In 2024, drug misuse deaths in Scotland fell by 13%, down by 155 fatalities to 1,017, marking the lowest level since 2017 .
Despite this decrease, Scotland still holds the highest drug-related death rate in Europe for the seventh consecutive year .
The long-term trend remains troubling: these figures, at 191 deaths per million (age-adjusted), are 3.6 times higher than in 2000—and nearly three times higher than England’s rate, with Estonia trailing as the second highest in Europe .
Regional Disparities
Highest council-area death rates were recorded in Glasgow City, Dundee City, and Inverclyde for the 2020–2024 period .
In Dumfries & Galloway, however, drug deaths doubled to 24 in 2024, compared to 12 the previous year—highlighting growing localized impacts despite national declines .
Emerging Risks & Substances
Substances most frequently involved in 2024 fatalities included:
Opiates and opioids: present in 80% of cases.
Benzodiazepines: 56%.
Cocaine: 47%. Notably, deaths involving cocaine remain at record-high levels (479 deaths for the second year running) .
While deaths involving opiates/opioids and benzodiazepines decreased, the persistence of cocaine-related fatalities underscores its growing threat .
Early 2025: Signs of a Rebound
The first quarter of 2025 saw a sharp rise in suspected drug deaths:
308 deaths between January and March—a 33% increase from the previous quarter, though slightly lower than the same period in the year prior .
Other reports cite 312 suspected fatalities in the same period, which would mark one of the deadliest early quarters in a decade .
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Government Response and Harm-Reduction Efforts
Drugs Minister Maree Todd acknowledged the decline in fatalities but emphasized the need for sustained action, particularly amid emerging threats like synthetic opioids (e.g., nitazenes)—which are highly potent and increasingly implicated in overdose deaths .
The Scottish Government is deploying record levels of funding across drug and alcohol services, expanding access to treatment, residential rehabilitation, and naloxone distribution. Efforts also include drug-checking services and the rollout of Safer Drug Consumption Facilities .
New Safe Injection Facilities
In January 2025, the UK’s first legal drug consumption site, known as The Thistle, opened in Glasgow. It operates daily, offering supervised injection space and reducing public health risks like discarded needles .
A second facility is being proposed in Edinburgh’s Old Town (likely in Cowgate or Spittal Street), with public consultations and a formal business case expected in early 2026. The goal: reduce overdose deaths and address public health harms, though it faces both support and criticism .
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