Opioid‐related deaths and their counterpart by occurrence era, age group and coimplicated drugs: Scotland vs. England and Wales.

Aims: Compare by occurrence era and age group how opioid‐related deaths (ORDs) and their counterpart evolved in Scotland vs. England and Wales during 2006–2020. For Scotland, compare coimplication rates between ORDs and non‐ORDs for any benzodiazepine, cocaine or gabapentin/pregabalin, and consider whether coimplication in ORDs depended on opioid‐specificity. Methods: Cross‐tabulations of drug misuse deaths (DMDs) obtained by 3 yearly occurrence era (2006–2008 to 2018–2020) and age group (under 25, 25–34, 35–44, 45–54, 55+ years) for England and Wales and subdivided by whether at least 1 opiate was mentioned on death certificate (DMD‐Os or not); and of Scotland's opioid‐related deaths (ORDs vs. non‐ORDs) together with (i) coimplication by any benzodiazepine, cocaine or gabapentin/pregabalin; and (ii) opioid‐specificity of ORDs. ORD is defined by heroin/morphine, methadone or buprenorphine being implicated in DMD. Results: Per era between 2012–2014 and 2018–2020, Scotland's ORDs increased by 54% and non‐ORDs by 34%. Increase in DMD‐Os in England and Wales was more modest. Cocaine was implicated in 83% of Scotland's 2690 non‐ORDs during 2006–2020; and any benzodiazepine in 53% of 8409 ORDs. However, in 2018–2020, coimplication rates in 2926 ORDs (880 non‐ORDs) were 81% (33%) for any benzodiazepine, 30% (74%) for cocaine and 38% (22%) for gabapentin/pregabalin. Coimplication rate in 2018–2020 for any benzodiazepine was lowest at 70% (616/877) for heroin/morphine ORDs; and, by age group, at 66% (160/241) for ORDs aged 55+ years. Conclusions: Drug testing to inform users, shared intelligence between police and public health for earlier detection of changes in supply and monitoring of prescribed daily‐dose of methadone are urgent. [ABSTRACT FROM AUTHOR]