This category includes accidental deaths due to the use of mind-altering (psychoactive) substances for non-medical purposes, also referred to as substance misuse, drug misuse, illegal drug use and recreational drug use. Deaths due to alcohol are covered in Map 40, while deaths due to suicide/undetermined by poison are included in Map 38.

Accidental deaths due to drugs account for three deaths a day in Britain. There is clearly a rural–urban divide with the highest rates seen in Glasgow, Brighton and London, followed by other towns and cities as well as some coastal resorts of former glory. The latter are often places in which local authorities have rehoused those whom they are obliged to accommodate under homeless persons legislation. In contrast, some remote rural areas, particularly in Scotland, have extremely low rates.

A wide range of often illegal drugs is included here (although the two most commonly used recreational drugs – alcohol and tobacco – are not included here). They include opiates (such as heroin and morphine), amphetamines, cocaine, barbiturates (sleeping pills), drugs that cause hallucinations (such as lysergic acid, LSD) and hydrocarbons (‘glue sniffing’). There is often more than one drug used and alcohol is frequently also involved. This can make it difficult to attribute the cause of death to one particular drug.

Estimating mortality directly attributable to illicit drug use such as overdose death is often difficult because the drugs are illegal, stigmatised and hidden.

Deaths from diseases spread by non-sterile needles and syringes, such as Hepatitis B and C (see Map 44) and HIV/AIDS (see Map 28), are counted separately.