Drug-related Deaths in Scotland: an Ongoing Problem

Scotland’s drug abuse problem has been recognised for some time now. The movie Trainspotting first shed light on this epidemic, which has been growing since the 1980s. Unfortunately, the problem is still there and seems to be getting worse every year. More than drug use itself, the mortality rates are of great concern. Drug-related deaths in Scotland have been steadily rising, and they show no signs of slowing.

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The latest data from National Records of Scotland show that 2017 had 934 deaths, one of the highest recorded statistics for drug-related deaths in Scotland since 1996. That’s more than double just a decade ago (445 deaths), nearly 2.5 times the UK average. The rate of drug deaths in Scotland is the highest in Europe. For Scotland alone, it is about 8% higher than the previous year.

These numbers have forced the government to classify the situation as an emergency. Although many steps have been taken to alleviate the problem in the past, now it’s time to get serious.

What Drugs Are Responsible for Scotland’s Deaths?

One of the things that was noticed in the 2017 data is that poly-drug use is on the rise. There is often no one drug that is held to be responsible. However, the biggest sources of the problem appear to be opioids, benzodiazepines, and methadone.

Opioids have always accounted for a large percentage of drug-related harm in the UK. But this year has seen a notable rise in deaths from prescription opioids as well. Heroin, morphine, methadone, fentanyl, and other prescription painkillers contributed to 87% of drug-related deaths. Methadone is often used as a harm-reducing substitute in opioid-addiction treatment. It was involved in significantly more deaths than the years before.

Benzodiazepines are the second-largest contributor, and were involved in 59% of drug-related deaths.

Other popular illicit drugs, such as cocaine, amphetamines, and MDMA, were accountable for a relatively low number of deaths in comparison.

Over the past several years, there has been a significant shift in the patterns of drug misuse, especially concerning medications originally prescribed for medical purposes.

In 2008, less than 1% of drug-related fatalities involved gabapentin and/or pregabalin, medications commonly prescribed for epilepsy and nerve pain. However, by 2022, this figure had skyrocketed to 35%. Concurrently, there was a noticeable uptick in the proportion of deaths involving cocaine, with figures rising from 6% in 2008 to 35% in 2022.

The trends surrounding alcohol’s role in drug misuse deaths are different. While the absolute number of these cases has remained relatively consistent over the years, the proportion has seen a decrease, falling from 29% in 2008 to 11% in 2021.

New Psychoactive Substances (NPSs) have emerged as a concern. Designed to replicate the effects of illegal drugs such as cocaine and ecstasy, their prevalence has grown in recent times. According to the NRS by 2022, controlled NPSs were involves in as many as 476 drug misuse deaths. It’s essential to highlight that a significant majority of these NPSs were benzodiazepines, with etizolam being a notable example.

These statistics underline the pressing need for increased awareness, monitoring, and interventions in the realm of drug misuse.

Poverty Is A Problem

According to the report, drug use disorders are 17 times higher, and alcohol dependence is more than 8 times higher in deprived communities. About 1 in 5 homeless people have some sort of drug or alcohol problem, and/or comorbid mental disorder. This shows that the problem may be influenced by the lack of support for addiction and dual diagnosis.

People in deprived communities also make up about 50% of drug-related hospital admissions and 40% of alcohol-related hospital admissions.

Female Drug Deaths in Scotland Are Increasing

Although males account for 70% of all drug-related deaths, the increase in mortality among women is becoming more and more worrying. Specifically, the problem appears to be the biggest among women aged 55 and over.

It is unclear why exactly female drug use is increasing. One potential contributing factor could be the concurrent rise in women’s mental and physical health problems. In addition, women often experience addiction and recovery differently than men do for a number of reasons. Castle Craig offers women’s only therapy, but it can be difficult to find other rehabs that do, which could be important to keep women from relapsing.

Attention on the Ageing Population

The main age group of concern is referred to as the “Trainspotting generation” people who started using in the 80s and 90s. In 2017, people over 35 accounted for nearly three-quarters of all drug-related deaths in Scotland. In 2009, that same age group accounted for only about half of them. The average age for drug-related mortalities are 41 and 34.

However, it is encouraging that the data also shows that drugs are becoming less of a problem among younger people. Scotland’s drug-related deaths in those under 25, and 25-34 are decreasing and have been since 2012. Nearly two decades ago, the case was quite the opposite.

This is one of the many statistics proving that today’s younger generations are less likely to use alcohol or drugs. It also shows that there needs to be a larger focus on the ageing population when it comes to drug abuse.

What Can Be Done about Scotland’s Drug-related Deaths?

There are a number of ways to address drug use and drug-related harm. In addition to improving the availability of and access to treatment, it would be wise to implement more harm-reduction services. It is also important to educate the public about substance abuse. All of these approaches will help reduce stigma as well, which can help people in the future.

Access to Treatment

The lack of availability of drug and alcohol treatment is definitely making the problem worse. Only 40% of problem drug users have received treatment in Scotland. This is low when you compare it to 60% in England and Wales, and 80% in Europe. Because comorbid psychological conditions are known to influence substance abuse, mental health needs to be addressed as well at a dual diagnosis rehab.

Treatment options need to be made available throughout the country. The top three areas for drug-related deaths in Scotland, and therefore require more focus, are Dundee, Glasgow, and Inverclyde. In fact, Glasgow has seen the largest jump in drug-related deaths from the previous years.

In addition to improving access to treatment, there needs to be a focus on retention in treatment and relapse prevention. Indeed, relapse is a major consideration, and cannot be ignored, especially with highly addictive drugs such as opioids.


While harm-reduction will not solve the growing drug problem, it can alleviate the damage caused by drug abuse. Because opiates, such as heroin, are the largest cause of drug-related deaths in Scotland, it could very well help to introduce more harm-reduction centres. Providing more safe-injection sites, clean needles, drug-testing kits, and naloxone could greatly reduce overdose deaths and the rise in HIV rates.

Opioid-substitution treatments can help, but they can also harm. There are problem users who claim that being accepted into one of these programs isn’t easy. This forces them to turn to street methadone as a means of self-treatment, which is dangerous. Some people also argue that there are already too many methadone patients that aren’t being given necessary attention, leaving them stuck on methadone for far longer than they need to be.

Positive Outlook for Scotland’s Substance Abuse Problem

Although Scotland has spent over £740 million in the last decade trying to address the epidemic, clearly more needs to be done. Following these findings, the Scottish government has made addressing substance abuse a priority. With the establishment of a drug-expertise group, hopefully we will see progress in the near future.

Finding help for drug or alcohol addiction isn’t always easy but it is possible. Despite limited access to treatment, more people are seeking help. For example, there has been an increase of peer-led recovery and support groups in the country. Support groups are a great way to address one’s addiction and begin the journey to recovery.

For more serious addictions, however, it is better to inquire about residential rehab. With highly addictive drugs, it can be difficult to quit without proper care. Although not wide-spread, there are plenty of rehabs in Scotland that address various drug, alcohol, or behavioural addictions.

Castle Craig, located just outside Edinburgh and not far from Glasgow, has been treating patients for over 30 years. In addition to accepting private patients, they also work with the NHS to help people receive the treatment they need. If you’d like to enquire about admission, or simply have questions about treatment, don’t hesitate to contact us by phone or email. For general inquiries, contact us at +44 1721 789 152.

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