In 2021, there were 322 deaths related to drug poisoning in Wales compared to 224 the year before. While it is expected that COVID-19 led to fewer fatalities in 2020, this is still a particularly high number compared to previous years. Swansea and Cardiff were the most affected areas with forty-eight and thirty-seven deaths respectively. Drug addiction treatment and alcohol detox centres across the UK are also registering higher admission rates during the post-pandemic period.
Opiates are still involved in the highest number of drug poisoning deaths across England and Wales, with about 46% of drug poisoning deaths in 2021 involving opiates. There is a relatively stable number of long-term heroin users. With an ageing population of heroin users, we can expect more opiate-related deaths and illnesses as people develop more severe health needs. However, while opiate-related deaths have increased by 22 from 127 to 149 over the last ten years, cocaine deaths have increased by a factor of more than ten from 4 to 47. Of all drugs, cocaine has the most pronounced and rapid rise in death rates.
Cocaine is consistently the second most used drug in England and Wales after cannabis and in the last five years, the number of people taking it has increased sharply. This seems to be particularly the case for powder cocaine and is driven by white men under thirty years old. Around 77% of cocaine related deaths across England and Wales in 2021 were men. An increase in crack cocaine also seems to relate to a new population of younger crack cocaine users.
Most people who take powder cocaine are occasional users; however, there is a risk that this causes problems in the future. Powder cocaine use is a risk factor for crack cocaine use and is a dangerous drug with the potential for causing drug poisoning.
What is Causing the Increase in Drug-Related Deaths?
As mentioned, cocaine use has been the second-most consumed drug across the UK for a long time, so why are we seeing such an increase in deaths now? Part of this will be due to the sharp increase in people using; even people overdose on cocaine proportionally less than on heroin. The more people who use, the more chance there is of overdose.
Another reason is related to the production of cocaine. From 2013, there was a boom in worldwide production of cocaine. This meant that there was more competition among UK supplies which drove up the quality of product so that crack and powdered cocaine have seen an increase in purity. In terms of the drugs being mixed with other potentially dangerous chemicals, this is, of course, a good thing. However, if people are used to less potent cocaine, they may take their usual dose with a more potent cocaine, making overdose more likely.
Symptoms of Overdose
Knowing the symptoms of an overdose could help to save lives. The quicker you can get medical attention to someone, the more likely it is that they will survive. Symptoms will depend on whether they have taken a depressant such as an opioid or a stimulant such as cocaine. If you see someone experiencing these symptoms, call 999 immediately.
Symptoms of a Heroin Overdose
- Bluish fingertips and lips
- Pale skin
- Shallow breathing
Symptoms of a Cocaine Overdose
- High blood pressure
- Extreme anxiety or agitation
- Trouble breathing
- High temperature and sweating.
How do We Stop the Increase in Drug-Related Deaths?
Drug deaths continue to increase across Wales. The patterns of who takes drugs and what they take has tended to stay the same over the years. Generation X, those born between the late sixties and early seventies, have consistently had the highest rates of drug misuse deaths for the last twenty-five years. We can expect this age group to face continuing problems as those who are long-term users begin to struggle with more severe consequences of drug use.
The sharp increase in cocaine-related deaths over the last decade has been unprecedented and is extremely worrying. It is partly driven by an increase in powder cocaine use, which can cause overdose. It is a risk factor for crack cocaine use which is a more potent and addictive drug leading to more severe long-term physical and mental health problems. Only 3% of powder cocaine users report to get treatment. Increasing purity of both powder and crack cocaine is also thought to be a factor in increasing cocaine-related deaths.
To deal with the worrying increases in drug-related deaths, we need to make drug treatment more easily available and reduce the stigma about drug use which creates a barrier for many to seek treatment. It is also important to deal with the root causes for drug abuse. The demand for drugs and deaths from misuse is closely associated with poverty and deprivation. This should worry us for the coming year as one third of households in the UK are projected to face fuel poverty this winter. One in three people sentenced for supplying crack and one in four people sentenced for supplying heroin are under twenty-one. Children who display vulnerabilities such as poverty, family breakdown, and exclusion from school are targeted predominantly to ‘run’ drugs and money. To address drug deaths and the dangers of the drug production line, we must address poverty.
Substance use disorders are also more likely in those who have experienced childhood abuse, people with a family history of drug use and, potentially related, people who were exposed to drugs in their environment. Many of these issues can be dealt with better availability and access to mental health services.
Finally, countries such as Portugal have seen success through the decriminalisation of drugs. When possession of drugs is decriminalised, this opens the door for drug testing sites, supervised injection sites, and decreased stigma. More people are likely to seek treatment for drug use if they do not fear persecution. Dealing with drug deaths requires a multifaceted approach.