Government Buildings Tel: 020 7592 8613 Cardiff Road E-mail: [email protected] Newport NP10 8XG www.statisticsauthority.gov.uk Professor Sir Ian Diamond | National Statistician Grahame Morris MP House of Commons London SW1A 0AA 13 November 2020 Dear Mr Morris, As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Question asking what proportion of drug-related deaths registered in 2019 involved combinations of cocaine with (a) opiates, (b) fentanyl and (c) other synthetic opiates (114142). The Office for National Statistics (ONS) produces an annual report on deaths related to drug poisoning in England and Wales, which includes figures for deaths involving cocaine. The most recent figures available are for deaths registered in 20191. ONS mortality statistics are compiled from information supplied when deaths are certified and registered as part of civil registration. Drug poisonings deaths involve a broad spectrum of substances, including controlled and non-controlled drugs, prescription type drugs and over-the- counter medications. It is important to be aware that over half of all drug poisoning deaths involve more than one drug and/or alcohol, and it is not possible in those cases to tell which substance was primarily responsible for the death. The ONS does not have access to post-mortem reports or toxicology results, so the accuracy of figures on deaths related to drug poisoning depends on the information provided by the coroner on the death certificate. Table 1 shows the number of deaths where the underlying cause was drug poisoning and cocaine was mentioned anywhere on the death certificate. Figures are for deaths registered in England and Wales in 2019. Percentages has been calculated where cocaine was mentioned in combination with opiates, fentanyl and other synthetic opiates. Yours sincerely, Professor Sir Ian Diamond 1https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrel atedtodrugpoisoninginenglandandwales/2019registrations Table 1: Number of deaths and percentage of drug-related poisonings where cocaine was mentioned anywhere on the death certificate and in combination with opiates, fentanyl and other synthetic opiates, England and Wales, registered in 201912345 Mentioned on the death certificate Number of deaths Percentage (%) Drug poisoning involving cocaine 708 a) …in combination with opiates 410 57.9 b) …in combination with fentanyl 10 1.4 c) …in combination with other synthetic opiates 0 0.0 Source: ONS 1Cause of death was defined using the International Classification of Diseases, Tenth Revision (ICD-10). The underlying cause of death codes used to select drug poisoning deaths are shown below in Box 1. International Classification of Diseases, Tenth Revision (ICD-10) codes used to define deaths related to drug poisoning Description ICD-10 Codes Mental and behavioural disorders due to drug use (excluding alcohol and F11–F16, F18–F19 tobacco) Accidental poisoning by drugs, medicaments and biological substances X40–X44 Intentional self-poisoning by drugs, medicaments and biological substances X60–X64 Assault by drugs, medicaments and biological substances X85 Poisoning by drugs, medicaments and biological substances, undetermined Y10–Y14 intent 2Figures for England and Wales combined include deaths of non-residents. 3Figures are for deaths registered in 2019, rather than deaths occurring. Due to the length of time it takes to complete a coroner’s inquest, it can take months or even years for a drug-related death to be registered. More details can be found in the 'deaths related to drug poisoning' statistical bulletin: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrela tedtodrugpoisoninginenglandandwales/2019registrations 4Figures for opiates exclude opiates contained in a paracetamol compound, i.e. co-codamol, co-dydramol and co-proxamol. The figures also include synthetic opiates such as fentanyl; as such the percentages in this table should not be summed. 5In this table ‘other synthetic opiates’ includes only fentanyl analogues such as Acetylfentanyl, Alfentanil, Carfentanyl, Furanylfentanyl, Parafluorofentanyl, Remifentanil, Cyclopropylfentanyl, Methoxyacetylfentanyl, Ocfentanil, Benzylfentanyl. .