Drug use deaths in Scotland rose by 11% in 2025, with 1,133 people losing their lives. That is 116 more than the year before, and it takes the total for the past decade to more than 11,000.
The figures, published by National Records of Scotland (NRS), confirm that the country still has the highest rate of drug deaths in Europe. After adjusting for age, the rate was 21.4 deaths per 100,000 people, four times the level recorded when the series began in 2000.
A rise after a fall
The increase follows a 13% drop in 2024, so the latest numbers will be hard to take for anyone who hoped the country had turned a corner. The total is still below the peak of 1,339 deaths in 2020, but the number has bounced around over the last five years rather than falling steadily.
Men drove the rise. Male deaths climbed 19% to 830, while female deaths fell 5% to 303. The gap between the sexes has narrowed since the early 2000s, when the male rate was around five times the female rate, but men are still dying at nearly three times the rate of women.
The typical age of those who die is also shifting. The average has risen from 32 in 2000 to 46 in 2025, and people aged 35 to 44 and 45 to 54 now have the highest rates.
Poorest areas hit hardest
Where you live still shapes your chances. Drug use deaths in Scotland were 15 times more common, by rate, in the most deprived areas than in the least deprived. For deaths from all causes, the gap is only about two times.
Across the five years from 2021 to 2025, Glasgow recorded the highest rate at 380 deaths per million people, followed by Dundee on 340 and North Ayrshire on 310. Over the latest year, deaths rose in 20 council areas, fell in ten and stayed the same in two. East Ayrshire (up 27) and North Ayrshire (up 25) saw the biggest increases, while North Lanarkshire recorded the largest fall, down 16.
Kirsten Horsburgh, chief executive of the Scottish Drugs Forum, said the link with deprivation and health inequalities was “really stark”. “Drugs don’t explain the extraordinary inequality and social disparity that we see in these deaths,” she said. “Drug related deaths are an extremely visible manifestation of who gets to live long and healthy lives.”
What is behind drug use deaths in Scotland?
Opiates and opioids were involved in 78% of deaths (881), while cocaine was implicated in 52% (589), the highest number since records began in 2008 and a rise of 23% on 2024. Benzodiazepines featured in 38% of deaths and gabapentin or pregabalin in 29%. In more than three quarters of cases, more than one drug was involved.
Nitazenes, a group of powerful synthetic opioids, were implicated in 247 deaths, or 22% of the total. That is more than three times the 76 recorded the previous year. NRS urges caution here, because testing for these drugs was limited before 2023 and has widened since. Even so, the direction is clear. Criminal gangs have been mixing nitazenes into heroin, cocaine and fake Valium pills, and users often have no idea what they are taking.
Catriona Matheson, professor of substance use at Stirling University, called the rise “deeply concerning”. Some nitazenes, she said, could be 50 times stronger than heroin. “People are not expecting that in the drugs that they’re taking,” she told BBC Radio Scotland. “They may be buying what they think is heroin and in fact it may contain several other substances in it.”
There was one small piece of better news. Deaths involving street benzodiazepines have fallen from a peak of 879 in 2020 to 300 in 2025. Ketamine and alcohol, however, were implicated in more deaths than the year before.
How Scotland compares
Among 15 to 64 year olds, Scotland’s rate was 277 deaths per million in 2025. The next highest in Europe was Estonia, on 112 per million in 2024, the latest year available. Scotland’s own figure for 2024 was 246 per million. The European Union Drugs Agency warns that its data are minimum estimates, and NRS notes that better recording in Scotland may explain part of the gap.
Within the UK, the picture is just as stark. On the latest comparable data from 2024, Scotland’s age adjusted rate of drug poisoning deaths was 216 per million, against 91 in England, 140 in Wales and 135 in Northern Ireland.
Political reaction
Alcohol and Drugs Minister Maree Todd described the deaths as “devastating, deeply concerning and unacceptable”. She told MSPs that more than 1,100 residential rehabilitation placements were funded last year, and that a new strategic plan would link treatment, housing and other services while targeting the communities most at risk. The first local drug checking service is due to open in Glasgow next month, with sites to follow in Aberdeen, Dundee and Edinburgh. “Every life lost to drug harms is preventable,” she said.
Opposition parties were scathing. Labour’s Jackie Baillie called the figures “a national scandal” and accused ministers of working at a “snail’s pace”. Conservative Miles Briggs said there had been 16,082 drug deaths in Scotland over 20 years and called for a “national shift to rehabilitation and a right to recovery”. His party leader, Russell Findlay, criticised the minister for saying nothing about the organised crime gangs supplying the drugs. The Liberal Democrats and Greens want safer consumption centres and a major expansion of harm reduction, while Ms Todd said such facilities are restricted by the Misuse of Drugs Act 1971.
Reform UK has said it will lodge a motion of no confidence in Ms Todd. It needs the backing of 25 MSPs to proceed. At First Minister’s Questions, John Swinney said new synthetic drugs were emerging at the rate of one a week, which was complicating efforts to protect lives.
Beyond the headline figure
Behind every one of these numbers is a family, and the debate is increasingly about what comes before the crisis point. One commentator who works in addiction and is in recovery argued that Scotland should measure recovery rather than activity, make detox and residential rehabilitation genuinely accessible, and build support that lasts long after an emergency has passed. The same writer pointed to the 830 male deaths as a sign of wider problems among working age men in the poorest communities, including alcohol, suicide, homelessness and isolation.
Whatever the political argument, the evidence in the latest report points one way. Drug use deaths in Scotland are concentrated among people in poorer areas, people using several substances at once and people exposed to an unpredictable supply. Earlier help, clearer warnings about what is circulating and easier routes into treatment all aim at the same thing: stopping the next death before it happens.
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