This report examines fatal overdoses between 2017 and 2021 based on NZ Drug Foundation analysis of coronial data (1). We know drug harm and fatalities far exceed the number presented in this report, including suicides, communicable and chronic health conditions.
Overdoses have been neglected in public policy in Aoteaora New Zealand, as have the physical health impacts of drug use. Every year, New Zealanders’ lives are lost to drug overdoses. Every one of these people’s lives deserved to be saved.
We look across the world and see alarming year-on-year increases in overdose fatalities, particularly attributed to potent opioids such as fentanyl.
We hope this report goes some way to encouraging New Zealand to put in place measures that will reduce overdose fatalities and to get better prepared for an opioid crisis while we can.
Across the five-year period from 2017 – 2021, cases rose by 54% (2), whereas the population increased by only 6% (3).
Notably, there was an increase in overdose deaths in 2017/2018. The synthetic cannabinoid overdose crisis peaked in these years, and significantly contributed to these numbers.
Concerningly, the cumulative number of overdose deaths has risen steadily over the last 5 years. This is primarily a result of increasing numbers of deaths from opioids, alcohol, and benzodiazepines; combined with smaller but noticeable increases in deaths involving stimulants and other drugs.
The coroner data identified 702 overdose death cases between 2017 and 2021. In most cases multiple substances were identified in the toxicology report, thus it is not possible to definitively identify which substance or combination was responsible for death.
Māori are disproportionately affected by drug harm and fatal drug overdose in New Zealand. While making up approximately only 15% of the population (3), Māori made up 27% of the total closed overdose cases between 2017-2021 and 25% of all cases (closed and open).
Based on the population rates, Māori were approximately three times more likely to die of an overdose (0.03% of population) compared to Pākehā/European (0.01% of population).
Māori were overrepresented in synthetic cannabinoid overdoses, making up 67% of cases. Pākehā/European made up on 16% of synthetic cannabinoid deaths, and Pacific Peoples made up 17%.
Alcohol was attributed to 129 cases (closed and open) between 2017 to 2021 (4), with a sharp increase in 2020 and 2021. Further, alcohol was listed on the toxicology report of 47% of closed overdose cases in the past five years (199 of 419 cases). There are likely more open cases in which alcohol use contributed to a person’s death.
In the majority of closed overdose cases, people had a number of drugs in their system when they died; this includes illicit drugs, alcohol and medicines (OTC and prescription).
This data shows a clear relationship between the number of substances in a person’s system and the likelihood of dying of an overdose. This is especially concerning due to the prolific nature of ‘mixing’ substances, and the large number of vulnerable people who engage in poly-substance use.
As seen above, poly-substance use was implicated in most closed cases over the last 5 years. Substances were then classified into ‘depressants’, ‘stimulants’ and ‘hallucinogens’.
Medicines available in New Zealand (prescription (5) and OTC) feature heavily in overdose deaths. From 2017-2021, at least one medicine was listed on the toxicology report in 321 of 419 (77%) closed cases.
Of the closed overdose cases recorded from 2017-2021, diazepam was listed in nearly one quarter (97 cases) of cases. Zopiclone appeared in nearly one in five cases (72 cases).
The data in this report clearly outlines concerning trends in drug overdoses in New Zealand. With the changing post-COVID drug landscape, we anticipate that these issues will persist and likely increase, particularly in vulnerable populations.
Based on this report, the NZ Drug Foundation makes the following recommendations:
All efforts have been made to represent the data provided by the coroner as accurately as possible. A list of limitations is included below.
Survey participants also reported that barriers to accessing services, resources and information were high.
A group of powerful synthetic opioids that were first detected in the country just a year ago may have already been linked to several deaths.
95% of respondents reported positive effects, in a study that looked at both prescription and black market cannabis use.