Almost 90% of drug overdose deaths in Ireland in 2021 involved at least one prescribable drug, while the number of deaths involving cocaine continues to rise at the same time, according to a new report from the Health Research Board (HRB).
The report, Drug Poisoning Deaths in Ireland in 2021, also found that eight in 10 overdose deaths in 2021 involved ‘polysubstance use’, meaning that more than one drug was implicated.
There were 354 drug poisoning deaths in Ireland in 2021, which represented a decrease of almost one-fifth (19.4%) on the 439 drug deaths noted a year earlier in 2020.
Opioids (68.9%) were the most implicated drug group when it came to overdose deaths, followed by benzodiazepines (52.8%) and antidepressants (35%).
Almost nine in 10 deaths (88%) involved at least one prescription drug, with four of the six top drugs involved in deaths coming under that category.
Those drugs were methadone (36.4%), diazepam (31.6%), alprazolam/Xanax (30.2%) and pregabalin (23.4%). The top six drugs were rounded out by cocaine (30.2%) and alcohol (25.7%).
Heroin was involved in 79 drug poisoning deaths in 2021, which along with cocaine, was more likely to be found in male deaths.
The research found that the number of deaths involving cocaine tripled between 2012 and 2021, from 26 to 107 deaths – an increase of 311.5%.
The median age of the deceased was 42.5 years (41 years for males and 47 years for females).
At least one in two (51.1%) of the deceased were not in employment, but most (76.8%) were living in stable accommodation. Just over one in 10 (15.3%) of the deceased were homeless at the time of their death.
The majority (79.9%, 283) of the deceased had a history of substance misuse or dependency, while at least 48% were experiencing mental health issues at the time of their death.
The largest proportion (28.5%) were residing in the HSE Dublin and North East health region, followed by HSE Dublin and Midlands (23.4%), and HSE Dublin and South East (19.2%).
The report notes that while the sex distribution of deaths has fluctuated over the 2012-2021 period, males continue to constitute the majority of drug overdose deaths, accounting for at least six in 10 of those deaths for every year since 2012. There were 3,379 overdose deaths recorded by the National Drug-Related Deaths Index (NDRDI) over the course of the last decade.
In 2012, the number of drug poisoning deaths was 273.
Opioid deaths increased from 182 to 244 (34.1%) over the decade, while benzodiazepine-implicated deaths from 129 to 187 (45%), mainly attributable to an almost fivefold (494.4%) increase in alprazolam (Xanax), from 18 to 107 deaths.
Meanwhile, antidepressants increased by 55%, from 80 to 124 deaths, driven by mirtazapine (from 21 to 48 deaths) and sertraline (from fewer than 5 deaths to 27 deaths).
In 2012, seven in 10 drug overdose deaths were polysubstance poisonings compared to eight in 10 in 2021.