Association between disability-related budget reductions and increasing drug-related mortality across local authorities in Great Britain

Drug-related mortality in the UK rose markedly after 2012. Here we test the hypothesis that cuts to disability-related spending were associated with increased drug-related mortality across local governments in Great Britain. We regressed changes in drug-related death rates (years 2010–12 versus 2015–17) on local government disability-related budget reductions, adjusting for a range of regional, demographic, and economic factors. Budget reductions are captured with a combined measure of financial losses due to Incapacity Benefit and Disability Living Allowance reforms, expressed in pounds sterling per capita, per year. 364 local authorities across England, Scotland, and Wales were included in the study. Greater budget reductions were associated with greater increases in drug-related death rates. In the unadjusted model, each £100 per capita budget reduction was associated with an increase in drug-related death rates of 3.30 per 100 000 population (95% CI: 2.43 to 4.17). The magnitude of the association increased after adjusting for region and demographic factors (b = 4.84; 95% CI: 3.26 to 6.43). The association remained statistically significant after adjusting for a full set of controls, including baseline and trends in unemployment rates, median hourly pay, and gross disposable household income per capita (b = 4.41; 95% CI: 2.57 to 6.24). Deeper cuts to local government spending in Great Britain in the 2010s were associated with larger increases in drug-related deaths. •Drug-related mortality in the UK has increased substantially since 2012.•One hypothesis that has yet to be explored is the role of austerity measures in the UK.•Increases in drug mortality rates correlated with disability-related budget reductions.•Continued budget cuts could exacerbate the rise of drug-related mortality in the UK.