Drug-related deaths in Scotland have fallen to their lowest level in five years (2023)

The number of people who died from drug use in Scotland last year fell by 279 to the lowest level in five years.

Figures from National Registers of Scotland show that 1,051 people died from substance abuse in 2022.

It is the first significant decline after years of records.

However, Scotland still has the highest rate of drug-related deaths in the UK and the rest of Europe.

Despite the decline in drug-related deaths, they are still more than three times more common than they were 20 years ago.

As of 2022, opioids and opioids, including heroin, morphine and methadone, were involved in more than eight out of ten drug-related deaths.

The majority of drug deaths were classified as accidental poisoning, while 7% were classified as intentional self-poisoning.

The number of drug poisoning deaths in Scotland was 2.7 times the UK average in 2021, the most recent year for which UK-wide data is available.

Julie Ramsey, head of demographic statistics at National Records of Scotland, said drug-related deaths had been increasing for 20 years, with a particularly sharp rise after 2013.

The latest statistics showed the biggest year-on-year decline since records began in 1996, he said.

"Those living in the most deprived areas of Scotland are almost 16 times more likely to die from substance misuse than those living in the least deprived areas," Ramsay said.

Men are twice as likely to die from substance abuse as women, Ms Ramsay said, and the age profile of substance abuse deaths has grown, now reaching an average of 45 years.

Over the past 20 years the number of drug-related deaths in Scotland has increased in most years, with the largest increase in 2018.

The highest number of drug-related deaths was recorded in 2020, with 1,339 deaths (25.2 per 100,000 people).

For 2022, the figure was 19.8 deaths per 100,000 people in Scotland.

Glasgow City Council had the highest rate of drug deaths over a five-year period (44.4 per 100,000), followed by Dundee City (43.1).

The lowest rates over the same period were in East Renfrewshire (9.5) and Aberdeenshire (11.1). Orkney and the Western Isles had fewer than ten deaths during this period, so no figures were calculated

The vast majority of drug-related deaths in Scotland involve people who have used more than one substance, known as multiple drug use.

Heroin, methadone and other opioids were involved in 867 deaths, but often in combination with other drugs such as 'street gas'.

Benzodiazepines such as diazepam and etizolam can be prescribed for anxiety or insomnia, but the vast majority of the 601 related deaths were due to drugs obtained illegally.

Experts say high-risk opioid users commonly abuse benzodiazepines for self-medication or to enhance the effects of heroin or methadone. They also take benzos to treat symptoms of psychiatric disorders, negative emotional states, and withdrawal symptoms.

Gabapentin and/or pregabalin - drugs used by doctors to treat epilepsy and nerve pain - have been implicated in 367 deaths from misuse.

Cocaine was implicated in 371 deaths.

Is this the first sign that the tide is turning? Those at the forefront of tough addiction treatment in Scotland certainly hope so.

The sharp fall in overdose deaths over the past year follows a period in which Scotland's uncompensated record for drug-related deaths is among the worst in Europe.

This drew international attention to what exactly had gone wrong in Scotland.

But it has also resulted in £250 million being spent on solving a crisis rooted in decades of social deprivation - just look at the difference in death rates between the poorest and richest areas of the country.

The restoration offer is increasing. Emergency services carry naloxone, a nasal spray that can reverse the effects of an opioid overdose. Services also reach non-fatal overdose patients within hours. An NHS clinic in Glasgow treated 600 people in the first six months of last year.

Did that make a difference? Here's an analysis of the so-called National Mission, which looks at what worked and what didn't.

However, the threat remains as synthetic opioids enter the heroin stockpile and the composition of "street" Valium also changes.

In the last decades of the 20th century, Portugal was hit by a heroin and HIV crisis.

He responded by decriminalizing possession of drugs for personal use, an idea now being proposed by SNP ministers in Edinburgh for Scotland.

London's Conservative government, which controls drug regulation, opposes the idea, but could it work?

Although possession of a limited quantity of drugs is not a crime in Portugal, it is not legal either. Users may be referred for treatment and counseling and fines or penalties may be issued.

There are concerns that decriminalization will normalize drug use among young people and increase crime.

But policy advocates say shifting drug users — and the resources to deal with them — from the criminal justice system to the health care system has been a big success.

There are no major efforts to reverse the policy and even though Portugal has nearly doubled the population of Scotland, there are far fewer drug-related deaths in the country.

Scotland's Drug Policy Minister Elena Whitham said: "While I am delighted that hundreds of families have been spared this pain and lives have been saved, every life lost is a tragedy and the death toll is still very high."

He said the minister would never underestimate the scale of the challenge they face, including responding to emerging threats such as the use of synthetic opioids and stimulants.

Scottish Conservative leader Douglas Ross said the latest figures suggested some progress from an "absolutely devastating base" but Scotland was still a worryingly long way from being the drug-related death capital of Europe.

"SNP ministers have a duty to explain why, to paraphrase Nicola Sturgeon, they took their attention off the ball when this national emergency got out of hand and cut funding from drug treatment programmes," Ross said.

After the crisis hit record levels in 2021, the Scottish Government announced it would spend £50m a year tackling the drug crisis.

This includes funding local alcohol and drug partnerships and grassroots organizations and improving methadone prescribing standards.

In Glasgow, one of the initiatives is the Enhanced Drug Treatment Service, also known as Heroin Assisted Treatment.

The service currently serves 25 patients who have been prescribed diamorphine -- or heroin. They then administer the drug under supervision and receive aftercare.

Services manager Lynn MacDonald told BBC Scotland News that the intention is to link with other services such as housing and other medicines.

He said: “They attend the services at least daily, mostly twice a day. And this seven days a week, 365 days a year.

"We are in the process of increasing our numbers. Our goal is for about 40 people to participate."

The service costs around £1.3m a year.

The Scottish Government also supports the decriminalization of drugs for personal use, believing it would help develop a "public health approach" to tackling the problem.

The government also aims to provide 1,000 inpatient rehabilitation beds a year from 2026. It says it wants to spend more than £100m on improving access.

However, others say not enough is being done to reach that number.

The Scottish Conservatives are developing - in partnership with interest groups - a Right to Restitution Bill to be introduced to Holyrood later this year.

This would legally enshrine the right of individuals to their chosen treatment option, from rehabilitation to medically assisted treatment.

Douglas Ross, leader of the Scottish Tories, said: "One of the biggest problems for people with addiction problems is access to treatment."

"That's why the Right to Rehabilitation Bill I'm bringing through Parliament is vital - because it will enshrine in law every person's right to the potentially life-saving treatment they need - and because it is supported by experts, charities and people." with disabilities supported lived experience.

“Humza Yousaf made encouraging noises in support of the Bill during the SNP leadership election but has since remained silent.

"It's troubling that he appears to be advocating drug decriminalization."

David was addicted to heroin for most of his adult life.

He was admitted to the charity's Turning Point stabilization center earlier this year for poor sleep and use of other drugs, including cocaine and street valium.

The 45-year-old has been drug-free since February.

Earlier this month, BBC Scotland News filmed David preparing for a show with the project Recovering Voices.

The project is run by the Creative Change Collective and funded by the Scottish Government with £400,000 across four council areas.

David performed in front of 200 people at the Oran Mor in Glasgow.

He then said: “Something like this was not possible half a year ago. I was covered in seven bricks and accidentally ended up in the stabilization unit.

“That saved my life. I'm not going to stop doing things like [the show].

"I feel great."