Why is NRS excluding potentially hundreds of drug related deaths from the statistics?

National Records Scotland is using a different methodology for recording drug deaths compared to England and Wales. There are potentially hundreds of drug related deaths excluded from the figures.

The overall accuracy, completeness, and consistency of data is a must for policy makers, businesses and writers. Data integrity means reliable statistical information which is stored securely and accessibly. Sadly, new revelations reveal Scottish drug deaths data is deploying differing methodologies from those found in England and Wales. Worse still, the National Records Scotland approach to recording drug deaths opens the door to allegations of inconsistency and incompleteness.

Recording drug deaths

When reading National Records Scotland (NRS) document titled ‘drug-related deaths in Scotland in 2022 - Annex A’, I found something interesting. According to the document, which outlines the methodology used to record drug deaths in Scotland, potentially hundreds of deaths are being excluded from the final figures.

The NRS definition for drug deaths is as follows

But when we glance at the very next page, we discover something interesting

To put all of that simply, the NRS is excluding deaths from the ‘drug deaths’ statistics in cases where someone may pass on due to organ failures caused by long term drug misuse. All on the rationale that said drug addiction doesn’t constitute “the direct ands immediate cause of death”.

Compare this to England and Wales. Down there they do not exclude secondary infections, such as bacterial or viral infections, resulting from the injection of contaminated drugs. The fact that the Scottish data does make these exclusions, it means deaths from hepatitis (direct cause of death) is not counted (even if the primary cause was driven by the secondary factor of drug misuse and addiction). Somebody dies from HIV in Scotland, caused by a long term drug abuse? Excluded from the figures.

It is far from clear to me why the NRS is choosing to adopt data collection methodologies not shared elsewhere in the UK. Why are we not counting in Scotland deaths caused by the long-term consequences of drug abuse such as heart or liver failure? It is anyone’s guess, but it opens up the legitimate issue of incompleteness in the drug deaths figures; which is an issue for data integrity.

Surprisingly, even deaths due to “mental and behavioural disorders” caused by drug misuse are excluded too. Again, not the case in methodological approach in England or Wales.

According to Annemarie Ward, the director of Glasgow-based charity Faces & Voices of Recovery UK who spoke with The Scotsman newspaper

“We see lots of deaths from infections, contaminated drugs and the complications caused by drug abuse,”

“I couldn’t even guesstimate what those numbers are. The problem is they’re not collecting the data, or if they are, there’s no way to access it.

“We’ve seen an uptick in the number of deaths being recorded as ‘inconclusive’, but the families involved know fine well they are drug deaths.

“These people have been suffering with drug addiction for a long time, and all of a sudden the data is inconclusive.

“There’s probably at least 50 per cent of these deaths not being recorded. That’s based on my personal experience. I went to five funerals last year. In that year, four of those deaths were recorded as inconclusive, but the families know they were drug deaths.

“Especially with the trend towards poly drug use, there’s no way these deaths are being recorded accurately.

“I do think there’s some jiggery and pokery going on. Why wouldn’t there be? It would be foolish and naïve to sense that there wasn’t. It’s such a high, political-points-scoring issue.”

The latest NRS data tells us that 1,051 people died due to drug misuse in 2022. The good news is this represents a decrease of 279 deaths (21%) when compared with 2021. This is also the lowest finding since 2017. And while I see no reason to doubt that there has indeed been a decrease in drug deaths in Scotland, the question of how many are being excluded is raised.

We are talking about potentially hundreds of deaths linked to drug misuse and abuse being kept off the figures in Scotland - but not in England and Wales. Annemarie Ward suggests “jiggery and pokery”, which may hold some merit. After all, the drug deaths in Scotland has become a national shame and a major political headache for an SNP government presiding over the worsening crisis ever since 2007. Even if political machinations are unfounded, the very fact that they can be credibly raised is proof that data integrity is not robust regarding drug deaths statistics.

It is time the NRS started answering some questions as to why they are taking a different methodological approach as opposed to colleagues in England and Wales. They can start by revealing if they hold data related to deaths from infections, contaminated drugs and the complications caused by drug abuse. And if they don’t hold those figures, time to say why.

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