Table DRD-0 provides bibliographic references and sources according to National definitions on which in all other tables and figures are based on.
Tables DRD-1 to DRD-4 summarize all the information regarding drug-related deaths, regarding all the different definitions (national and EMCDDA standards).s
Table DRD-5 part (i) and Table DRD-5 part (ii) provides data on the impact of drug-related deaths in the general population (Population mortality rates and proportional mortality due to drug-related deaths)
Figure DRD-1 gives information on the proportion of acute drug-related deaths that show presence of opiates.
Drug-related death is a complex concept that may include different types of deaths. In the EMCDDA Annual Report and standard protocol on drug deaths, drug -related deaths refer to those caused directly by the consumption of one of more drugs, happening shortly after the drug use. These deaths are also known as 'acute drug deaths', 'overdoses' or 'poisonings'.
Between 1990 and 2003, between 6 500 to over 9 000 acute drug deaths were reported each year by EU countries, adding up to more than 113 000 deaths during this period, this being possibly an underestimation (see Table DRD-2 part (i)).
Overdoses are one of the main causes of mortality among young adults in the EU countries. In the United Kingdom was estimated that drug deaths are the main component of the harm related to illicit drug use.
Population mortality rates due to acute drug-related deaths varied widely between European countries, ranging from 0,2 to over 50 deaths per million inhabitants (average of 13) (see Table DRD-5 part (i)). Acute drug-related deaths account for 3 % of all deaths among Europeans aged 15 to 39 years in 2003 to 2004, and for more than 7 % in Denmark, Estonia, Luxembourg, Malta, Austria, United Kingdom and Norway (see Table DRD-5 part (ii)).
Opiates are present in most cases of ‘drug-related deaths’ due to illegal substances reported in the EU, although in many cases other substances are also present (see Figure DRD-1).
The majority of overdose victims are men. Most victims are in their twenties or thirties, with a mean age in the mid thirties (range between 20 and 44 years) (see Figure DRD-10).
Since 2000, many EU countries have reported decreases in the numbers of drug-related deaths, although figures are still high from a longer term perspective. However, among countries reporting data in 2004 (19), there was an overall increase of 3 %, with increases reported in 13 out of the 19 reporting countries (inferences for the whole EU should be made with caution).
Drug-related deaths among people younger than 25 years have been decreasing almost steadily since 1996 in the old Member States, indicating a possible decrease in the number of young injectors in those countries. In several new Member States there is a high proportion of overdose cases younger than 25 years, which may represent a younger heroin-using population in these countries, which could be due to a shorter history of the epidemic of heroin use in these countries (see Table DRD-2 part (iv)).
Opiate users (mainly those who inject) have an overall mortality that is up to 20 times higher that the general population of the same age due to overdoses, but also violence, diseases (AIDS and others), etc.
Several countries reported the presence of methadone in a substantial proportion of drug-related deaths but it is difficult to assess what was the role of methadone in the death. Deaths due to buprenorphine poisoning seem rare.
For the time being, deaths involving ecstasy remain relatively unusual compared with opiate deaths, but in some countries they are not negligible and monitoring of these deaths needs improvement. Reporting of ecstasy deaths is not harmonised, and sometimes the exact role that ecstasy played in the fatal outcome is not clear. In Europe as a whole, there were references to 78 deaths which should be considered as a minimum estimate.
Despite the limitations of the information, in the countries that explicitly reported data on cocaine deaths, this substance seemed to have played a determinant role in 0 to 20 % of the cases. A very rough overall estimation for the whole EU would be 10 %, which could account for several hundreds of deaths per year in Europe. In the 2005 national reports, over 400 deaths related to cocaine were identified by countries that reported this information. This is probably an underestimation, as identification of these deaths could have difficulties, In addition cocaine may be a contributor to deaths due to cardiovascular problems.