There are ‘early signs of new changes’ in the street benzo market in Scotland, says the latest Rapid Action Drug Alerts and Response (RADAR) quarterly report from Public Health Scotland (PHS).
A new street benzodiazepine, ethylbromazolam, has now been detected 16 times in Scottish WEDINOS samples from seven NHS board areas following no previous detections. It has also been detected in hospital toxicology for the first time.
‘There is a risk that people who use drugs are at increased risk of overdose and death if ethylbromazolam, a sedating and emergent benzodiazepine, establishes itself in the Scottish market,’ PHS states.
Suspected drug deaths between June and August this year were down by 13 per cent on the previous quarter, but were 12 per cent higher than the corresponding quarter in 2024, the report continues.
Scottish Ambulance Service naloxone administration incidents were 11 per cent up on the previous quarter and 12 per cent higher than the corresponding quarter last year, while drug related attendances at A&E departments and drug-related hospital admissions were 8 and 10 per cent higher than the previous quarter respectively. While the latest set of official drug death statistics – published by National Records of Scotland last month – showed a 13 per cent fall to 1,107, the total is still almost four times higher than 25 years ago.
Contamination of drugs with toxic substances remains ‘both common and widespread’ in Scotland, PHS says, with an ‘urgent need for accessible drug checking services across the country’. Nitazenes have previously been detected in drugs sold as heroin, benzodiazepines and oxycodone in Scotland, with more than half of Scottish samples submitted to WEDINOS not ‘solely’ containing the intended purchase. A new xylazine type drug, medetomidine, is also now being used as an adulterant in heroin, the report adds.
There was a 4 per cent decrease in drug treatment starts compared to the previous quarter, with powder cocaine now the most commonly reported main drug for people being assessed for treatment.
There is an ‘urgent’ need for coordination to improve the country’s ability to respond to polysubstance use and a continually evolving drug market, the report states. ‘Drug-related harms were higher between June and August 2025 compared to the same period in 2024, but lower than in 2023. Most harms involved multiple drugs, reflecting continued polysubstance use. Significant market shifts were observed: detections of nitazene-type opioids in deaths reached their highest level to date; cocaine was the most frequently reported drug across treatment and toxicology data; and a new street benzodiazepine, ethylbromazolam, emerged.’
The changing profile of the drug market was contributing ‘to a very high likelihood of sudden, localised spikes of severe harms’, it continues. ‘There remains an urgent need for evidence-based benzodiazepine harm reduction and treatment support interventions to be delivered at scale. These should be available for community and prison settings.’
Scotland’s public health response needed to ‘move faster to keep pace with the rapidly changing drugs landscape,’ added Scottish Drugs Forum chief executive Kirsten Horsburgh. ‘The planned introduction of drug checking services in Dundee and Glasgow is a long-overdue step forward. These facilities will save lives by allowing people to check their drugs for dangerous contaminants, such as nitazenes, and make informed decisions about their own health. But two sites alone are nowhere near enough. To prevent further harms and loss of life, drug checking must be made available in every part of the country.’
Rapid Action Drug Alerts and Response (RADAR) quarterly report
October 2025 available here