1. Drug-related deaths and treatment We hold an extract of data from the ONS drug poisoning database which contains all drug poisonings registered between 1993 and 2010, with the following information: Date of death Demographic information, plus local authority of residence Underlying cause of death Substances cited on death certificate or in coroners report (up to seven) Whether the death was defined as being related to drug misuse We are hoping to get a revised extract which indicates where alcohol has been mentioned in relation to drug poisonings, and is also more up-to-date 1Drug-related deaths and treatment

2. Available ONS data ONS published data indicates that drug misuse deaths in England and Wales increased through the 1990s and have fluctuated since (and they currently appear to be declining) 2Drug-related deaths and treatment

3. Available ONS data However, there is a more complex situation when broken down by individual substances. Heroin and cocaine deaths appear to be declining, but methadone and benzodiazepine deaths have increased in recent years 3Drug-related deaths and treatment

4. Available ONS data ONS give information on whether substances were cited alone or in conjunction with other substances. Trends indicate increased citation of multiple substances. For deaths registered in 2011: Our extract will enable us to look at the detail of these combinations 4Drug-related deaths and treatment

5. Plans for future analyses We are in the process of matching the ONS extract to NDTMS to answer several key questions: Is treatment protective against drug poisonings? If so, does this protective effect change with time / between different sub-populations / between different treatment pathways? Research has suggested an increased risk of drug poisoning early on in treatment and immediately after leaving treatment What variables at triage seem to indicate increased relative risk of drug poisoning, with a view to early intervention where an individual is at increased risk Will be particular focus on poly- substance abuse and whether particular combinations indicate increased risk – again with a view to clinical utility 5Drug-related deaths and treatment