Contribution of Drugs to Drowning in Scotland from 1996 to 2020

Objective: Psychoactive substance 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 drownings in the United Kingdom (UK). This Scottish case-study aimed to fill this knowledge gap. Methods: Anonymised data for individual drug-poisoning-related drowning registered from 1996 to 2020 were provided by the National Records of Scotland. Statistical analyses were performed for socio-demographics, ICD coding, cause of death, and substances implicated. Results: It has been reported that death registrations increased from 7 in 2017 to over 20 during 2019-20. These deaths (n=160) accounted for <1% of all drug-related poisoning deaths; this proportion rose to record levels (c.1.5%) during 2019-20. Most deaths (69%) involved males. The mean age was 39.8 (range 16-81, SD 15.0) years. The main drug classes implicated were: opiates/opioids (41%), benzodiazepines (31%), stimulants (19%), and antidepressants (14%). Moreover, 57% of benzodiazepines were 'designer' drugs. Conclusion: Scottish drownings associated with drug consumption are increasing rapidly. It has been observed that central nervous system depressant drugs (e.g., opioids, benzodiazepines, alcohol) are often involved in drowning. '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.