Image copyright Chris Morris/Getty Images Image caption Dr John Cawdrey of the Department of Poison and Virology at Imperial College London
Overdose deaths from heroin and heroin-mixing injected drug use reached a record high in England and Wales, the latest NHS figures show.
A total of 5,086 overdose deaths were recorded between April 2016 and April 2017.
The numbers are still falling but are at the highest level recorded in these figures since 2002/03.
Image copyright Warner Baxter Image caption Figures from 2005-2016 show a steady rise in deaths
The figures come as addicts are often facing shortages of supplies at homeless or non-solid substance injecting spaces in some places.
This has led to concerns that people are increasingly using known deadly substances like spice, also known as synthetic cannabis, at these spaces.
The latest figures include heroin-related deaths, as well as those from the use of heroin in the heroin substitute methadone.
But they are not the same deaths as those recorded by the wider authorities, which take into account drug seizures and other factors.
Use of the synthetic opioid fentanyl has also grown. The drugs are mixed with heroin and can be about 100 times more potent than morphine.
Deaths have increased as heroin prices have fallen, so that it is now available for as little as £2 per gram, although purity and purity levels vary.
But the overall number of deaths from an overdose of drugs or alcohol also continues to fall.
Deaths have fallen in every year for at least 10 years, but the latest figures reveal a record number in 2017.
The number of people who died from an overdose of drugs or alcohol in England and Wales in 2017 was 2,674, a decrease of 9% from 2016 and a reduction of 25% from the 5,226 in 2015.
Photo: Max Mumby/Indigo/Getty Images Image caption People are worried about sharing needles to try and avoid abuse
The number of people who died from an overdose of legal highs fell to the lowest level since 2017, at 174.
New figures also show a large rise in those dying from tuberculosis infections.
A total of 972 people were hospitalised with the disease between April 2016 and April 2017, up 3.4% on the previous year.
The figures also show that death rates from flu and pneumonia have fallen for the first time in 17 years.
The fall in flu deaths between 2016 and 2017 is expected to continue for the next few years.
In the longer term, deaths from dementia and Alzheimer’s disease have also continued to drop.
Deaths from lung cancer fell for the second year in a row and deaths from breast cancer are at their lowest in a decade.
Deaths from Type-1 diabetes in adults fell for the fifth year in a row – but deaths from Type-2 diabetes in adults rose by 25%.
Hospital admissions for suicide are at their lowest since 2014, and yet deaths from lower respiratory infections and complications of people being resuscitated are up year on year.
Image copyright AFP Image caption Overdose deaths have been on the rise in recent years, as heroin prices have dropped
More research on this year’s figures is needed, the Department of Health and Social Care said, while it acknowledged the downward trend in deaths for a number of years.
The latest figures also show the number of people under the age of 14 who die of drug use fell by more than 10% in 2017 – the seventh year in a row that this figure has been falling.
The figure was also partly due to a reduction in the number of accidental poisonings and deaths in drug use, meaning that the overall drug-related toll is down.
Image copyright EPA Image caption Drugs experts think fatal overdoses may be driven by effects of fentanyl
“Increasing numbers of people are taking steps to avoid suffering the devastating consequences of drug misuse and as a result the number of people now living with drugs is at its lowest level since 1994,” said Jon Rouse, chief executive of the charity DrugScope.
The report from the National Institute for Health and Care Excellence found that 95% of patients receiving methadone therapy in the first 12 months of use do not need another dose, highlighting that in-patient treatment can be maintained and no longer used as a way of handling chronic drug use.
A spokeswoman for the Department of Health and Social Care said: “Deaths from a wide range of drug use remains an ongoing issue across England. This report has found a steady decline in the number of heroin users dying.
“As well as improving public awareness of the risks around drug use, support for people who use illegal drugs like heroin and crack is changing as more effective and appropriate treatment is made available.”