Overdose deaths: recent increases

Drug use is a recognised cause of avoidable mortality among European adults. Studies on cohorts of high-risk drug users commonly show total mortality rates in the range of 1–2 % per year. Overall, opioid users in Europe are 5 to 10 times more likely to die than their peers of the same age and gender. Increased mortality among opioid users is primarily related to overdose, but other causes of death indirectly related to drug use, such as infections, accidents, violence and suicide, are also important. Ill-health, marked by accumulated and interlinked conditions is common. Chronic pulmonary and liver conditions as well as cardio-vascular problems are frequent and account for an increased share of deaths among the older and chronic drug users.

In Europe, drug overdose continues to be the main cause of death among high-risk drug users, and over three quarters of overdose victims are male (78 %). Overdose data, especially the European cumulative total, must be interpreted with caution. Among the reasons for this are systematic under-reporting in some countries and registration processes that result in reporting delays. Annual estimates therefore represent a provisional minimum value.

It is estimated that at least 7 585 overdose deaths, involving at least one illicit drug, occurred in the European Union in 2015. This rises to an estimated 8 441 deaths if Norway and Turkey are included, representing a 6 % increase from the revised 2014 figure of 7 950, and increases have been reported in almost all age bands. As in previous years, the United Kingdom (31 %) and Germany (15 %) together account for around half of the European total. This relates partly to the size of the at-risk populations in these countries, but also to the under-reporting in some other countries.

Focusing on countries with relatively robust reporting systems, revised data for 2014 confirm an increase in the number of overdose deaths in Spain, while increases in the number of overdose deaths reported in 2014 in Lithuania and the United Kingdom have continued into 2015, and increases are also now reported in Germany and the Netherlands. A continued upward trend is also observed in Sweden, though it may be partly due to the combined effects of changes in investigation, coding and reporting practices. Turkey is continuing to report increases, but this appears to be largely driven by improvements in data collection and reporting.

Number of drug-induced deaths reported in Europe in 2014 and 2015, by age band

Reflecting the ageing nature of Europe’s opioid-using population, who are at greatest risk of drug overdose death, the reported number of overdose deaths increased among older age groups between 2007 and 2015, while those among younger age groups decreased. However, 10 % of the overdose cases are younger than 25 years, and there has recently been a slight increase in the number of overdose deaths reported among those aged under 25 in several countries including Sweden and Turkey.