24th September 2026
Scotland's drug death figures have moved in the wrong direction again.
New figures from National Records of Scotland show that 1,133 people died from drug use in Scotland in 2025, an increase of 116 deaths, or 11%, on the previous year.
That is below the terrible peak of 1,339 deaths recorded in 2020, but it is still the sixth-highest annual total on record. The age-standardised death rate was 21.4 per 100,000 people, around four times the rate recorded when the current series began in 2000.
There is also a striking change in the age of those dying. The average age has risen from 32 in 2000 to 46 in 2025. This is no longer primarily a problem of very young people. It increasingly involves an ageing population of people who may have been using drugs for many years and whose health may already be damaged.
The latest increase was driven by men. Male drug deaths rose by 19%, or 131 deaths, while deaths among women fell by 5%.
The substances involved also tell an important story.
Opiates and opioids were implicated in 881 deaths, or 78% of the total. Cocaine was implicated in 589 deaths, more than half of all drug deaths, and this was a 23% increase on 2024 and the highest number recorded since the series began in 2008.
Nitazenes are another growing concern. These powerful synthetic opioids were implicated in 247 deaths in 2025, more than three times the number in 2024. They were involved in more than one in five drug deaths.
And most deaths are not caused by one substance in isolation. More than one drug was implicated in 78% of deaths.
That makes the Scottish drug problem considerably more complicated than simply counting heroin deaths, for example. People can be exposed to combinations of opioids, cocaine, benzodiazepines, pregabalin and other substances, with the risks changing as the illegal drug supply changes.
But there is another number we should look at
There is a second set of figures which rarely gets the same attention as the death statistics.
Scotland has been distributing naloxone, a drug which can rapidly reverse an opioid overdose, on an increasingly large scale.
In the financial year 2025/26, 36,955 take-home naloxone kits were supplied, the highest annual total since the national programme began. Public Health Scotland estimates that the programme had reached 88.9% of people considered at risk of opioid overdose by the end of March 2026.
That raises an important question.
If someone suffers an overdose which could have been fatal but another person has naloxone available and reverses it, that incident does not appear in the drug-death statistics.
In other words, the 1,133 deaths tell us about people who died. They do not tell us how many people came close to dying and survived.
We should be careful here. It would be wrong to take the 36,955 kits distributed and suggest that this represents tens of thousands of overdoses, or to calculate a supposed number of deaths prevented. Public Health Scotland does not currently estimate how many deaths have been prevented by naloxone.
But the principle is important. Deaths are not the whole measure of the drug problem.
There is another intriguing change in the statistics. The Scottish Ambulance Service recorded 3,710 incidents in which its staff administered naloxone in 2024/25. That was 18% fewer than the previous year and 30% below 2020/21.
At first sight, that might appear to suggest that serious overdoses are falling.
The Scottish Government, however, cautions against such a simple interpretation. Naloxone is now much more widely available to people who use drugs, their friends and families, community organisations, police and other services. An overdose may therefore be reversed by someone carrying a take-home kit before an ambulance arrives. That could mean fewer ambulance administrations without necessarily meaning fewer overdoses.
This is one of the more difficult aspects of understanding Scotland's drug problem.
A fall in ambulance use can be good news because people are getting help sooner. But it also means that one of the measures previously used to understand the scale of serious overdoses becomes harder to interpret.
The country may be getting better at preventing some overdoses from becoming deaths while the underlying supply of dangerous drugs remains a serious problem.
Scotland still has an exceptional problem
The NRS figures also show the enormous geographical and social inequalities involved.
In 2025 the drug-death rate in Scotland's most deprived areas was 15 times higher than in the least deprived areas. That is a much larger difference than the roughly twofold difference seen for deaths from all causes.
NRS also reports that Scotland's rate of drug-induced deaths is higher than those reported by the European countries included in the EU Drugs Agency comparison. There are important qualifications around international comparisons because countries use different definitions, toxicological information and recording systems. The European figures are themselves described as minimum estimates.
Nevertheless, Scotland's figures remain exceptionally serious.
And this latest rise comes after years in which governments, health services, police and voluntary organisations have put considerable effort into tackling the problem.
There have been some positive developments. Naloxone is much more widely available. Treatment and harm-reduction services have expanded, and some indicators of drug-related harm have fallen.
But the death figures show that progress has not been sustained.
The danger is that a few better years can create the impression that the crisis is gradually being solved, when the longer-term picture remains much more stubborn.
The 2025 figures provide a reminder that Scotland's drug problem has not disappeared. It has changed.
The people dying are older than they were a generation ago. Cocaine is increasingly involved. Synthetic opioids such as nitazenes are appearing in the statistics. Multiple drugs are involved in most deaths.
And increasingly, there is another number sitting alongside the death toll: the number of people carrying naloxone.
That may be a sign of successful harm reduction. It may also be a reminder that there are many potentially fatal overdoses which never become deaths because somebody happened to have the right medicine at the right moment.
We simply do not have a reliable figure for how large that hidden part of the problem is.
Perhaps that is one of the questions Scotland now needs to answer.
Read the full NRS report HERE