The topic of drug-related deaths went quiet for many years during the major focus on HIV and the prevention of the spread of HIV and AIDS. Of course the problem of drug-related mortality never went away. Now it is very welcome to have a comprehensive and thoughtful review from the Advisory Council on the Misuse of Drugs. This report collates a vast amount of epidemiological information and will be a key resource on the subject for anyone wishing to review or research it.

The report outlines the current state of knowledge and the difficulties that any strategy to reduce drug-related deaths faces. In particular, the current classification systems and the current coronial system lack consistency and are in need of a major overhaul. Drug-related deaths have increased in number very significantly over the past 2 decades and they now come a close second to deaths from road traffic accidents.

Reducing Drug Related Deaths provides a good balanced review of the role of agonist maintenance pharmacotherapy and outlines how such treatment has a major impact on reducing drug-related deaths among opiate-dependent individuals. However, it also points out that in the UK, as a result of diversion and possibly some other reasons, there is a disproportionate number of methadone-related deaths. It supports the recommendations from the Guidelines for the Clinical Management of Drug Dependence Working Group for tighter supervision and control of methadone prescribing and calls for urgent and radical action to ensure that methadone-related deaths be reduced.

I am sure that I will return time and again to this report as a key source of documented and referenced material on drug-related deaths. I trust that as a report it will impact strongly on the field and be part of the process of reducing drug-related deaths.