Drug-related deaths in Scotland rose by 11 per cent in 2025, with 1,133 people losing their lives to illicit drugs as the country continues to record the highest fatality rate in Europe.
According to the National Records of Scotland, the 2025 figure increased by 116 deaths from the previous year, taking the number of drug-related deaths recorded over the past decade to more than 11,000.
After adjusting for age, Scotland recorded 214 drug-related deaths per million people.
The NRS defines such deaths as cases in which drug poisoning was the underlying cause, a controlled substance was present in the body and drug use directly resulted in the death.
The latest figures showed a sharp increase in deaths involving nitazenes, a group of powerful synthetic opioids that have increasingly been mixed with drugs such as heroin, cocaine and counterfeit Valium tablets.
Nitazenes were linked to 247 deaths in 2025, representing more than 22 per cent of the total. The number was more than three times the 76 deaths recorded in 2024.
Opiates and opioids, including heroin, remained the substances most commonly associated with deaths, featuring in 78 per cent of cases.
Cocaine was implicated in 52 per cent of deaths, the highest proportion recorded since the NRS began publishing specific figures in 2008.
The increase followed a 13 per cent decline in drug-related deaths in 2024 and was largely driven by a rise among male drug users.
Deaths involving men increased by 19 per cent, while the rate among women fell by five per cent.
The figures also highlighted a strong link between deprivation and drug deaths, with the rate in Scotland’s most deprived communities 15 times higher than in the least deprived areas.
The average age at death has also risen significantly, from 32 in 2000 to 46 in 2025.
Over the five years to 2025, Glasgow recorded the highest average drug-related death rate in Scotland at 380 per million, followed by Dundee at 340 and North Ayrshire at 310.
Using its comparison with other European countries, the NRS recorded a drug death rate of 277 per million among people aged 15 to 64 in Scotland in 2025.
Estonia had the next highest rate, at 112 per million in 2024, according to the latest available figures from the European Union Drugs Agency.
Scotland’s comparable rate was 246 per million in 2024.
Professor Catriona Matheson of the University of Stirling said the increase was “deeply concerning” and linked it to major changes in the illegal drug market, particularly the growing presence of nitazenes.
Speaking to BBC Radio Scotland Breakfast, she said the potency of the synthetic opioids was unpredictable, with some potentially being 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 also identified the growing use of multiple substances as another factor that could contribute to fatal overdoses.
Kirsten Horsburgh, chief executive of the Scottish Drugs Forum, said the relationship between deprivation, health inequality and drug 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.”
Scotland’s Alcohol and Drugs Minister Maree Todd described the increase as “deeply concerning and unacceptable”, saying the rise in cocaine-related deaths and the continued threat posed by nitazenes required stronger coordinated action.
“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 funded more than 1,100 residential rehabilitation placements during the past year, while a new strategic plan would strengthen cooperation between treatment, housing and other support services. Scotland’s first local drug-checking service is also due to open in Glasgow next month.
Scottish Labour health spokesperson Jackie Baillie criticised the government over the figures, describing them as “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.
Reform UK Scotland spokesman Victor Currie accused the government of abandoning recovery efforts.
“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 government’s approach had “catastrophically failed”, calling for the closure of the Thistle facility in Glasgow and opposition to plans for further drug consumption rooms.
Scottish Green spokesperson Kayleigh Kinross-O’Neill, meanwhile, called for an expansion of harm reduction and treatment services, including safe consumption facilities, drug checking and heroin-assisted treatment.
Scottish Liberal Democrat leader Alex Cole-Hamilton also called for safer drug consumption centres to be introduced nationally and for funding for “long-overdue” drug-checking services.
