Drug-related mortality is a complex phenomenon, which accounts for a considerable percentage of deaths among young people in many European countries. The EMCDDA, in collaboration with national experts, has defined an epidemiological indicator with two components at present: deaths directly caused by illegal drugs (drug-induced deaths) and mortality rates among problem drug users.
These two components can fulfil several public health and methodological objectives, notably as an indicator of the overall health impact of drug use and the components of this impact, identify particularly risky patterns of use, and potentially identify new risks.
The appropriate implementation of the component on deaths directly caused by drugs requires the existence of quality information sources: general mortality registries and/or special mortality registries. An EMCDDA protocol establishes common criteria and procedures to extract and report cases from existing registries. Estimation of mortality rates among drug users requires follow-up studies, for which a working protocol has been developed. The quality of key indicator information depends on the quality of its sources, and will increase with improvement of post-mortem investigations and with full use of this information for death certification and coding.
Considerable progress has been obtained in this indicator over the last 12 years, and in many European Union (EU) countries both General and Special Mortality Registries exist, and cohort studies have been or are being conducted. However, considerable work still has to be done in some countries to improve quality and completeness of drug-related mortality information. This improvement has to be seen in general in the context of improvement of the quality of information on external causes of death and youth mortality.