Contribution of drugs to drownings in Scotland, 1996-2020

Objective Psychoactive substances use (including alcohol) can affect risk perception, leading to accidents and deaths. There is little detailed or up-to-date information on the role of drugs in United Kingdom (UK) drownings. This Scottish case-study aimed to fill this knowledge-gap. Methods Anonymised data for individual drug-poisoning related drownings registered in 1996-2020 were provided by the National Records of Scotland. Statistical analyses were undertaken for socio-demographics, ICD coding, cause of death, substances implicated. Results Death registrations rose from 7 in 2017 to over 20 in 2019-20. These deaths (n=160) accounted for <1% of all drug-related poisoning deaths; this proportion rose to record levels (c.1.5%) in 2019-20. Most deaths (69%) involved males. Mean age was 39.8 (range 16-81, SD 15.0) years. Main drug classes implicated were: opiates/opioids (41%); benzodiazepines (31%); stimulants (19%); antidepressants (14%); 57% of benzodiazepines were ‘designer’ drugs. Conclusions Scottish drownings associated with drug consumption are increasing. Central nervous system depressant drugs (e.g., opioids, benzodiazepines, alcohol) are often involved. ‘Designer’ benzodiazepines are a principal factor in increasing Scottish drug-related poisoning deaths; they may be partially responsible for increasing numbers of related drownings. Evidence-based strategies to further reduce the number of preventable drownings should include reference to the dangers of drugs.