There were 1,133 drug-related deaths recorded by National Records of Scotland (NRS) last year, an 11 per cent increase on 2024.
The overall average age of death was 46. The rate of drug deaths among males rose by nearly 20 per cent compared to 2024, but deaths among females fell by 5 per cent. The death rate per 100,000 people is now 21.4 – four times higher than in 2000 when records began.
Nitazenes were implicated in almost 250 deaths, with etonitazene – the most common nitazene – implicated in 215. Public Health Scotland recently warned that anyone using street drugs should ‘assume they are contaminated with other substances’. While opiates/opioids were implicated in 78 per cent of deaths, cocaine was implicated in 52 per cent – 23 per cent higher than in the previous year, and the highest number since records began. Benzodiazepines were implicated in 38 per cent of deaths, and gabapentin and/or pregabalin in 29 per cent. More than one drug was implicated in nearly 80 per cent of all drug use deaths.
Scotland’s drug death rate is now 15 times higher in the most deprived areas than the least deprived, with deaths in increasing in 20 local authority areas and falling in ten. Over the past five years, drug death rates have been higher than the Scottish average in Glasgow City, Dundee City, North Ayrshire, Inverclyde, West Dunbartonshire and East Ayrshire. Scotland’s drug fatality rate has long been the worst in Europe, with the country’s drug poisoning death rate 2.4 times that of England.
Earlier this a year a report from the Social Market Foundation estimated the financial cost of drug harm to Scotland at around £6bn per year. While 2024 saw a 13 per cent fall in drug deaths, this could prove to be ‘nothing more than a blip’ in the overall upward trend, the organisation warned. The Scottish Government published its ten-year plan to reduce drug and alcohol deaths in March.
‘The number of drug use deaths in Scotland is below the peak of 2020 but still the sixth highest year on record,’ said head of vital events statistics at NRS, Phillipa Haxton. ‘Deaths among males drove the latest increase. The number of deaths among females is at its lowest since 2017.’
The fact that nitazenes were implicated in one in five deaths was ‘a stark indication’ of the changing risks, said Scottish Drugs Forum chief executive Kirsten Horsburgh. ‘We must act quickly to expand the support and services that can help people reduce harm – such as safer drug consumption facilities, drug checking services, and the wider provision of harm reduction equipment.’ However, no single intervention would end Scotland’s drug-related deaths crisis, she stated. ‘We need effective prevention, treatment and recovery support, alongside action across government to overcome the deep-rooted social and economic conditions that shape people’s health.’Â
‘People will rightly ask why so many are still losing their lives,’ said national harm reduction lead at WithYou, Gareth Balmer. ‘We’ve had strategies, task forces, targets and pilots, yet Scotland continues to lose more than a thousand people a year to this crisis.’ While synthetic opioids in the drug supply were ‘clearly part of it’, dangerous and unpredictable drug markets also existed elsewhere, he said. ‘What stands out here is how closely deaths follow poverty, poor health, trauma and exclusion. Stigma is still a real barrier, too. People who use drugs are judged in a way people with many other health problems aren’t, and that affects whether someone asks for help, how they’re treated when they do, and, for some, whether they survive.’
‘Scotland remains in the grip of a drugs death crisis, which is being made even more difficult to control by the emergence of new synthetic opioids and other substances,’ said Abbeycare chief executive Paul Bowley. ‘It is clear that the national mission to reduce the harms caused by drugs has much work still to do, with more investment needed in treatment and recovery services and clearer pathways for people to seek help.’
Drug-related deaths in Scotland, 2025 available here