New figures from Public Health Wales show that opioids continue to be the leading cause of drug misuse deaths, prompting renewed warnings about the serious harms associated with these substances.
In 2024, a total of 417 drug poisoning deaths were registered in Wales – up from 377 in 2023. Of these, 288 were drug misuse deaths, the highest number ever recorded. Most deaths (84%) resulted from accidental poisoning.
Opioids were involved in 200 deaths (69%), making them the most common substances identified in drug misuse fatalities. More than half of these deaths involved heroin or morphine.
Other substances frequently reported in deaths included:
- Cocaine – involved in over a quarter of drug misuse deaths, an increase on the previous year
- Pregabalin
- Bromazolam
- Methadone
- Diazepam
Polysubstance use is also on the rise, with 62% of drug misuse deaths involving more than one substance – most commonly opioids combined with cocaine or benzodiazepines.
Public Health Wales reports significant inequalities in drug misuse deaths:
- People in the most deprived areas were five times more likely to die from drug misuse than those in the least deprived areas over the past decade.
- Local authority rates varied widely in 2024, ranging from 2.8 to 21.2 deaths per 100,000 population.
- Men were nearly three times more likely to die from drug misuse than women.
- Older adults were most affected: people aged over 50 accounted for 34% of all drug deaths.
- 17 young people under 25 died – an increase on the previous year.
Head of Substance Misuse Programme at Public Health Wales, Professor Rick Lines, said:
"These figures show the continued harm opioids are causing across Wales, often alongside substances such as cocaine and benzodiazepines. The rise in cocaine involvement reflects what local services have been reporting for some time.
"The data also highlights the importance of Take-home Naloxone as part of our national response. It is safe, effective, and it saves lives. We encourage anyone at risk, and those around them, to access free training and kits.
"Drug-related deaths remain far more common in our most deprived communities. This shows the need for wider action on housing, poverty and health inequalities alongside the work of specialist drug services."
The All‑Wales Take‑home Naloxone programme remains a key intervention in preventing fatal overdoses. Since 2013, naloxone has been used in 4,199 overdose events, with a fatal outcome in only 1.3% of cases.
In 2024, naloxone was used 307 times, again with the same low fatality rate. Access continues to increase, with 2,476 new individuals receiving naloxone kits last year.
Public Health Wales emphasises that reducing drug deaths requires addressing broader social factors that influence people’s lives – including access to safe housing, fair work, and supportive communities.
Image credit: iStock
