Background: In 2000 and 2001, there were 292 and 332 drug-related deaths in Scotland, respectively. Of the 332 people who died in 2001, 65 were of female sex, 80 were younger than 25 years, and 112 were older than 34 years. We assessed the effect of region, sex, and age group on drug-related deaths in Scotland per 100 injecting drug users.
Methods: We used published regional estimates of current injecting drug users (n=22805), their sex (30% female) and age distribution (8% older than 34 years in mid-1990s), or corresponding data for problem drug users (21% older than 34 years in 2000) to compare observed with expected drug-related deaths by region, sex, and age group per 1000 population or per 100 injecting drug users.
Findings: Regional population-based expectations fitted poorly to observed drug-related deaths, but those based on injecting drug users fitted tolerably. Drug-related deaths in 2001 per 100 injecting drug users were significantly lower in female (0.9 [95% CI 0.6-1.1]) than in male drug users (1.5; 1.3-1.7). They were between two and six times more frequent per 100 injecting drug users older than 34 years than younger than 25 years, depending on whether current injecting drug users' age distribution was assumed to be the same as problem drug users' or as injecting drug users' in the mid-1990s (2.1 [1.7-2.5] or 5.3 [4.3-6.3], respectively).
Interpretation: Older and male injecting drug users were at highest risk of drug-related death. Injecting drug users' age distribution should be assessed and compared across countries.