Exclusive:Scotland drug deaths crisis: ‘Hundreds of deaths’ missing from official drug statistics, investigation reveals

Scotland’s drug death crisis could be much worse than initially feared, as an investigation by The Scotsman has revealed hundreds of deaths are being excluded from official statistics.

Hundreds of ‘inconclusive’ drug deaths could be going unrecorded in Scotland every year, according to campaigners, as enquires made for this investigation confirmed Scotland’s data gathering excludes ‘secondary’ deaths caused by drug abuse.

In contrast to England and Wales, Scotland’s drug deaths data – which focuses on ‘drugs misuse’ - excludes secondary infections, such as bacterial or viral infections, resulting from the injection of contaminated drugs. This would exclude deaths caused by clostridium, hepatitis and HIV/AIDs where drug use led to infection.

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Scotland also excludes conditions “which could be regarded as later complications of drug use”, meaning deaths caused by the long-term consequences of drug abuse – such as heart or liver failure – are not recorded as drug deaths.

Scotland's drug-deaths rate is far higher than the rest of the UK and Europe (Picture: Christopher Furlong/Getty Images)Scotland's drug-deaths rate is far higher than the rest of the UK and Europe (Picture: Christopher Furlong/Getty Images)
Scotland's drug-deaths rate is far higher than the rest of the UK and Europe (Picture: Christopher Furlong/Getty Images)

This includes “bronchopneumonia, lobar pneumonia, bilateral pneumonia, septicaemia or organ failure where drug misuse was not specified as the direct and immediate cause of death”.

The investigation has not uncovered any direct data to challenge findings published earlier this week that drug-related deaths did still fall significantly last year, with NRS figures showing an official drop by 20 per cent from 2021 to 2022. While the number of excluded drug deaths increased last year, the overall number of recorded drug deaths still appears to have decreased.

The NRS also recorded 214 ‘unknown’ deaths in 2022, although this figure has remained somewhat constant over the past few years.

Between 2011 and 2021, the National Records of Scotland (NRS) excluded an annual average of 24.4 ‘secondary’ drug deaths from the official statistics. Last year, when figures saw a 20 per cent drop in drug deaths, NRS excluded 43 – nearly double the annual average.

A man leaves a cross for his brother as part of a remembrance event for victims of drug deaths in Scotland (Picture: John Devlin)A man leaves a cross for his brother as part of a remembrance event for victims of drug deaths in Scotland (Picture: John Devlin)
A man leaves a cross for his brother as part of a remembrance event for victims of drug deaths in Scotland (Picture: John Devlin)

It also excluded 23 deaths from hepatitis-C and HIV/AIDs associated with drug use. According to the UK’s Office for National Statistics, England and Wales’s drug death figures - which focus on ‘drug poisoning deaths’, including all ‘drugs misuse’ deaths - would likely include all of these deaths, where a coroner has judged they were associated with the cause of death.

Poisoning deaths by controlled drugs – either prescribed or illegal – are also excluded from Scotland’s figures where the NRS has judged it to not be related to drug misuse. There were 92 exclusions of this type last year. A spokesperson for the NRS told The Scotsman the policy around which figures were excluded had been in place “since the series began”.

Furthermore, campaigners have warned hundreds of drug deaths are being treated as ‘inconclusive’.

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Annemarie Ward, the director of Glasgow-based charity Faces & Voices of Recovery UK, said her organisation had seen “an uptick” in deaths recorded as ‘inconclusive’ – despite family members and support workers knowing the death was drug-related.

“We see lots of deaths from infections, contaminated drugs and the complications caused by drug abuse,” she said.

“I couldn’t even guesstimate what those numbers are. The problem is they’re not collecting the data, or if they are, there’s no way to access it.

“We’ve seen an uptick in the number of deaths being recorded as ‘inconclusive’, but the families involved know fine well they are drug deaths.

“These people have been suffering with drug addiction for a long time, and all of a sudden the data is inconclusive.

“There’s probably at least 50 per cent of these deaths not being recorded. That’s based on my personal experience. I went to five funerals last year. In that year, four of those deaths were recorded as inconclusive, but the families know they were drug deaths.

“Especially with the trend towards poly drug use, there’s no way these deaths are being recorded accurately.

“I do think there’s some jiggery and pokery going on. Why wouldn’t there be? It would be foolish and naive to sense that there wasn’t. It’s such a high, political-points-scoring issue.”

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The latest figures released by the NRS show 1,051 people died due to drug misuse in 2022 – a decrease of 279 deaths (21 per cent) compared with 2021 and the lowest annual total since 2017.

Scotland now has a drug deaths rate of 248 deaths per million people. Comparatively, the latest estimates for the island of Great Britain as whole, from 2018, is 84.4 deaths per million, meaning Scotland’s drug death rate is almost three times higher.

The number of drug deaths in the EU per million was 18 – 13 times lower than Scotland’s rate.

To make matters worse, the number of annual drug deaths in Scotland is roughly twice what it was in 2013, when it stood at 527. The SNP has been in power since 2011.

A spokesperson for the NRS said: “A small proportion of the deaths are not counted as drug misuse deaths due to the exclusions specified in [the methodology].

“Some of these cases would lead to a death being counted under the wider definition of a drug poisoning death, but not under the headline definition of a drug misuse death.

“Others would not be counted as either drug misuse or drug poisoning and would be included elsewhere in our death statistics under another cause.

“The definitions of drug misuse deaths and drug poisoning deaths used by NRS are based on definitions defined by the Advisory Council on the Misuse of Drugs (ACMD) cross UK working group in 2000. More information on methodology used is available in our blog.

“This policy has been in place since the series began.

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“NRS has an advisor at Public Health Scotland who makes the decision on which deaths to include and exclude. The advisor is a consultant in public health and an expert in substance misuse.”

The Scottish Government declined to comment, directing The Scotsman towards NRS as the appropriate agency.

Scottish Conservative shadow health secretary Dr Sandesh Gulhane said Scotland’s drug death crisis was “truly heart-breaking”, and “behind the figures lie tales of personal and family tragedy”.

“The official tally of 1,051 fatalities last year is horrific enough, yet it appears it actually underestimates the true number of people who have died due to drugs,” he said.

“If we are finally to get on top of this national emergency, we need to know the full extent of the crisis we’re dealing with.”

Drug policy minister Elena Whitham had earlier this week welcomed the fall in deaths recorded last year, but stressed: “My sympathy goes out to all those affected by the loss of a loved one through drugs.

“While I am pleased to see that hundreds of families have been spared this agony and lives have been saved, every life lost is a tragedy and the number of deaths is still too high.”

The Scottish Government has been pressing for a safe consumption facility to be set up and has also called for wider decriminalisation of drug use, with efforts having so far been blocked by Westminster.



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