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Sign in or register for an accountDrug-related deaths in England and Wales have reached record levels, with 5,448 drug poisoning deaths recorded in 2023 - equating to 93 deaths per million population. This figure has more than doubled since 2012 and represents the highest number since records began in 1993. Drug poisoning deaths, a subset of drug-related deaths caused specifically by the toxic effects of drugs, disproportionately affect men (127.6 per million) compared to women (59.8 per million), with the highest rates among people aged 40 to 49 years.
Opiates are involved in nearly half (46.8%) of drug poisoning deaths; however, research suggests that this proportion could be higher still. This highlights the importance of naloxone, a drug that can temporarily reverse opioid overdose, distribution to prevent overdose fatalities. Cocaine-related poisoning deaths have increased by 30.5% from 2022 to 2023, the largest increase among substances. In the North West region, drug poisoning death rates (12.8 per 100,000) and in Salford (10.8 per 100,000) remain above the England average (8.5 per 100,000), although Salford’s rates have recently declined slightly.
Focusing on preventing drug-related and drug poisoning deaths is critical because they not only cause significant loss of life but also reflect wider social, health, and economic harms. These deaths often affect people in their most productive years, placing a heavy burden on families, communities, and health and social care services. Drug related deaths are considered avoidable deaths and effective prevention and treatment can reduce mortality, improve quality of life, and help address inequalities linked to deprivation and social exclusion. National initiatives such as expanding access to naloxone, improving drug treatment services, and tackling the causes of drug misuse are essential to reverse these trends and protect vulnerable populations.
The most recent data (2021–23) for deaths from drug misuse shows that Salford has a rate of 8.9 deaths per 100,000 population, which is significantly higher than the England average of 5.0 per 100,000. This continues a long-term trend where Salford’s rate has remained consistently above the national average since the mid-2000s. The rate has more than doubled since the early 2000s (from 4.1 in 2001–03), peaking at 9.8 in 2020–22. Despite a slight drop in the most recent period, Salford still ranks as an area of concern, indicating a continued need for focused interventions and targeted public health strategies.
According to most recent data, amongst its statistical neighbours, Salford ranks ninth out of 16, placing it in the mid-range. It performs better than cities like Liverpool and Middlesbrough (both 13.1), but worse than areas such as Sheffield (8.8), Derby (7.5), and Reading (6.6). Salford’s rate remains above the statistical neighbour average and is considerably higher than similar areas within London including Enfield (3.0) and Greenwich (3.1). This comparison highlights the need for Salford to continue addressing the underlying drivers of this elevated rate.
Deaths from drug misuse have increased over time with Salford having a higher rate than England for most of the last 20 years
[Download the drug misuse death chart data (cvs format, 2kb)]
Drug-related deaths in Salford show a clear gender disparity consistent with national trends. Males in Salford experience a higher rate of drug poisoning deaths, with a rate of 14.8 per 100,000 population, placing the city 48th highest out of 150 upper tier local authorities in England with sufficient numbers of deaths to calculate a rate. This indicates that Salford ranks in the upper third for male drug death rates, reflecting a significant local impact within the broader national pattern where male rates are generally higher. For females, Salford’s drug-related death rate is 5.7 per 100,000, ranking 72nd highest out of 141 local authorities with a calculated rate. Overall, Salford’s drug-related mortality rates for both genders fit the wider England and Wales trends, demonstrating a higher burden among men but a noticeable impact across both populations.
Nationally, individuals living in the most deprived areas of England (deprivation quintile 1) experience significantly higher rates of drug poisoning deaths than those in less deprived areas. Between 2021 and 2023, the mortality rate for males in the most deprived quintile was 347.3 per 100,000, compared to 213.6 in quintile 2 and just 47 per 100,000 in the least deprived quintile (quintile 5). A similar pattern was observed among females, highlighting a persistent and stark link between deprivation and drug-related mortality. Whilst the causal chain is difficult to determine, these inequalities are likely driven by a range of interrelated factors, including socioeconomic stress, housing instability, unemployment, barriers to healthcare and treatment access, and higher prevalence of co-occurring mental ill-health in more deprived communities.
Nationally, there have also been notable shifts in the age profile of drug-related deaths. For males, the average age at death has increased by 9 years since 1993, reaching 44.5 in 2023. The rise in drug-related deaths reflects an ageing cohort—those who began using heroin and other drugs in the late 1990s and early 2000s—now experiencing the cumulative harms of long-term use. This group has faced persistent risks, which may include polydrug use (e.g. opioids with benzodiazepines or alcohol), declining mental and physical health, and limited or inconsistent engagement with treatment. While a shift toward harm reduction has helped reduce overdose deaths among younger men, as a consequence, it has resulted in longer drug use over time for many, leading to more complex health conditions. Despite earlier treatment expansions, many in this cohort lacked holistic, sustained support, and services have not kept pace with their changing needs. Now in their 40s and 50s, they present with complex health and social issues, contributing to rising mortality in this age group.
In contrast, the average age at death for females has decreased slightly — by 2.6 years since 1993 — and now stands at 47.5. Despite this decline, women still tend to die at an older age than men, possibly due to lower engagement in high-risk behaviours, differences in substance use patterns, and higher likelihood of accessing support. However, the decreasing age at death may signal increasing harms among younger women, linked to trauma, mental health challenges, and changing drug use patterns. These trends underscore the importance of trauma-informed, gender-sensitive approaches to drug treatment, as well as a continued focus on the wider social determinants of health. Local services must be equipped to support both ageing drug-using populations and emerging patterns of risk in younger cohorts, particularly in deprived communities.
Unfortunately, small areas data for Salford —particularly information disaggregated beyond gender at the local authority level—is not currently publicly available. However, national evidence shows that deaths of despair - encompassing drug-related deaths, alcohol misuse, and suicide - are significantly more prevalent in the North of England, particularly in areas marked by socioeconomic deprivation, low educational attainment, and limited access to mental health and addiction services. These structural risk factors are known to elevate premature mortality and are strongly associated with long-term public health inequalities.
In Salford, several wards exhibit risk factors that closely align with the national profile for increased vulnerability to deaths of despair; this includes risk factors such as deprivation, for example, almost half the population in Salford live in the 20% most deprived areas in England, as well as, the fact that 16 out 20 wards have at least one LSOA that is ranked in the 10% most deprived areas in England. This means that pockets of deprivation exist even within relatively less deprived areas. As such, vulnerability to deaths of despair is likely to be unevenly distributed across the city, with certain wards facing compounded disadvantage compared to others.
To effectively inform targeted interventions and local strategies, further analysis at the ward and sub-ward levels is crucial. Whilst, some socio-demographic data is available from the Drug and Alcohol Related Deaths Panel, convened by Liverpool John Moores University, this information is primarily used for internal panel reviews and is considered highly sensitive. As such, it is not included in this summary. However, more detailed insights for areas surrounding Liverpool (not including Salford) can be found through the panel’s publicly available reports.
Despite efforts, drug-related deaths continue to be a major public health issue. Statutory agencies including local and central government, health, and criminal justice need to continue to work together with communities to reduce drug use and prevent drug-related deaths. It is also important for individuals and families affected by drug use to seek appropriate support and treatment. Continued government investment into drug treatment services is of paramount importance to help reduce drug use and prevent drug-related deaths. Ensuring people are receiving the right treatment at the right time and recognising that one person’s treatment needs and journey is completely unique.
In 2017, the government launched its Drug Strategy, From harm to hope: A 10-year drugs plan to cut crime and save lives - GOV.UK. This strategy aims to reduce the harm caused by drugs to individuals, families, and communities, by focussing on four key areas: reducing demand for drugs, restricting supply, building recovery, and tackling drug-related crime.
Harm reduction approaches recognise that while some individuals may not be ready to stop or reduce their drug taking entirely, they can still benefit from strategies to minimise harm. The use of naloxone, a drug that can temporarily reverse opioid overdose, is now more widely available.
Using drugs while alone is a leading risk for overdose death. Messaging from harm reduction and public health sectors should focus on encouraging people who use drugs never to use drugs alone. This can be done through effective communication strategies that address the risks associated with using alone and promotion of safety measures. Moreover, in other parts of the world and most recently in Scotland there are drug consumption rooms being rolled out. The first one is in the UK was opened in Glasgow in January 2025. It is difficult to ascertain how successful this has been due to the relatively brief time since the intervention was launched, the small number of people it serves, and the first evaluation will not be available for over two years.
However, Salford Royal Hospital has specialist alcohol and drug nurses offering advice within an A&E setting and on the wards. They provide person-centred, evidence-based, holistic care which is appropriate to the individual. This includes initiating inpatient detoxification when required and linking patients with other services or agencies when it is needed.