Scotland’s Drug Death Crisis Worsens as Fatalities Rise 11%

Scotland has recorded another significant rise in deaths linked to drug use, with new official figures showing that 1,133 people died in 2025. The latest statistics from National Records of Scotland (NRS) represent an increase of 116 deaths, or 11%, compared with 2024.

Although the number remains below the record 1,339 deaths recorded in 2020, the latest figures highlight the continuing scale of Scotland’s drug death crisis. They also show how the changing nature of the illegal drug market is creating new challenges for health services, communities and people who use drugs.

Drug deaths increase after a fall in 2024

The latest figures follow a 13% reduction in drug-related deaths in 2024. The increase recorded in 2025 therefore represents a significant reversal of that improvement.

NRS reported 21.4 drug use deaths per 100,000 people in Scotland in 2025 after adjusting for age. This rate is around four times higher than it was when the current statistical series began in 2000.

The figures also reveal a notable difference between men and women. There were 830 male drug use deaths in 2025, an increase of 19% compared with the previous year. Female deaths fell by 5%, with 303 deaths recorded.

The average age of people dying from drug use has also changed considerably over the long term. In 2000, the average age was 32. By 2025, it had risen to 46.

That shift indicates that Scotland's drug death crisis is not limited to younger people. Increasing numbers of deaths are occurring among people in older age groups, with the highest rates in 2025 recorded among those aged 35 to 44 and 45 to 54.

Nitazenes emerge as a major concern

One of the most significant developments in the latest statistics is the growing involvement of nitazenes.

Nitazenes are a group of highly potent synthetic opioids. According to NRS, they were implicated in 247 drug use deaths in Scotland during 2025. That represents more than one in five deaths covered by the statistics.

The number was more than three times higher than in 2024.

Etonitazene was the most frequently identified nitazene, being implicated in 215 deaths.

NRS cautions that comparisons over longer periods should be treated carefully because testing for nitazenes has expanded in recent years. Routine testing for additional nitazenes has also been introduced, meaning some of the increase may reflect improved detection as well as changes in the drugs circulating in Scotland.

Nevertheless, the figures demonstrate the growing importance of synthetic opioids in Scotland's drug market.

Multiple drugs are often involved

The latest figures also underline another important feature of Scotland's drug death problem: many deaths involve more than one substance.

NRS found that multiple drugs were implicated in 78% of drug use deaths in 2025.

Opiates and opioids remained the most commonly implicated category, appearing in 881 deaths, equivalent to 78% of the total.

Cocaine was involved in 589 deaths, or 52%. This was the highest number recorded since NRS began publishing specific cocaine figures in 2008 and represented a 23% increase from 2024.

Benzodiazepines were implicated in 433 deaths, while gabapentin and/or pregabalin were involved in 330.

These figures demonstrate why focusing on a single substance can provide only part of the picture. People who use drugs may encounter combinations of substances, sometimes without knowing exactly what a product contains.

The presence of several substances can also make prevention and treatment more complicated.

Deprivation remains closely linked to drug deaths

Another striking feature of the statistics is the relationship between deprivation and mortality.

In 2025, the age-adjusted rate of drug use deaths in Scotland's most deprived areas was 15 times higher than in the least deprived areas.

The difference is particularly notable because the gap is much larger than the disparity seen across deaths from all causes. For all causes of death, the rate in the most deprived areas is around twice that of the least deprived areas.

The figures therefore point to drug deaths as part of a wider pattern of health inequality.

The issue is not evenly distributed across Scotland. Over the five-year period from 2021 to 2025, several council areas recorded drug death rates above the national average.

These included Glasgow City, Dundee City, North Ayrshire, Inverclyde, West Dunbartonshire and East Ayrshire.

Five-year figures are used for local comparisons because they provide a more reliable picture, particularly in areas with smaller populations.

Scotland compared with the rest of the UK

Scotland continues to record a substantially higher drug poisoning death rate than other parts of the UK.

For comparisons between UK countries, NRS uses the broader drug poisoning definition rather than its headline drug use death measure.

The most recent comparable figures, covering 2024, show that Scotland's age-standardised drug poisoning mortality rate was 2.4 times the rate recorded in England. It was also 1.6 times the rate in Northern Ireland and 1.5 times the rate in Wales.

However, comparisons between countries need to be interpreted carefully because statistical definitions and registration practices can differ.

NRS also compares Scotland with European countries using data from the European Union Drugs Agency. The agency warns that international comparisons can be affected by differences in coverage, toxicological information and coding practices.

This means that while Scotland's recorded rate is exceptionally high, comparisons should not be interpreted without considering methodological differences.

What is driving the latest increase?

The latest rise appears to have been influenced by several factors rather than one single cause.

The changing drug market is one important element. The increased presence of synthetic opioids such as nitazenes creates additional risks because their potency can vary and they may be present in drugs sold as other substances.

The continued involvement of cocaine is another important development. More than half of all drug use deaths in 2025 involved cocaine.

Polydrug use is also significant. With several substances implicated in most deaths, the risks can be difficult to predict.

At the same time, the strong relationship between deprivation and drug deaths suggests that the issue cannot be understood solely through the availability of individual substances.

Housing, poverty, health inequalities, access to treatment and wider social circumstances can all form part of the environment in which drug-related harm occurs.

What happens next?

The Scottish Government has described the latest figures as deeply concerning and has pointed to measures including residential rehabilitation placements and plans to strengthen connections between drug treatment, housing and other support services.

A drug-checking service is also due to open in Glasgow, providing a way to analyse substances and potentially identify unexpected or dangerous compounds.

Whether these measures reduce deaths will depend on how effectively they reach people at greatest risk and how the wider drug market develops.

The latest statistics show that Scotland's drug death crisis remains complex. The increase in deaths during 2025 came alongside a rise in male deaths, increased cocaine involvement and a substantial increase in deaths involving nitazenes.

At the same time, the statistics show a longer-term picture of inequality, with drug deaths disproportionately concentrated in Scotland's most deprived communities.

The figures are therefore more than a single annual statistic. They provide an indication of the scale and changing nature of drug-related harm across Scotland.

With 1,133 deaths recorded in 2025, the latest data reinforces the need for continued attention to prevention, treatment, harm reduction and the wider social conditions associated with drug-related mortality.

Sources

National Records of Scotland, Drug-related deaths in Scotland, 2025, published 23 September 2026.

National Records of Scotland, Drug use deaths increase by 11%, published 23 September 2026.

European Union Drugs Agency, data and methodology on drug-induced deaths, as referenced by National Records of Scotland.

Disclaimer

This article is an independently rewritten summary based on publicly available official statistics. It is intended for general information and does not replace professional medical, legal or public health advice. Drug death statistics can be affected by definitions, registration practices and changes in toxicology testing, so figures should be interpreted in their appropriate statistical context.