Geographical variations in deaths related to drug misuse in England and Wales, 1993-2006.

Drug misuse is a significant public health issue in England and Wales. This article examines geographical variations in drug misuse mortality in England and Wales over the period 1993 t 2006. Geographical variations in deaths related to drug misuse have generally persisted over this period, one of substantial change in these deaths (with a peak in 2001 and numbers in 2006 being almost double those in 1993), although there were some significant changes to the regional level pattern. The regions with the highest mortality rates aggregated over the whole time period were the North West, Yorkshire and The Humber, and London, although by 2004/06 the rate in London was among the lowest and the rate in the North East was higher than the North West. Three Drug Action Teams (DATs), Brighton and Hove, Blackpool, and Camden, consistently had the highest drug misuse mortality rates. Urban areas tended to have the highest rates, but the rate in the most sparsely populated areas was similar to those of towns. The mortality rate in the most deprived parts of England and Wales was five times the rate in the least deprived areas. Areas with low rates were generally large, mostly rural areas, as well as areas in outer London and the south east of England.