This study examined the impact of drug misuse on sudden, unexpected, violent or unnatural male deaths, checking the association between official mortality statistics, health records, and coroner evidence and verdicts. However, complexities in cause of death classification where drug use is a factor make it difficult to be confident of estimates of the impact of drug misuse on rising male mortality. A report by the Advisory Council on the Misuse of Drugs (ACMD), 2000 argued that the system for recording deaths is inadequate for systematic data collection. The report identified a range of problems within the current system including: variability in the conduct of toxicological examinations; unsatisfactory and confusing verdict choice; no recording of whether a toxicological examination was carried out and whether injecting drug misuse was involved; and conflicts between the coding frame used by the Office of National Statistics (ONS) and that used by coroners. The study suggests the use of a standardized set of criteria for recording drug-related deaths such as that developed by the European Union. The study explored the relationship between accidental/undetermined and suicide verdicts, and post-mortem drug and alcohol toxicity. The study included 238 cases; 221 had toxicological data and formed the final sample. There was post-mortem evidence of drugs in 90 cases, alcohol in 102, and both in 46. Overdose verdicts were given in 74 cases. The study found evidence of significant alcohol problems in 18 cases and drug misuse in 74 cases. Analysis of the data found that the presence of drugs at post-mortem was significantly related to accidental/undetermined verdicts rather than suicide. While coroners determined drugs to be related to death in 90 cases, official classifications would have recorded this figure as 60 using the ONS standard or 40 using the European Union recommended classification. The findings support the ACMD report examining the reduction of drug related deaths. Tables, references