Published23 September 2026, 09:32 BST
Deaths related to illicit drugs rose by 11% in Scotland last year to 1,133 as the country struggles to tackle the worst fatality rate in Europe.
National Records of Scotland (NRS) said the figure for 2025, external was 116 higher than the previous year, bringing the total deaths in a decade to more than 11,000.
After adjusting for age, there were 214 drug-related deaths per million people.
NRS defines drug-related deaths as those where the underlying cause was drug poisoning, a controlled substance was in the body at the time of death, and drug use led directly to the death.
Efforts to save lives over the past year have been hampered by criminal gangs mixing powerful synthetic opioids such as nitazenes with existing drugs including heroin, cocaine and fake Valium pills.
Nitazenes were implicated in 247 deaths in 2025 – more than 22% of the total. The figure had more than trebled from 76 deaths the previous year.
Opiates and opioids, such as heroin, continued to be the most common type of drug implicated in deaths, accounting for 78% of the total.
Cocaine was implicated in 52% of deaths, the highest figure since NRS began publishing specific data in 2008.
NRS said the increase in deaths – which came after a 13% fall in 2024 – had been driven by a rise in deaths of male drug users. This increased by 19%, while the rate of female deaths fell by 5%.
The rate of drug-related deaths in the most deprived areas of Scotland was 15 times as high as in the least deprived areas.
The average age of death has increased from 32 in 2000 to 46 years in 2025.
Over a five-year period from 2021-25, Glasgow recorded the highest average death rate at 380 per million, followed by 340 per million in Dundee and 310 per million in North Ayrshire.
When comparing Scotland with the rest of Europe, NRS measures the death rate among 15-64 year olds – which was 277 per million in 2025.
The next highest rate in Europe was Estonia with 112 deaths per million in 2024, the most recent year for which figures are available from the European Union Drugs Agency (EUDA).
Scotland's death rate in 2024 was 246 per million.
NRS says its methodology produces "similar" outcomes to EUDA's count of "drug-induced deaths", with the caveat that the two methods use slightly different lists of drugs.
When comparing Scotland with the rest of the UK, NRS uses a wider measure of age-adjusted drug poisoning deaths.
This includes all deaths where the underlying cause was listed as mental and behavioural disorders due to psychoactive substance abuse or poisoning by drugs whether accidental, intentional, of unknown intent or as a result of assault.
The most recent comparable data from 2024 shows that Scotland had an age-adjusted death rate of 216 per million compared with 91 for England, 140 for Wales and 135 for Northern Ireland.
Why is Scotland the drug deaths capital of Europe?
Catriona Matheson, professor of substance use at Stirling University, said the "deeply concerning" increase in deaths was being driven by significant changes in the drug market – including the growth of nitazenes.
She told BBC Radio Scotland Breakfast that their potency was unpredictable and that some could be 50 times stronger than heroin.
"People are not expecting that in the drugs that they're taking," she said.
"They may be buying what they think is heroin and in fact it may contain several other substances in it."
Matheson said an increase in "polydrug use" in recent years, where people take more than one substance, had contributed to the problem and could prove to be lethal.
Professor Catriona Matheson said the rise in deaths was deeply concerning
Kirsten Horsburgh, chief executive of the Scottish Drugs Forum, said the link between deprivation, health inequalities and drug-related deaths was "really stark".
"The risk is we become fixed on chasing individual substances in an unregulated market and we lose sight of the individual circumstances that are related to that," she said.
"Drugs don't explain the extraordinary inequality and social disparity that we see in these deaths.
"Drug-related deaths are an extremely visible manifestation of who gets to live long and healthy lives."
Alcohol and Drugs Minister Maree Todd said the rise in deaths was "deeply concerning and unacceptable".
"The increase in deaths involving cocaine, and the continued threat from dangerous synthetic opioids like nitazenes, must drive more coordinated action across the country," she said.
Todd said the government had taken "important steps" – including funding more than 1,100 residential rehabilitation placements last year – but that it was clear much more needed to be done.
She said the government's new strategic plan would deepen links between treatment, housing and other services, and target support at the communities most at risk. The country's first local drug-checking service will open in Glasgow next month.
Scotcast: The new killer drugs flooding Scotland
Martin Geissler speaks to James Cook about the criminal gangs making nitazenes and how law enforcement is struggling to keep up.
Scottish Labour's health spokesperson Jackie Baillie said the figures were "a damning indictment of the Scottish government's failure to support some of the most marginalised people in Scotland".
"They must take responsibility for this crisis and deliver joined-up action to save lives and help people recover," she said.
Victor Currie, Reform UK Scotland's spokesman, said the government had "given up on getting addicts into recovery and settled instead for managing the death toll".
"The SNP has evidently run out of ideas, run out of interest and frankly run out of excuses," he said.
Scottish Conservative spokesman Miles Briggs said the SNP's approach to tackling Scotland's drugs deaths crisis had "catastrophically failed".
"They must shut down their flagship Thistle facility in Glasgow and ditch any plans for more state-sponsored drug taking at drug consumption rooms," he said.
Scottish Green spokesperson Kayleigh Kinross-O'Neill said a major expansion of harm reduction and treatment services was needed, including safe consumption facilities, drug checking, heroin-assisted treatment and stabilisation services.
Scottish Liberal Democrat leader Alex Cole-Hamilton called for a national rollout of safer drugs consumption centres and funding for "long-overdue" drug checking services.
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