Facts & Stats


There is an international crisis of drug overdose. Over the last twenty years drug overdose deaths have increased significantly in many parts of the world. Each year a record number of deaths are reported, predominantly driven by the misuse of opioids, often in combination with other drugs including benzodiazepines, stimulants and alcohol.

In 2020, an estimated 284 million people – one in every 18 people aged 15-64 – had used a drug in the past 12 months, a 26 per cent increase from 2010.

Opioids account for two-thirds (69 per cent) of drug overdose deaths. The estimated number of people using opioids globally has doubled from 26-36 million people in 2010 to 61.3 million in 2020. There are currently multiple ongoing opioid overdose epidemics in the world; one is driven by the increased presence of the synthetic opioid fentanyl in the United States and Canada, while another in North Africa, West Africa, the Near and Middle East and South-West Asia is due to the non-medical use of the synthetic opioid tramadol.

Some of the new drugs available today – most notably synthetic opioids and amphetamine-type stimulants – are more dangerous than their counterparts were 20 or even 10 years ago. There were 1,127 new psychoactive substances reported in 134 countries and territories between 2009 and 2021. Opioids are the fastest-growing and most harmful group of new psychoactive substances – there were 87 different types recorded globally in 2020, an increase from just one in 2009.

Beyond a few countries and regions, most notably North America, the European Union, United Kingdom, Australia and New Zealand, reliable data on fatal and non-fatal overdose do not exist or are at best questionable. In many low-resource countries, deaths caused by overdose are not reliably recorded, instead being classified as heart attacks or respiratory failure. This occurs for many reasons; among the important contributors are widespread stigma about drug use, fear of police harassment, political pressure, and inconsistent or inadequate coronial systems. The illegal nature of drugs and profound stigma associated with drug use leaves an overwhelming reluctance in many parts of the world to acknowledge let alone report on drug related deaths.

Penington Institute (2022). Global Overdose Snapshot.
UNODC (2022). World Drug Report 2022.

United States

In 2021, provisional data from the Centres for Disease Control and Prevention yielded an estimate of 107,622 drug overdose deaths in the United States, an increase of 15 per cent from 2020. Two-thirds of these deaths involved synthetic opioids, primarily fentanyl.
The United States reported an age-adjusted mortality of 216 per 1 million people for the 15–64-year age bracket for 2019.

Penington Institute (2022). Global Overdose Snapshot.
National Centre for Health Statistics, 2022.
UNODC (2022). World Drug Report 2022.


There was a total of 32,632 apparent opioid toxicity deaths between January 2016 and June 2022.

A majority of deaths occurred in British Columbia, Alberta, and Ontario; high rates were also observed within other regions.

In 2021, fentanyl was responsible for 87 per cent of opioid-overdose deaths in Canada. Of the accidental stimulant toxicity deaths during the year, 62 percent involved cocaine, while 55 percent involved methamphetamines.

Government of Canada (2022). Health Infobase.


The World Health Organisation reports that use, abuse, dependence, and overdose attributed to tramadol have in recent years emerged as serious public health concerns in countries across several regions, but most notably in Africa and Middle Eastern countries.

It is projected that the number of people using drugs by 2030 will rise by 11 per cent globally, and by as much as 40 per cent in Africa.

Penington Institute (2022). Global Overdose Snapshot.
WHO Expert Committee on Drug Dependence (2018). Forty-first meeting of the Expert Committee on Drug Dependence report 12-16 November 2018, p. 31.
UNODC (2021). World Drug Report 2021, booklet 1, p. 11.
IDPC (2022), The World Drug Report 2021.



In 2020, there were 2,220 drug-induced deaths in Australia, a rate of 8.5 deaths per 100,000 people. This equates to 69,741 years of life lost to drug-induced deaths, with an average of 33 years of life lost per drug-induced death. The number of all drug-induced deaths surpassed the road toll in 2008 and has continued to rise in the years since. For Australians aged 30-39, drug-induced deaths were the second-leading cause of death behind suicide in 2020.

Penington Institute (2022). Global Overdose Snapshot.


In 2014, the UNODC estimated that there were 49,000 drug-related deaths in China. However, Chinese media reports estimate the number of drug users at 14 million, suggesting the rate of drug-related mortality could be much higher than reported.

A 2020 document from the Office of China National Narcotics Control Commission dismisses the issue, claiming that the situation of drug abuse continues to improve and that drug abuse in China has been curbed.

Penington Institute (2022). Global Overdose Snapshot.
Sui-Lee Wee, ‘Drug abuse cost China $80 billion last year as it clocked 49,000 drug related deaths’, Insider June 24, 2015.
Office of China National Narcotics Control Commission (2020). Drug Situation in China (2019), p. 3.

England and Wales

In 2020, 4,561 deaths related to drug poisoning were registered in England and Wales (equivalent to a rate of 79.5 deaths per million people). This is the highest number since records began in 1993 and is 3.8 per cent higher than the number of deaths registered in 2019 (4,393 deaths; 76.7 deaths per million).

In 2020, the number of deaths due to cocaine in England and Wales increased for the ninth consecutive year. There were 777 deaths involving cocaine registered in 2020, which was 9.7 per cent higher than the previous year (708 deaths). The number of deaths has increased by five times since 2010 (144 deaths).

The Office for National Statistics reported that there were 137 deaths registered in England and Wales in 2020 where new psychoactive substances were mentioned on the death certificate.

Penington Institute (2022). Global Overdose Snapshot.
Deaths related to drug poisoning in England and Wales QMI.
Office of National Statistics (2021). Deaths related to drug poisoning in England and Wales: 2020 registrations, p. 2.

European Union

Stimulants are the second most reported category of drug consumed across Europe. Based on the United Nations Office on Drugs and Crime annual report questionnaire, 11 per cent of countries reported stimulant drugs as the drug group causing the greatest number of drug-related deaths.

In 2020, the number of deaths involving amphetamines increased in Finland (67), Austria (28), Czechia (18), Slovakia (17), and Estonia (17) compared with the previous year. Amphetamine, MDMA, and methamphetamine were all among the 11 most common substances reported in acute drug toxicity presentations at European hospitals.

A European project monitoring cases involving medical treatment for non-fatal overdoses found 6.2 per cent of cases related to new psychoactive substances in 2014–2017. While deaths related directly to the use of new psychoactive substances do occur, they were rare in the countries that were able to provide relevant data.

Deaths involving synthetic cannabinoids were reported by three countries in 2020: Germany (9), Hungary (34) and Turkey (49).

In 2020, 3-MMC (a type of synthetic cathinone) was involved in 38 acute drug toxicity presentations in 5 Euro-DEN Plus hospitals.

Penington Institute (2022). Global Overdose Snapshot.
UNODC (2022). World Drug Report 2022.
EMCDDA (2022). European Drug Report Trends and Development 2022, p. 39.


1,339 people lost their lives to a drug-related death in Scotland in 2020. In 2019, there were 1,280 drug-related deaths in Scotland, a rate of 234 drug-related deaths per million. This is a 5 per cent increase from 2019 and represents the highest number of drug-related deaths ever recorded in Scotland, for the seventh consecutive year. Scotland has the highest per capita rate of drug deaths in Europe at 25.2 deaths per 100,000 people, which is more than three and a half times higher than the rest of the United Kingdom.

Penington Institute (2022). Global Overdose Snapshot.
National Records of Scotland (2021). Drug Related Deaths in Scotland 2020, p. 2.

New Zealand

In 2019, there were 307 drug related deaths in New Zealand. Cases are considered drug-related where the death was due to external causes, and where drugs made a contribution to death. The national rate of drug-related deaths was 6.4 deaths per 100,000 population. In 2019, 84.7 per cent of opioid-related deaths involved the opioid as a primary contributor to death. Roughly 46 accidental opioid overdoses are recorded each year by the New Zealand Ministry of Health (five-year average from 2014-2018).

Penington Institute (2022). Global Overdose Snapshot.
NCIS Fact Sheet (2022). Drug-related deaths in New Zealand in 2019.
New Zealand Drug Foundation (2022). State of the Nation 2022: A stocktake of how New Zealand is dealing with drug use and drug harm, p. 23.

Northern Ireland

Northern Ireland recorded 218 drug-related deaths in 2020. There has been a general upward trend in the number of drug-related deaths in Northern Ireland, with deaths increasing from 92 in 2010 to 191 in 2019 and 218 deaths in 2020. The number of drug-misuse deaths have increased from 64 to 182 between 2010 and 2020.

Penington Institute (2022). Global Overdose Snapshot.
Northern Ireland Statistics and Research Agency (2020). Drug-related and drug-misuse deaths in Northern Ireland, p. 5.


In 2019, there were 57 drug-induced deaths in Serbia, equating to 8.21 deaths per million people. In 2018 there were 47 drug-induced deaths. Drug Policy Network South-East Europe emphasised controversies and questions regarding the reliability of the data.

Penington Institute (2022). Global Overdose Snapshot.
Republic of Serbia, Office for Combating Drugs, Presentation of the analysis, Drug-induced deaths in Serbia 2008-2019, March 2021, Presentation to Drug Policy Network South-East Europe.

South America and Latin America

South and Central America and the Caribbean have the highest proportion of people worldwide who are in drug treatment due to the use of cocaine, which is often consumed in smokable forms that are cheap and frequently toxic.

In Mexico, amphetamines have become the most frequently detected drug in the deceased. The dominance of methamphetamine use, as compared with the use of other amphetamines, is illustrated by the 29,680 methamphetamine users in drug treatment in 2020, compared with only 727 amphetamine users in treatment. This represents a 218 per cent increase in the number of clients in drug treatment with amphetamine type stimulant as their primary drug compared to 2013.

There are also reports of new psychoactive substances – sometimes containing fentanyl – circulating in party and street markets in Colombia, Argentina, Uruguay, and Chile.

However, whilst drug use is seen as a significant and growing problem in South America, there is little reliable information available to determine the extent of harms caused from drug use. In Colombia, for instance, different government agencies have reported widely varying and contradictory numbers of fatal opioid overdoses.

Penington Institute (2022). Global Overdose Snapshot.
Pacurucu-Castillo, S.F, Ordóñez-Mancheno J. M et al. (2019). ‘World Opioid and Substance Use Epidemic: A Latin American Perspective’. Psych Res Clin Pract, 1, pp. 2–38.
65 ATS Corporation (2021). ‘How many deaths are there from opioid overdose in Colombia? We do not know’. ATS Corporation.


In 2019, there were 421 deaths caused by psychoactive substances, an increase from 2018 when 335 deaths were recorded. 319 deaths were classified as accidental overdose. Opioid-related overdoses totalled 209 deaths, synthetic opioids accounted for 18 cases, and five cases involved psychostimulants.

Penington Institute (2022). Global Overdose Snapshot.
Report on the drug and alcoholic situation in Ukraine for 2020 (according to 2019 data), Kyiv 2020, p. 17.

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