Two Decades of Rising Drug Related Deaths

Data from National Records Scotland reveals Scotland’s drug-related death (DRD) crisis has exploded over the past two decades.   Since 2004 the DRD rate has grown from 356 to 1065 deaths per year (see Figure 1 and Table 1).

Breaking down the data by gender reveals even more distressing disparities. In 2023, male deaths accounted for an ASR of 31.7 compared to 13.6 for females – continuing a long-standing pattern where Scottish men are approximately 2-3 times more likely to die from drug misuse than women (data not shown but available in data sources cited below).

Deprivation is a key driver of drug use and is associated with a high drug-related death rate (see Social Deprivation and Drug-Related Deaths this website).

Figure 1: Long Term Trend in Drug-Related Deaths in Scotland
The number of deaths attributed to drug misuse from 1996 to 2024

Comparison With the Rest of the UK

The regional data for 2022 (the latest data when data for all regions is available) provides stark evidence of how Scotland’s crisis dwarfs that of other UK nations and regions (see Figure 2). With an ASR of 22.7, Scotland’s drug death rate was:

• 4 times higher than London’s rate (5.66)
• 3.4 times higher than the South East (6.73)
• 2.7 times higher than England’s average (8.29)
• Nearly double that of Wales (10.96), the next highest UK nation

Only two English regions – the North East (13.39) and North West (12.66) – approached half of Scotland’s mortality rate. Even Yorkshire and Humber, with the highest English regional rate at 11.54, recorded less than half of Scotland’s figure.

Public Health Scotland has attributed this disparity to a combination of factors including “higher prevalence of problematic drug use, an older cohort of people who use drugs, and more hazardous patterns of drug use” (https://publichealthscotland.scot/publications/drug-related-deaths-in-scotland/drug-related-deaths-in-scotland-2022/).

Figure 2: Comparison of Age Standardised Rates of Drug-Related Death in UK Regions
Age Standardised Rates Drug-Related deaths in UK regions in 2024

Table 1: Drug-Related Deaths in UK Regions
Data for 2022 deaths and ASR rates per 100,000
population in UK regions.

International Comparisons

When placed in a global context, Scotland’s drug death rates stand out as exceptionally high:

According to OECD data, Scotland’s 2022 rate (20.0) was approximately:

• 15 times higher than Portugal’s rate (1.3 in 2021)
• 10 times higher than Italy’s (2.0 in 2021)
• 3 times higher than Canada’s (6.6 in 2021)
• 2.5 times higher than the United States (8.1 in 2021)

A 2023 study in the Lancet noted that “Scotland’s drug-related death rates are now the highest ever recorded by any European country” (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00459-5/fulltext). The researchers highlighted the particular lethality of Scotland’s drug supply, with poly-drug use (especially opioids combined with benzodiazepines) being a major factor.

Data Sources

Main Page for data on drug related deaths
https://www.nrscotland.gov.uk/publications/drug-related-deaths-in-scotland-in-2023/

Link to Download master data file from source above
https://www.nrscotland.gov.uk/media/i5jduiff/drug-related-deaths-23-data.xlsx

Notes