Cocaine-related deaths rising but most fatal overdoses involve prescription drugs

The number of overdose deaths involving cocaine quadrupled in the decade to 2021 while the majority of fatal overdoses now involve prescription drugs such as Xanax, Lyrica, Valium and methadone, latest figures show.
Data from the Health Research Board (HRB), published on Wednesday, show there were 354 drug poisoning deaths recorded in 2021 – down from 439 a year earlier.
Opioids, mainly methadone, were the most common drug group reported in poisoning deaths (70 per cent) in 2021. Nine in 10 deaths, however, involved one or more prescription drugs. Of the top six drugs implicated in deaths, four were prescription drugs.
The most common drugs involved in 2021′s fatal overdoses were methadone (129), diazepam (112 and also known as benzodiazepine), alprazolam (107, more commonly known as Xanax), pregabalin (83, also known as Lyrica), and Zopiclone (59).
A quarter of the deaths involved pregabalin – prescribed to treat epilepsy, anxiety and opioid withdrawal – and was implicated in a higher number of deaths among females (28 per cent) than males (21 per cent).
A third of deaths involved antidepressants, and again were implicated in a higher number of female overdose deaths (47 per cent), than male deaths (28 per cent).
The most common illicit drugs involved in the deaths were cocaine (107) and heroin (79), both of which were more likely in male deaths. Four in five of the cocaine-related deaths were among males.
The median age of the deceased was 42.5 years – 41 years for males and 47 years for females. One in two deaths were among people aged 35 to 54 years
Most (77 per cent) were living in stable accommodation, with more than 10 per cent experiencing homelessness when they died. The largest proportion were living in the HSE region of Dublin and northeast (28.5 per cent), followed by Dublin and Midlands (23 per cent), and Dublin and southeast (18 per cent).
Looking at trends from 2012 to 2021 the study found there were 3,379 overdose deaths during the decade.
The number of deaths involving cocaine increased fourfold, from 26 to 107. These deaths are typically polysubstance – more than one drug involved – poisonings, the study found.
Opioid deaths increased by 34 per cent, from 182 to 244 over the decade, while deaths involving benzodiazepines increased by 45 per cent, from 129 to 187, mainly attributable to an almost fivefold increase in alprazolam (Xanax), from 18 to 107 deaths.
The chief executive of the HRB, Dr Mairéad O’Driscoll, said it was “encouraging to see a decrease in the number of drug poisoning deaths recorded in 2021.
“However, behind each of these numbers is a person, their family and a life lost. By monitoring these trends over time, the HRB can report on the impact that drugs have on our society, as well as identifying changes in use and behaviour. Understanding the factors influencing poisoning deaths is key to informing future responses and preventive measures,” she said.