Drugs in reported road fatalities in Great Britain, data to 2021
Updated 28 September 2023
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This publication is available at https://www.gov.uk/government/statistics/developing-drug-driving-statistics/developing-drug-driving-statistics-initial-feasibility-study
About this release
This release summarises initial work towards developing statistics on levels of drugs in drivers and riders involved in reported road collisions, based on data from coroners related to those killed in road collisions.
This is an update of the initial feasibility study first produced in 2021 with data up to 2019. This update adds drug data for 2021 to the report.
We welcome feedback from users on the next steps to inform further development.
Introduction
The Department for Transport has produced statistics for reported road casualties in Great Britain involving drivers with illegal alcohol levels for many years, with the most recent statistics for 2021. These estimates are based on data from coroners as well as driver breath test results.
Following the recommendation in the recent PACTS report: “The Department for Transport should produce and publish robust offence and casualty data on drug driving using coroner data and other sources, as they do for drink driving”, we have updated this short report to analyse the latest available data as a basis for further development.
Background
Summary of approach
Producing estimates of drug driving even for road fatalities is not as straightforward as for drink driving, because:
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it is necessary to distinguish between recreational drugs and prescribed drugs that impair driving from those that do not.
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unlike alcohol, where there is only one thing to test for, there are many different drugs which can impair driving, with different legal limits. The list of drugs covered by legislation is available
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we also need to determine which drugs found in the body may have been administered by paramedics at the scene, rather than taken by the road user.
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there a number of important caveats relating to how the data is captured which can affect the results (for example whether test are based on blood, urine or other samples, the time between death and a sample being taken and the range of drugs tested for).
To examine these issues and the feasibility of developing drug driving statistics, the Department commissioned the Transport Research Laboratory (TRL) in collaboration with the National Programme for Substance Abuse Deaths (NPSAD) to undertake a feasibility study on how the drug toxicology data from fatalities in reported road casualties can be used more effectively. This report is available alongside this summary and contains more detail on the above issues and data limitations.
Following on from this updated report, we intend to continue to engage with stakeholders to consider the value of this approach, and explore the extent to which data on drug use by non-fatal casualties can be estimated (see section on next steps below).
Classification of drugs
For this initial work, we have considered the drugs recorded in the coroners data in two distinct ways.
Firstly, the NPSAD coding was used to classify the drugs into the nine categories. Of these, there are three categories that impair the ability to drive safely:
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psychoactive medications with impairment potential (for example, benzodiazepines) : Drugs that fall into this category can of course be abused (for example, benzodiazepines)
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query psychoactive drugs, drugs that could be prescribed, abused or used in emergency medical treatment (morphine, alfentanil, fentanyl, ketamine)
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drugs of abuse (for example, cocaine, LSD), these are drugs that have no medical use according to The Misuse of Drugs Regulations 2001
For simplicity, in the following we have referred to drugs in these groups as ‘impairment drugs’. Full details of the groupings are given in the TRL report.
Secondly, we have explored the data available for the 17 individual drugs set out in the drug driving legislation. Initial results of this analysis are included in the TRL report and we intend to develop this further as part of the planned work to build on this feasibility study.
Findings 2014 to 2021
Number of deceased drivers with drugs detected by type of drug
Table 1 shows the number of deceased drivers where drugs in each of the drug categories were detected (in any amount) from 2014 to 2021. Table 2 shows the presence of alcohol to assist comparisons. It should be noted that these figures are very likely to be underestimates of the actual number of drivers with drugs detected, as there are cases where data is not available, either because coroner data was not provided or a toxicology report was not available. The number of deceased drivers in each table are the overall number whether are not they were tested for the presence of alcohol or drugs.
Broadly, the number of deceased drivers with at least a trace of impairment drugs is higher than those with any amount of alcohol. However, it should be borne in mind that, as well as cases where drug toxicology analysis is not available (as shown in the table), there are over 100 fatalities a year in which a coroner’s report has not been provided and the alcohol level is unknown. This includes cases where the driver died more than 12 hours after the collision. We need to be cautious in comparing drink and drugs as, for example, alcohol stays in the body for a shorter time than drugs.
The number of deceased drivers with ‘impairment drugs’ present has increased by over 60% from 2014 to 2021 while those where alcohol has been detected has barely changed. The drug driving increase could reflect changes to testing, and add further years data as it becomes available.
Table 1: Number of deceased drivers in reported road collisions; whether the presence of drugs was tested for, GB: 2014 to 2021
| Drug type | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 |
|---|---|---|---|---|---|---|---|---|
| At least one impairment drug detected | 106 | 138 | 188 | 202 | 208 | 172 | 167 | 171 |
| Medical drugs | 16 | 35 | 31 | 26 | 28 | 25 | 18 | 19 |
| Drugs of abuse | 69 | 85 | 130 | 153 | 142 | 117 | 123 | 128 |
| Query drugs | 33 | 49 | 66 | 61 | 74 | 57 | 57 | 52 |
| Drugs tested for | 539 | 591 | 654 | 694 | 684 | 605 | 510 | 510 |
| Number of deceased drivers | 951 | 968 | 953 | 948 | 962 | 915 | 775 | 856 |
The three categories ‘medical drugs’, ‘drugs of abuse’ and ‘query drugs’ will be greater than the number ‘at least one impairment drug detected’ as more than one drug type can be detected in one driver.
Table 2: Number of deceased drivers in reported road collisions; whether the presence of alcohol was tested for, GB: 2014 to 2021
| Drug type | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 |
|---|---|---|---|---|---|---|---|---|
| Alcohol detected | 162 | 143 | 155 | 172 | 175 | 143 | 138 | 155 |
| Alcohol tested for | 801 | 810 | 824 | 849 | 859 | 764 | 635 | 728 |
| Number of deceased drivers | 951 | 968 | 953 | 948 | 962 | 915 | 775 | 856 |
The number of drivers where the contributory factor ‘impaired by drugs’ was allocated in 2021 is the lowest since 2015. However, the percentage of all fatal collisions, where any contributory factor has been allocated by a police officer, is broadly inline with each year since 2016, apart from 2020.
Table 3: Number of reported fatal road collisions where the contributory factor ‘impaired by drugs’ has been allocated by a police officer, GB: 2014 to 2021
| Value | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 |
|---|---|---|---|---|---|---|---|---|
| Number | 47 | 62 | 81 | 96 | 80 | 82 | 84 | 73 |
| Percentage | 3.0% | 4.2% | 5.6% | 6.5% | 5.5% | 5.8% | 7.2% | 5.7% |
Tables on contributory factors allocated by a police officer in reported road collisions are available.
Percentage of deceased drivers with impairment drugs detected
As noted above, the actual numbers are likely to understate the number of drivers with drugs detected, so the following looks at percentages, for impairment drugs, and for alcohol.
It is possible that alcohol and drugs are more likely to be tested for in cases where use is suspected. If this is so the percentage of drivers tested where drugs have been detected will be on the high side. The percentage of those with drugs detected as a percentage of all deceased drivers (including those where no report has been provided) will be on low side as there will potentially be some drivers where drugs would have been detected had a report had been provided. The true figure, therefore, is likely to be between the two.
It is possible that alcohol and drugs are more likely to be tested for in cases where use is suspected. If this is so the percentage of drivers tested where drugs have been detected will be on the high side. The percentage of those with drugs detected as a percentage of all deceased drivers (including those where no report has been provided) will be on low side as there will potentially be some drivers where drugs would have been detected had a report had been provided. The true figure, therefore, is likely to be between the two.
The percentage of deceased drivers where alcohol was detected has remained fairly stable since 2014. However, those where impairment drugs have been detected has risen over these years. In 2021, the percentage with impairment drugs was between 20% and 34%.
Table 4: Percentage of deceased drivers in reported road collisions, GB: 2014 to 2021
| Drug type | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 |
|---|---|---|---|---|---|---|---|---|
| % of deceased drivers where impairment drugs detected and a toxicology report provided | 20% | 23% | 29% | 29% | 30% | 28% | 33% | 34% |
| % of all deceased drivers where impairment drugs detected | 11% | 14% | 20% | 21% | 22% | 19% | 22% | 20% |
| % of deceased drivers where alcohol detected and a report provided | 30% | 24% | 24% | 25% | 26% | 24% | 27% | 30% |
| % of all deceased drivers where alcohol detected | 17% | 15% | 16% | 18% | 18% | 16% | 18% | 18% |
Casualties in collisions where a deceased driver has drugs detected
Table 5 and table 6 shows a breakdown of the casualties in reported road casualties where at least one deceased driver had impairment drugs or alcohol detected (though was not necessarily over the limit).
Across all years, between 60% and 70% of casualties in collisions where an impairment drug was detected were fatalities. This is similar to collisions where alcohol was detected. The percentage of the fatalities that were drivers with alcohol or drugs detected is around 90% showing that most fatalities are drink or drug drivers themselves. Most of the rest are passengers of the drink or drug driver.
Table 5: Casualties in reported road collisions where at least one deceased driver had an impairment drug detected, GB: 2014 to 2021
| Category | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 |
|---|---|---|---|---|---|---|---|---|
| Killed | 117 | 153 | 204 | 224 | 235 | 186 | 175 | 190 |
| Seriously injured | 38 | 37 | 73 | 64 | 59 | 53 | 42 | 49 |
| Slightly injured | 38 | 46 | 61 | 76 | 56 | 48 | 40 | 43 |
| All casualties | 193 | 236 | 338 | 364 | 350 | 287 | 257 | 282 |
| Fatalities: driver with drugs detected | 106 | 138 | 188 | 202 | 209 | 172 | 167 | 172 |
| Fatalities: other | 11 | 15 | 16 | 22 | 26 | 14 | 8 | 18 |
| Percentage of casualties that were fatalities | 61% | 65% | 60% | 62% | 67% | 65% | 68% | 67% |
| Percentage of fatalities that were drug drivers | 91% | 90% | 92% | 90% | 89% | 92% | 95% | 91% |
Table 6: Casualties in reported road collisions where at least one deceased driver had alcohol detected, GB: 2014 to 2021
| Category | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 |
|---|---|---|---|---|---|---|---|---|
| Killed | 180 | 163 | 170 | 194 | 200 | 160 | 154 | 178 |
| Seriously injured | 47 | 35 | 58 | 62 | 56 | 42 | 36 | 41 |
| Slightly injured | 40 | 55 | 41 | 57 | 50 | 23 | 31 | 32 |
| All casualties | 267 | 253 | 269 | 313 | 306 | 225 | 221 | 251 |
| Fatalities: driver with alcohol detected | 162 | 143 | 155 | 172 | 175 | 143 | 138 | 155 |
| Fatalities: other | 18 | 20 | 15 | 22 | 25 | 17 | 16 | 23 |
| Percentage of casualties that were fatalities | 67% | 64% | 63% | 62% | 65% | 71% | 70% | 71% |
| Percentage of fatalities that were drink drivers | 90% | 88% | 91% | 89% | 88% | 89% | 90% | 87% |
Levels of drugs and alcohol detected
Table 7 shows the number of drivers with drugs detected, that are under or over the legal limits for each year from 2014 to 2021. Also included are cases where no drugs were reported.
The level of alcohol detected is shown for each of the drug limit categories to enable a comparision between the levels of drugs and alcohol to be made. The main points include:
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there were no drugs reported for 77% of deceased drivers. Of these over 70% had no alcohol present or died after more then 12 hours when the level of alcohol cannot be determined.
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the number of drivers that had some drugs present but less than the drug drive limit was 11%. More than 60% of these had no alcohol present or died after more than 12 hours.
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only 1% of drivers were over the drug drive limit but under twice the limit.
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yet 11% were more than twice over the drug drive limit. Of these nearly 60% had no alcohol present or died after more than 12 hours. However, over 30% of these were over the drink drive limit as well.
Table 7: Levels of drugs and alcohol detected in deceased drivers, GB: 2014 to 2021
| Drug level | Alcohol level | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | All years | % All years |
|---|---|---|---|---|---|---|---|---|---|---|---|
| under the limit | under the limit | 8 | 11 | 23 | 6 | 15 | 11 | 12 | 13 | 99 | 1.3 |
| under the limit | over the limit | 6 | 10 | 7 | 13 | 6 | 3 | 6 | 14 | 65 | 0.9 |
| under the limit | more than twice over the limit | 12 | 5 | 13 | 23 | 13 | 16 | 7 | 12 | 101 | 1.4 |
| under the limit | level present but unknown | 2 | 3 | 12 | 9 | 1 | 3 | 13 | 0 | 43 | 0.6 |
| under the limit | low or trace | 35 | 50 | 58 | 48 | 53 | 41 | 33 | 56 | 374 | 5.1 |
| under the limit | died after more than 12 hours | 17 | 15 | 14 | 23 | 23 | 28 | 21 | 2 | 143 | 1.9 |
| over the limit | under the limit | 1 | 0 | 1 | 1 | 2 | 1 | 0 | 1 | 7 | 0.1 |
| over the limit | over the limit | 0 | 2 | 2 | 1 | 0 | 1 | 1 | 1 | 8 | 0.1 |
| over the limit | more than twice over the limit | 0 | 0 | 1 | 1 | 2 | 1 | 2 | 0 | 7 | 0.1 |
| over the limit | level present but unknown | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 2 | 0.0 |
| over the limit | low or trace | 3 | 7 | 8 | 10 | 10 | 3 | 5 | 4 | 50 | 0.7 |
| over the limit | died after more than 12 hours | 3 | 2 | 2 | 2 | 5 | 1 | 5 | 2 | 22 | 0.3 |
| more than twice over the limit | under the limit | 3 | 5 | 7 | 17 | 8 | 8 | 10 | 9 | 67 | 0.9 |
| more than twice over the limit | over the limit | 8 | 6 | 13 | 14 | 15 | 15 | 12 | 30 | 113 | 1.5 |
| more than twice over the limit | more than twice over the limit | 4 | 17 | 21 | 23 | 30 | 13 | 17 | 22 | 147 | 2.0 |
| more than twice over the limit | level present but unknown | 1 | 0 | 2 | 9 | 2 | 0 | 5 | 0 | 19 | 0.3 |
| more than twice over the limit | low or trace | 18 | 26 | 55 | 58 | 57 | 44 | 40 | 53 | 351 | 4.8 |
| more than twice over the limit | died after more than 12 hours | 3 | 2 | 16 | 13 | 17 | 16 | 20 | 6 | 93 | 1.3 |
| no drugs reported | under the limit | 58 | 51 | 50 | 53 | 70 | 40 | 53 | 31 | 406 | 5.5 |
| no drugs reported | over the limit | 30 | 17 | 14 | 23 | 17 | 25 | 17 | 21 | 164 | 2.2 |
| no drugs reported | more than twice over the limit | 47 | 43 | 49 | 42 | 35 | 38 | 35 | 40 | 329 | 4.5 |
| no drugs reported | level present but unknown | 66 | 58 | 77 | 87 | 76 | 78 | 81 | 0 | 523 | 7.1 |
| no drugs reported | low or trace | 411 | 409 | 380 | 399 | 381 | 327 | 266 | 345 | 2,918 | 39.8 |
| no drugs reported | died after more than 12 hours | 159 | 185 | 153 | 134 | 155 | 166 | 136 | 195 | 1,283 | 17.5 |
Notes
For the above table:
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the drugs reported are those specified in drug driving legislation
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where actual readings are not reported for drugs, a decriptor is used, in this table ‘low or trace’ is seperated from ‘level present but unknown’
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no drugs reported is where a coroner’s report on alcohol levels is provided but no toxcology report
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alcohol ‘level present or unknown’ is where the Blood Alcohol Content (BAC) is not reported
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alcohol ‘low or trace’ is under 10 mg per 100ml
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alcohol ‘died after more than 12 hours’ is where the alcohol level cannot be determined due to the time between the collision and time of death, in 2021 this includes some cases where blood alcohol levels were unknown
Type of drug detected
An examination of the level of different drugs in the body has been undertaken. This is shown in table 8 by the age of the deceased driver.
Each of the combinations of alcohol, medicinal drugs and illegal drugs along with all driver fatalities are shown.
‘Alcohol or drugs’ is the total number of fatalities in collisions in which at least one driver or rider was over the drink drive or drug drive limit. ‘Fatalities’ is the number of fatalities in collisions in which a coroners report was received.
The table shows that the percentage of fatalities in which at least one driver or rider is over the limit is higher for drivers or riders aged 16 to 39 than those aged 40 and over.
Table 8: Type of drugs detected, by age of deceased driver, GB: 2014 to 2021
| AgeGroup | Alcohol only | Medicinal only | Illegal only | Alcohol and medicinal | Alcohol and illegal | Medicinal and illegal | Alcohol, medicinal and illegal | Alcohol or drugs | Fatalities | % over the limit |
|---|---|---|---|---|---|---|---|---|---|---|
| 16 to 19 | 26 | 3 | 38 | 0 | 5 | 0 | 0 | 72 | 565 | 13 |
| 20 to 24 | 93 | 2 | 89 | 3 | 39 | 2 | 0 | 228 | 1,444 | 16 |
| 25 to 29 | 111 | 1 | 88 | 2 | 45 | 2 | 1 | 250 | 1,440 | 17 |
| 30 to 39 | 165 | 16 | 110 | 1 | 61 | 6 | 2 | 361 | 2,218 | 16 |
| 40 to 49 | 103 | 22 | 50 | 3 | 13 | 2 | 1 | 194 | 2,152 | 9 |
| 50 to 59 | 68 | 12 | 26 | 1 | 3 | 2 | 0 | 112 | 2,203 | 5 |
| 60 to 69 | 31 | 5 | 6 | 0 | 0 | 0 | 0 | 42 | 1,255 | 3 |
| 70 or over | 12 | 9 | 9 | 0 | 0 | 0 | 0 | 30 | 1,047 | 3 |
Estimate of the number of fatalities in reported road collisions when one driver or rider is over the drink drive or drug drive limit
Table 9 shows the estimated number of fatalities in collision when one or more deceased drivers or riders were either over the drink-drive limit or drug-drive limit for drugs of abuse, based on the limits set. It is important to note that drug driving limits relate to tests on living people, and that levels of drugs in the body can change after death. In addition, limits for drug-driving are set low for illegal drugs, as a ‘zero tolerance’ approach. Therefore these results may not reflect whether a driver was impaired by drugs at the time of death and should be treated in line with the rest of this report as part of a feasibility study.
Therefore, while these figures are presented as a high-level illustration of the comparison between drink and drugs, they should be interpreted with great caution and are included in this feasibility for further feedback and development.
As these results are based on coroners data only, the drink-drive estimates are lower than the headline drink-drive figures which includes collisions where the police conducted a breath test.
The estimated number of fatalities in reported road collisions in which at least one of the deceased drivers or riders was over the drink drive limit was higher than those over a drug driving limit up to 2015. Each year since 2016 the drug driving estimate has been higher.
The drugs which contribute to the total for drivers being over the in-life drug-drive limits are mainly cannabis or cocaine (or their metabolites). This likely reflects the prevalence of these drugs, how they behave in the body following death, the nature of tests conducted as well as the zero tolerance nature of the limits. Further work is required to explore this data and we welcome comments and suggestions from potential users of the statistics on whether statistics of this natuere are useful, or not.
Table 9: Number of fatalities in reported road collisions; where alcohol or drugs over the limit was found, GB: 2014 to 2021
| Year | Drink drive estimate | Drug drive estimate |
|---|---|---|
| 2014 | 130 | 70 |
| 2015 | 110 | 70 |
| 2016 | 120 | 130 |
| 2017 | 140 | 140 |
| 2018 | 120 | 150 |
| 2019 | 120 | 120 |
| 2020 | 100 | 130 |
| 2021 | 150 | 160 |
Next steps
The above is a summary of data on drugs detected among those killed in road collisions where toxicology data is available (via data collection from coroners) which we intend to develop further to assess whether robust statistics on drug driving can be produced.
While there are a number of caveats which must be kept in mind, we believe that these results are promising in terms of the amount of data captured and the broad comparability with, for example, data from contributory factors.
In the longer term, exploring what data on drug testing might be available from the CRASH system to capture cases where the driver does not die (as is the case with breath tests for drink driving)
We welcome feedback from potential users of these statistics on the initial analysis, or the proposed next steps, to inform future work in this area.
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