The most common street benzodiazepine in Scotland is now clonazolam, according to Public Health Scotland’s most recent Rapid Action Drug Alerts and Response (RADAR) quarterly report.
Detections of a new benzodiazepine, ethylbromazolam, have also continued to increase throughout Scotland, while detections of nitazene-type opioids in drug-related deaths have reached their highest level to date. ‘Contamination of drugs with toxic substances is both common and widespread’ the agency warns, adding that there is ‘an urgent need for accessible drug checking services across the country’.
Almost half of Scottish samples submitted to the WEDINOS drug testing service did not just contain the intended purchase, while a new depressant – medetomidine – was detected in five samples bought as diazepam. The ACMD recently warned of the need to ‘be vigilant and monitor for substances, such as xylazine and related compounds such as detomidine and medetomidine’ that might be used to augment the UK’s opioid market, with medetomidine likely to be around 200 times more potent than xylazine.
The majority of drug harms in Scotland continue to involve more than one substance, the RADAR report says, with the average number of controlled substances detected in post-mortem toxicology now five.
However, naloxone administration incidents fell by 25 per cent during September to November last year compared to the previous quarter, although they were 22 per cent up on the same period in 2024. Suspected drug deaths were also 18 per cent down on the previous quarter, with emergency department attendances seeing a 12 per cent fall. Cocaine remained the most frequently reported drug across treatment and toxicology data.
‘The changing profile of drugs contributes to a very high likelihood of sudden, localised spikes of severe harms,’ the report states, adding that there are ‘continued signs’ of a changing street benzo market. ‘There is a risk that people who use drugs are at increased risk of overdose and death if ethylbromazolam and clonazolam (potent emergent benzodiazepines with strong sedative effects), establish themselves in the Scottish market.’
Benzodiazepines had previously contributed to ‘significantly’ increased drug-related harm and deaths in Scotland, it continues, with ‘an urgent need for evidence-based benzodiazepine harm reduction and treatment support interventions to be delivered at scale across Scotland. These should be available for community and prison settings.’
Rapid Action Drug Alerts and Response (RADAR) quarterly report available here