between geographical areas:- for example, from 117 : 26 in Lanarkshire to 21 : 70 in Tayside and 59 : 175 in Lothian.
• A higher proportion of methadone compared to heroin/morphine -related deaths in Scotland occurred at the weekend (defined as Friday to Sunday). Drug-related deaths in Scotland, including those involving either heroin/morphine or methadone, have increased at a significantly higher rate among those aged 35-54 compared to 15-24 years during 1996-2003.

« Previous | Contents | Next »