A new report has revealed that more than 600 people in the West Midlands died as a result of drug misuse over a two-year period, with Birmingham facing the most acute challenge in the region.
The West Midlands State of the Region 2026 study, which will be presented to the West Midlands Combined Authority's Local Scrutiny Committee on Monday, September 7, found that there were 9,697 deaths from drug misuse across England between 2022 and 2024. Of these, 613 occurred in the West Midlands Combined Authority area, which includes Birmingham, Coventry, Dudley, Sandwell, Solihull, Walsall and Wolverhampton.
The report highlighted that Birmingham had the highest death rate in the region, with 10 deaths per 100,000 people, followed by Coventry with 8.7 deaths per 100,000. Wolverhampton recorded 8.5 deaths per 100,000, while Walsall had 6.5, Dudley 5, Solihull 3.9 and Sandwell 1.7.
Birmingham's drug misuse crisis
According to the report, Birmingham's death rate is 1.7 times the national average and accounts for more than half of all drug misuse deaths in the West Midlands Combined Authority area. The report states: "Across the seven LAs, Birmingham faces the most acute challenge, recording a rate of 10.0 deaths per 100,000. This is 1.7 times the national average and accounts for more than half of all drug misuse deaths in the WMCA."
The report also noted that 6.3 per cent of all drug misuse deaths in England (614 deaths) occurred within the WMCA area. It cited data from the Crime Survey for England and Wales, which indicated that approximately 8.7 per cent of adults aged 16 to 59 (approximately 2.9 million people) reported using drugs in the year ending March 2025.
More concerning, the report said, is the spike in frequent drug use among young people. For those aged 16 to 24, the figure rose from 2.5 per cent to 3.5 per cent in just twelve months to March 2025.
Smoking rates decline but vaping rises
The report also examined smoking rates across the region, which continue to decrease. The mean rate of current smokers in the WMCA area fell from 14.6 per cent in 2019 to 12.7 per cent. Solihull recorded the lowest rate in the region at 10 per cent, followed closely by Coventry at 10.6 per cent – both approaching the England average of 10.4 per cent.
Sandwell was the only area to see a rise, with its rate increasing from 15.3 per cent to 16.8 per cent – the highest in the region. Rates among males were higher than females across most of the region, except in Dudley where the female rate was 12.4 per cent compared with 11 per cent for men. In Birmingham, 16.3 per cent of males were current smokers, more than double the rate for women at eight per cent.
The report also raised concerns about the increase in vape use, with national e-cigarette users more than doubling from 6.6 per cent in 2020 to 15.3 per cent in 2024. It said this is "raising longer term questions about the health implications of sustained e-cigarette use."
Impact and next steps
The findings will be discussed at the Local Scrutiny Committee meeting on September 7, where members are expected to consider the implications for public health policy across the region. The report's data on drug misuse deaths and smoking rates will inform future strategies to address these challenges, particularly in Birmingham, which faces the highest death rate in the WMCA area.
