15 Apr 2026
In this latest Leading Forward Podcast release, our CEO Mike Trace, explores the shocking reality of drug and alcohol related deaths not getting the coverage it deserves.
In this episode of the Leading Forward podcast, Mike Trace looks at the continuing rising trends in drug and alcohol related deaths, and tries to understand why the responses still seem inadequate to the challenge.
Here's a short video intro to the podcast by Mike himself:
Soundcloud player
Disclaimer: This is an edited transcript of the episode, prepared for accessibility and readability. The meaning and content are unchanged.
Mike Trace, Chief Executive, Forward Trust
Hello everyone.
This is the latest of the Forward Thinking podcast series. I’m Mike Trace, Chief Executive of Forward Trust.
What we try to do with these recordings is for me to talk through an issue of relevance to our organisation, to our staff, to our work, to this time. We’re going to talk about drug‑related deaths.
I’ve touched on this in previous podcasts. It’s one of the big tragedies, one of the big challenges around our response to drug and alcohol use in society. I wanted to do a specific podcast on it because it remains one of the biggest challenges to our sector.
What prompted me to think about this is that we’re preparing a document that we’ll publish later in the year called Addiction in the UK. We’ve been working with consultants to bring together the data, the research evidence and the knowledge that’s out there around addiction, drug and alcohol use and markets. One section of that report is on drug‑ and alcohol‑related deaths.
The figures we’re gathering are very stark and very shocking. I’m always amazed by how many people die prematurely as a direct result of their drug or alcohol use.
Very broadly, the figures are around 7,000 people a year in the UK who die from drug‑related deaths. Around 10,000 people die from direct alcohol‑related causes. These figures are slightly different.
Drug‑related death figures are generally what we call acute deaths. People who die suddenly and quickly as a result of ingesting illegal drugs. These are usually overdose deaths. Those 7,000 deaths are people who die very directly and very quickly as a result of their drug use.
Alcohol‑related deaths are measured differently. They are usually chronic deaths, typically liver failure arising from many months or years of alcohol use. There are acute alcohol‑related deaths too, such as poisonings, but the larger numbers are chronic. Organ failure as a result of alcohol use.
There are also tens of thousands more deaths that are partly attributable to drug or alcohol use. These might be consequential deaths where drug or alcohol use has led to weak hearts, weak lungs or cancer. There are links between regular use of these substances and cancer.
Taken together, this represents a huge amount of premature death across society: acute deaths, chronic deaths and consequential deaths. Tens of thousands of people die every year as a result of their relationship with drugs or alcohol.
The main age group in these death cohorts is people in their 50s. There are significant numbers of younger people too. Even dying in your 50s means lives cut short by an average of around 30 years, given average life expectancy in the UK is now in the early 80s.
When people die in their teens, 20s or 30s, that is even more tragic — people starting out in life, dying as a result of drug use, overdose or long‑term use of drugs or alcohol.
The individual stories are often harrowing. What amazes me equally is how little outrage there is in mainstream society for these deaths.
I’m sure this is linked to stigma. The idea that people who die from overdoses or cirrhosis of the liver somehow brought it on themselves, that they are less valuable or less important. I think this prejudice and bias against people on the margins of society underpins the lack of focus on reducing these deaths. That makes me angry.
If we focus just on drug‑related overdose deaths, four times as many people in this country die from overdoses as die in road accidents. They’re not directly comparable, but it illustrates the lack of activity, outrage and policy attention on this issue.
The UK has among the highest drug‑ and alcohol‑related death rates in Europe. For many years, most drug‑related deaths in Europe have happened on these islands. Yet the issue does not get the policy profile it deserves.
In Scotland, the issue became a political priority around five or six years ago, leading to a national mission to reduce deaths. It has been debated at a high level since. In Westminster, however, despite years of work trying to draw attention to the issue, it is still not a particularly salient issue among politicians.
Trends in deaths have been rising for around 15 years. As a sector, we must be honest. We have had objectives for decades to reduce drug‑related deaths, but the trends are going in the wrong direction.
Treatment services are a protective factor. People in contact with treatment services are less likely to die. However, we have not been able to get all those at risk into treatment, and we haven’t been able to reduce overall numbers.
Forward Trust has seen some encouraging signs in the areas where we work, with death rates slightly below the national average, but that is no cause for complacency. The overall numbers remain unacceptable.
It is extremely difficult at a practice level to remove all risk, to engage people who are chaotic and most at risk. Even well‑funded national missions, such as Scotland’s, have not yet delivered sustained reductions.
We have tried many interventions: expanding treatment, rolling out naloxone, consumption rooms, minimum unit pricing, education campaigns. These reduce risk. They save lives. But none has fundamentally changed the upward trend.
My view is that we will not change these numbers until we address the basic realities of people’s lives. Poverty, isolation, alienation, poor mental health — these are the fundamentals that drive deaths of despair.
Healthier, more equal and inclusive societies have lower death rates from overdoses, liver disease and suicide. That is a universal truth.
As a sector, we will do everything we can to save lives. But reducing tens of thousands of tragic early deaths requires addressing wider social conditions.
I’m really interested in hearing other people’s views. I think we should be pushing government to do far more. It’s scandalous how little attention this issue still receives.
Those are my thoughts. I hope you found them useful.
