Are Deaths Due to Drug Use Among Young Men Underestimated in Official Statistics?

Abstract

Abstract We explored the impact of drug misuse on sudden, unexpected, violent or unnatural male deaths, checking the association between official mortality statistics, health records, and coroner evidence and verdicts. We searched health and coroner records for all Merseyside and Cheshire coroner cases for men aged 15–39 in 1995, comparing our data with government mortality statistics. We explored the relationship between accidental/undetermined and suicide verdicts, and post-mortem drug and alcohol toxicity. Our survey included 238 cases; 221 had toxicological data and formed our final sample. There was post-mortem evidence of drugs in 90 cases, alcohol in 102, and both in 46. Overdose verdicts were given for 74 cases. We found evidence of significant alcohol problems in 18 cases and drug misuse in 74. The presence of drugs at post-mortem was significantly related to a verdict of accident/undetermined rather than suicide (p = 0.03). Post-mortem Class A drug toxicity was significantly related to accidental/undetermined verdicts compared to Class B/C drugs. There was no significant relationship between the number of drugs found and the verdict. While coroners determined drugs to be related to death in 90 cases, official classifications would have recorded this figure as 60 (ONS standard) or 40 (EMCDDA—European Union recommended classification). Our findings support the recommendations of the recent ACMD report into the reduction of drug-related deaths [1].