Scotland drug deaths decrease - but rate still higher than rest of Europe
The country has seen a reduction in the number of people dying as a result of drug misuse for the second year running, after decades of constant rises.
Tuesday 22 August 2023 18:30, UK
Just over 1,000 people in Scotland died as a result of drug misuse in 2022, the lowest number since 2017.
It is 288 fewer than the peak of 1,339 recorded in 2020.
The lower number of 1,051 is still equivalent to almost three people dying every day, and is by far the highest rate of any country in Europe, including the rest of Great Britain.
In fact Scotland's drug death rate is still more than three times higher than the next worst affected European country.
The recent fall is led by a reduction in the number of men and 25 to 55-year-olds dying, but there are still rising deaths among older people and the number of deaths among women has remained high.
Elena Whitham, the SNP Drugs and Alcohol Policy Minister for Scotland, said: "My sympathy goes out to all those affected by the loss of a loved one through drugs.
"While I am pleased to see that hundreds of families have been spared this agony and lives have been saved, every life lost is a tragedy and the number of deaths is still too high."
Which areas are worst affected?
Glasgow City has overtaken Dundee this year with the highest drug misuse death rate of all local authority areas, with 44.4 people dying per 100,000 population, more than twice as high as the average across Scotland as a whole (19.8).
The rate in Dundee was slightly lower at 43.1, followed by Inverclyde at 37.6.
A clear link remains between deprivation and drug deaths, with people in the most deprived areas nearly 16 times more likely to die than those in the least deprived areas.
The reduction this year was fastest in the most deprived parts of Scotland, however, falling by a fifth since 2021.
Read more:
'I lost my leg to £15 heroin hit' - on the frontline of Scotland's drug epidemic
Deaths among women catching up with men
Men were exactly twice as likely to die from drug-related deaths in Scotland in 2022 compared with women, although that ratio has narrowed significantly in recent years, including a faster reduction in male deaths this year.
Since 2000 the number of men dying has tripled while the number of women has gone up seven times.
'The trainspotting generation'
The number of under-35s dying as a result of drug misuse has stayed relatively static over the past 20 years.
Younger age groups used to be the most likely to die, but now it's most common among people in their 40s - the average age of someone dying from drug misuse in Scotland is now 45, having been 32 in 2000.
Many of those people will have been coming of age in the late 1990s when Irvine Welsh's genre-defining novel about Scotland's drug culture, Trainspotting, was turned into a film by Danny Boyle, starring Ewan McGregor.
Deaths among that age group have more than doubled in the last 10 years alone, although there were significant reductions this year. This year saw reductions in every age group other than those aged 55 or over.
Speaking to Sky News, Welsh said the country "has always had a really bad relationship with intoxication".
"If you combine the kind of deep sense of systemic poverty that's existed and the complete apathy of governments over the years, then… you have this sort of thing that's ongoing.
"We've got all these cultural issues that relate to kind of Scotland's place in the world and Scotland's identity or… lack of, but there's a broader pattern.
Describing local politicians as a "glorified town council", Welsh added: "It seems to be people who won't do anything, and people who can't do anything, pointing the fingers at each other and blaming each other.
"What else are people going to do? They're not going to go to college, there's no investment in the communities, there's no employment for people - there is literally nothing else except drugs.
"And we have a cultural relationship with drugs in Scotland which compounds the issue."
What type of drugs are involved?
Cocaine was the only main drug class to increase its contribution to deaths this year. In 2021 it was involved in 30.3% of deaths, rising to 35.3% in 2022.
Opiates (for example heroin, morphine and codeine) were the most deadly, contributing to more than four in five deaths, followed by benzodiazepines (sedatives which include Xanax and Valium).
Deaths caused by these two drug classes both fell this year, however, having been responsible for much of the rise over the past decade.
More than nine in 10 drug deaths are caused by users taking a combination of more than one type of drug.
What's being done to help?
Ms Whitham said she will "never underestimate the scale of the challenge we continue to face", and that the Scottish government would continue to support grass-roots projects delivering vital services, as well as council and government-led schemes.
"As part of our £250 million National Mission on drugs, we'll continue to focus on getting more people into the form of treatment and support they need, expand access to residential rehabilitation and drive the rollout of life-saving Medication Assisted Treatment (MAT) Standards where we are making significant progress.
"As we highlighted in our recent Drug Law Reform proposals, the UK government could do more to work with us to help introduce harm reduction measures."
Standards for medical therapies to treat drug addiction were published in May 2021 as part of the Scottish government's National Drugs Mission Plan.
These include a range of targets known as the Medical Assisted Treatment (MAT) standards, for treatments including opioid substitution therapy with drugs such as methadone.
The first of these targets is that all people accessing services have the option to start medical assisted treatment from the same day of presentation. Data from Public Health Scotland shows that so far this target has not been met, although improvements have been made in the past year.
Half of the people who requested a prescription received it on the same day in 2023 on average across Scotland, while three-quarters received it within four days.
In 2022 however, half of those who requested a prescription received it within a much longer six days. with a range of four to 23 days.
Previous to the new MAT standards, data on the waits experienced by people commencing this type of treatment in Scotland were not available. As a result, there is no comparative data for earlier years.
Dr Andrew McCauley, the research lead for an ongoing NHS Public Health Scotland project involving people who inject drugs, told Sky News that the new figures were really welcome after such a consistent rise over a long period.
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But he added that "we can't say 'job done' on the basis of one year's worth of data showing a drop".
"Figures for Scotland are still comfortably three times higher than the rest of the UK, which put us top of the European charts and near the top of the global charts."
He said that the Scottish government deserves credit for recognising in 2019 that they were part of the problem and adjusting their response, but that this was not the only reason for the fall this year.
The pandemic ending also helped, as people were able to access treatment and care services again. And the fact there have been so many deaths in recent years among the at-risk population simply means that "deaths couldn't go on at the same rate".
He added that work needed to be done on health, inequality and poverty for Scotland to catch up with the rest of Britain and Europe.
"Poverty and inequality affects people's access to treatment, but it also affects people's opportunities in life as well and lots of the other ways they can overcome addiction - through employment, welfare, training, education."
The worst affected parts of England, with similar poverty levels to Scotland, have half as many drug deaths than Scotland as a whole.
"Poverty in Scotland is much more concentrated and complex and affects people's morbidity and mortality in much more stark ways than it does other parts of the country."
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