Drug-related deaths in Wales continue to be a significant public health issue. According to a report by DB Recovery Resources, opioids remain the leading factor in these fatalities. This article delves into the statistics and findings related to opioid-related drug deaths in Wales, with a focus on the role of take-home naloxone (THN), demographic factors, and regional variations.

Take-home Naloxone (THN) Usage

THN has been a critical tool in preventing fatal opioid overdoses:

• Events: Since July 2013, THN has been used in 3,675 opioid drug poisoning events.
• Success Rate: These interventions resulted in fatal opioid poisoning in only 1.3% (46 events).
• Recent Data: In the past year, THN was used in 303 drug poisoning events, with only 2 reported deaths (1%).
• Care Consistency: The frequency of follow-on care, including ambulance attendance and hospitalisations, remains broadly consistent with recent years.

Distribution and Provision of THN

The distribution of THN has seen an increase:

• Supply Increase: The number of supply events, new individuals supplied, and kits provided have all increased compared to the previous year.
• Regional Variation: There is notable regional variation in the provision and coverage of THN to those at risk.
• Demographics: Among new individuals receiving THN, around half were listed as family, partners, carers, or professionals working with at-risk populations.
• Service Access: 33% of people injecting opioids and regularly accessing NSP services only attend Pharmacy-based NSP services, where THN provision remains limited.

Drug Deaths in Wales

The Office for National Statistics provides a detailed account of drug-related deaths in Wales:

• 2022 Data: In 2022, there were 318 registered deaths due to drug poisoning.
• Drug Misuse Deaths: Of these, 205 were classified as drug misuse deaths, slightly down from 210 in 2021.
• Substances: Opioids were involved in 125 deaths (61%), with heroin/morphine accounting for 51% of these. Other substances included cocaine, methadone, pregabalin, etizolam, and diazepam. Poly-drug use was reported in 61% (126) of drug misuse deaths.
• Demographics: The male-to-female death ratio was around 3:1. Most deaths occurred in individuals over 50, accounting for 25% of all drug deaths. Thirteen drug deaths were reported in individuals under 25.

Geographic and Socioeconomic Variation

There remains considerable geographic and socioeconomic variation in drug misuse deaths:

• Geographic Variation: Age-standardised rates of drug misuse deaths varied across Wales, ranging from 3.2 to 13.9 deaths per 100,000 population.
• Socioeconomic Disparity: Drug misuse deaths were over five times higher among those living in the 20% most deprived areas compared to the 20% least deprived areas.

Fatal and Non-Fatal Drug Poisoning Reviews

The Harm Reduction Database provides insights into fatal and non-fatal drug poisoning reviews:

• Review Process: Since 2014, a total of 1,174 fatal and 1,095 non-fatal drug poisoning reviews have been conducted in Wales.
• 2022 Reviews: In 2022, 216 fatal drug poisoning cases were reviewed, representing 105.4% of the deaths recorded by ONS.
• Incident Locations: 62% of incidents occurred within a private residence, 18% in a hostel facility or public place, and 47% of the deceased were reported as living in non-secure housing or having no fixed abode at the time of death.
• Service Contact: In 48% of reviewed cases, there was ‘no known contact’ between the deceased and any local services (health, social care, or criminal justice) in the 12 months prior to death. Where contact was reported, 75% had a history of illness or diagnosed psychiatric disorder.

Source: DB Recovery Resources