Main Points
In 2025, there were 1,133 drug use deaths registered in Scotland, an increase of 11% (116 deaths) compared with 2024.
Drug use deaths have increased over time. The number has fluctuated in the last five years but remains lower than the highest point in the series in 2020 (1,339 deaths).
There were 21.4 drug use deaths per 100,000 people in 2025, after adjusting for age. This is four times as high as when the series began in 2000.
The rate of male drug use deaths was around three times the rate for females in 2025. The latest increase was driven by an increase in male deaths (19% or 131 deaths) while female deaths decreased (by 5% or 15 deaths).
The age profile of drug use deaths has become older over time. The average age of drug use deaths has increased from 32 years in 2000 to 46 years in 2025. Age groups 35 to 44 and 45 to 54 continue to have the highest rates of drug use deaths.
In 2025, the rate of drug use deaths in the most deprived areas of Scotland was 15 times as high as in the least deprived areas. In contrast, the rate is around two times as high for all causes of death.
Over the latest year, the number of drug use deaths increased in 20 council areas across Scotland, decreased in 10 areas and was unchanged in two areas.
The rate of drug use deaths was higher than the Scotland average in Glasgow City, Dundee City, North Ayrshire, Inverclyde, West Dunbartonshire, and East Ayrshire (measured over the five-year period 2021 to 2025).
Opiates/opioids continued to be the most common type of drug implicated in drug use deaths. They were implicated in 78% of drug use deaths in 2025 (881 deaths).
Cocaine was implicated in over half of the drug use deaths in 2025 (52% or 589 deaths). This is the highest number since the series began in 2008, and an increase of 23% (110 deaths) from 2024.
Nitazenes, a group of potent synthetic opioids, were implicated in more than one in five drug use deaths in 2025 (22% or 247 deaths). Etonitazene was the most common nitazene, implicated in 215 drug use deaths.
The main definition covered in this release is called drug use deaths. This includes deaths which meet one of the following criteria:
deaths where the underlying cause was mental and behavioural disorders due to drug use (excluding alcohol, tobacco, and volatile solvents), or
deaths where the underlying cause was poisoning and there was a controlled drug (listed in the Misuse of Drugs Act 1971) involved in the death.
This definition excludes cases where drug use indirectly led to the death or where chronic health conditions caused by drug use caused the death.
You can read more detail about how we define drug use deaths in our blog post.
“Drug use deaths” were referred to as “drug misuse deaths” in previous reports by NRS. We changed this terminology following feedback from users of these statistics. This change does not impact the underlying definition used in the statistics. More information can be found in our summary of the feedback received.
More detail on the definitions covered in these statistics can be found later in the definitions section.
NHS inform has a list of resources on support for people affected by drugs.
If you are a journalist covering these statistics in the media, please consider following the recommendations in Reporting of Substance Toolkit created by Scottish Families Affected by Alcohol and Drugs and Adfam.
Drug use deaths in Scotland
In 2025, there were 1,133 drug use deaths registered in Scotland. This is an increase of 11% (116 deaths) compared with 2024 (Figure 1).
The number of drug use deaths registered in Scotland has increased since the series began in 1996. Between 2014 to 2020, the number of deaths increased each year to the highest number in the series in 2020 (1,339 deaths). The number has fluctuated over the last five years but remains lower than 2020.
Figure 1: Drug use deaths increased in 2025
Number of drug use deaths, registered in 1996 to 2025
There were 21.4 drug use deaths for every 100,000 people in Scotland in 2025, after adjusting for age. This is at a similar level to 2024.
While the rate was 19.1 deaths per 100,000 people in 2024, this is not a statistically significant increase due to the uncertainty around the annual estimates as represented by the 95% confidence intervals (17.9 to 20.3 in 2024 and 20.1 to 22.6 in 2025).
The rate of drug use deaths in 2025 was four times as high as start of the series in 2000.
Age-standardised mortality rates are a better measure of mortality than numbers of deaths as they account for changes in population size and age structure. They provide more reliable comparisons between different areas and sexes, and over time.
In this report, age-standardised mortality rates are presented per 100,000 people and are standardised to the 2013 European Standard Population.
More information on the calculation of age-standardised mortality rates is available on our website.
Drug use deaths by sex
The latest increase in drug use deaths was driven by an increase in male deaths (Figure 2). In 2025, there were 830 male drug use deaths, an increase of 19% (131 deaths) from 2024. There were 303 female drug use deaths in 2025, a decrease of 5% (15 deaths) from the previous year.
The rate of drug use deaths for males is almost three times as high as for females. There were 32.3 drug use deaths per 100,000 males and 11.1 deaths per 100,000 females in 2025, after adjusting for age.
The gap between sexes has narrowed over time. In the early 2000s, the rate of male drug use deaths was around five times as high as the rate for females.
Figure 2: Recent increase in drug use deaths driven by male deaths
Age-standardised mortality rates of drug use deaths by sex, registered in 2000 to 2025
Drug use deaths by age
The age profile of drug use deaths has become older over time. The average age of drug use deaths has increased from 32 years in 2000 to 46 years in 2025 (Figure 3). The average age of female deaths has been slightly higher than males in most years since the series began in 2000.
Figure 3: The average age of drug use deaths has increased
Average age of drug use deaths by sex, registered in 2000 to 2025
In 2025, the age groups with the highest rates of drug use deaths were 35 to 44 and 45 to 54 (Figure 4). People aged 25 to 34 had the highest rate when the series began in 2000. The rate of deaths in those aged 55 and over has gradually increased over the same period.
Figure 4: Rate of drug use deaths highest in age groups 35 to 44 and 45 to 54
Age-specific mortality rates of drug use deaths by broad age group, registered in 2000 to 2025
Drug use deaths by deprivation
The rate of drug use deaths in the most deprived areas of Scotland was 15 times as high as in the least deprived areas in 2025, after adjusting for age. For all causes of death, people in the most deprived areas are around twice as likely to die as those in the least deprived areas.
The gap between the most and least deprived quintiles has changed over time (Figure 5). In 2011, the rate was 8 times as high in the most deprived as the least deprived areas. The highest was 19 times in 2019, and it has fallen since then.
Figure 5: Rate of drug use deaths 15 times as high in the most deprived areas compared to least
Age-standardised mortality rate of drug use deaths by SIMD quintile, registered in 2001 to 2025
Deprivation quintiles are based on the Scottish Index of Multiple Deprivation
Drug use deaths across areas in Scotland
The rate of drug use deaths varies across Scotland. Rates for council areas are calculated over a five-year period to provide more reliable rates, particularly for smaller areas. Council areas are usually based on where the deceased lived, rather than the place of death.
In the period 2021-2025, the following council areas had a higher rate of drug use death than the Scotland average: Glasgow City, Dundee City, North Ayrshire, Inverclyde, West Dunbartonshire, and East Ayrshire (Figure 6). There is a statistically significant difference between the rates for these areas and Scotland, as the confidence intervals do not overlap.
There may be large confidence intervals around rates for areas with smaller populations or numbers of deaths.
Figure 6: The rate of drug use deaths varies across Scotland
Age-standardised mortality rate of drug use deaths by council area, registered in five-year period 2021 to 2025
Error bars represent the likely range (95% confidence intervals).
Orkney Islands had fewer than 10 deaths, so no rates were calculated and it is not shown in the above chart.
Council areas are usually based on where the deceased lived rather than where the death took place. If the deceased was resident outwith Scotland, the death will be assigned to where the death took place.
While mortality rates are the most appropriate figures to use when making comparisons across area in Scotland, these give equal weight to deaths in each of the five years so may not express more recent changes. Figures below provide the change in number of deaths over the last year across Scotland.
The latest increase in the number of drug deaths was not seen across all areas of Scotland (Figure 7). The number of drug use deaths increased in 20 council areas, decreased in 10 areas and was unchanged in two areas.
The largest increases in drug use deaths between 2024 and 2025 were in East Ayrshire (+27 deaths) and North Ayrshire (+25 deaths). North Lanarkshire saw the largest decrease in drug use deaths over the latest year (-16 deaths). Note that this measure does not take into account the size of an area’s population.
Figure 7: Drug use deaths increased in 20 council areas, and decreased in 10 in the last year
Number and change in drug use deaths by council area, registered in 2024 and 2025
Council areas are usually based on where the deceased lived rather than where the death took place. If the deceased was resident outwith Scotland, the death will be assigned to where the death took place.
This measure does not consider the size of an areas population.
Similar data by health board area can be found in main tables HB1 to HB5 available at the links below.
Drug use deaths by substances implicated
More than one drug was implicated in 78% of all drug use deaths in 2025.
Of all drug use deaths in 2025, the most common substances which were implicated in deaths were:
Opiates/opioids (such as heroin/morphine or methadone): 881 deaths, or 78% of deaths
Cocaine: 589 deaths, or 52% of deaths
Benzodiazepines: 433 deaths, or 38% of deaths
Gabapentin and/or pregabalin: 330 deaths, or 29% of deaths
The number of deaths where cocaine was implicated in the death was the highest since the series began in 2008. This was an increase of 110 deaths (23%) from the previous year. Cocaine was the only drug implicated in 9% of all drug use deaths in 2025 (101 deaths).
The number of drug use deaths where opiates/opioids were implicated in the death increased in 2025. The number where benzodiazepines, and gabapentin and/or pregabalin were implicated in the death fell over the latest year (Figure 8a).
Figure 8a: Cocaine was implicated in over half of drug use deaths in 2025
Drug use deaths by most common drugs implicated in deaths, registered in 2008 to 2025
Substances implicated in deaths are those which were thought to be implicated in, or which potentially contributed to, the cause of death. This is usually determined by the pathologist based on substances detected in the body during toxicology testing.
We also record which drugs were present but not thought to have contributed to the death. The number of deaths by specific drugs implicated or present in the death are available in the substance tables below. Methodology Annex C includes more details on how drugs are recorded in NRS statistics.
The majority of drug use deaths where opiates/opioids were implicated in the death involved heroin/morphine and/or methadone (Figure 8b). We report heroin and morphine as one category because it is not possible to tell which form the drug was in from a post-mortem.
Of all drug use deaths in 2025, the most common opiates/opioids which were implicated in deaths were:
Heroin/morphine: 468 deaths, or 41% of deaths
Methadone: 338 deaths, or 30% of deaths
Nitazenes: 247 deaths, or 22% of deaths
Drug use deaths where heroin/morphine was implicated in the death increased over the latest year. The number of these deaths increased overall between 2008 (when the series began) to the highest point in 2019, then fell in each year of the next five years. This is the first year that drug use deaths where heroin/morphine was implicated have increased since 2019.
Drug use deaths where methadone was implicated in the death decreased over the latest year. Similar to heroin/morphine, the number of these deaths increased overall between 2008 to the highest point in 2020. The number of drug use deaths in which methadone was implicated have fallen almost every year since 2020.
Nitazenes are a category of potent new synthetic opioids. Some are hundreds of times more potent than heroin and Public Health Scotland have issued a public health alert for nitazenes. Nitazenes were implicated in 247 drug use deaths in 2025. This is more than three times the number of deaths in 2024. However, there was limited testing of nitazenes in post-mortems carried out prior to 2023 and additional nitazenes have been added to routine testing since then. Caution is advised when making comparisons with earlier periods. Etonitazene was the most common nitazene, implicated in 215 drug use deaths in 2025. It was incorporated into routine testing across Scotland in May 2025.
Drug use deaths where dihydrocodeine and codeine were implicated in the death increased over the latest year. The number where buprenorphine and fentanyls were implicated in the death decreased between 2024 and 2025.
Figure 8b: Nitazenes were implicated in more than one in five drug use deaths in 2025
Drug use deaths by drugs implicated in deaths, opiates and opioids, registered in 2008 to 2025
There was limited testing of nitazenes in post-mortems carried out prior to 2023 and additional nitazenes have been added to routine testing since then. Caution is advised when making comparisons with earlier periods.
Benzodiazepines can be separated into prescribable and street benzodiazepines (such as etizolam and bromazolam) which are novel benzodiazepine-type substances (Figure 8c). Prescribable benzodiazepines are often medications for anxiety or insomnia, such as diazepam. More information on the split between prescribable and street benzodiazepines can be found in methodology Annex H.
The number of drug use deaths where street benzodiazepines were implicated increased rapidly from one death in 2008 to a peak of 879 deaths in 2020. This number has fallen substantially since then, and they were implicated in 300 deaths (26% of all drug use deaths) in 2025.
Etizolam was previously the most common street benzodiazepine implicated in drug use deaths, with a peak of 806 deaths in 2020. Since then, the number of deaths involving etizolam fell rapidly and bromazolam replaced it as the most common street benzodiazepine implicated in drug use deaths. The highest number of drug use deaths where bromazolam was implicated was in 2023 (426 deaths), the number has since fallen to 103 deaths in 2025.
The number of drug use deaths where prescribable benzodiazepines were implicated has increased since series began in 2008 but has been fairly stable for the last six years.
Figure 8c: Drug use deaths where benzodiazepines were implicated in the death have fallen
Drug use deaths in Scotland by drugs implicated in deaths, benzodiazepines, registered in 2008 to 2025
There was limited testing for bromazolam in post-mortems carried out prior to 2023 so caution is advised when making comparisons over time.
Of all drug use deaths in 2025, other significant substances which were implicated in deaths were:
The number of drug use deaths where alcohol, ketamine and ecstasy type drugs were implicated in the death increased over the latest year. Deaths in which amphetamines and xylazine were implicated decreased between 2024 and 2025.
Figure 8d: Ketamine is implicated in an increasing number of drug use deaths
Drug use deaths by drugs implicated in deaths, other significant substances, registered in 2008 to 2025
Routine testing of xylazine began in 2024 so caution is advised when making comparisons over time.
Comparisons within the UK
We use the drug poisoning death definition when making comparisons across the UK. This definition covers a wider set of deaths than the drug use death definition.
The rate of drug poisoning deaths registered in Scotland in 2024 was higher than the rate of other UK countries. This is similar to the longer-term trend, with Scotland having a higher rate than other parts of the UK for the last decade.
After adjusting for age, the drug poisoning mortality rate in Scotland was 2.4 times the rate of England, 1.6 times the rate of Northern Ireland and 1.5 times the rate of Wales. Data for 2024 is the most recent year that data is available across the UK.
Figure 9: Scotland had the highest rate of drug poisoning deaths across the UK in 2024
Age-standardised mortality rate of drug poisoning deaths, UK countries and regions, registered in 2024
Source: National Records of Scotland, Office for National Statistics, Northern Ireland Statistics and Research Agency
These figures are based on death registrations in each calendar year. The delay between the date that a death occurred and the date it is registered may differ across the UK due to different registration procedures.
Comparisons with European countries
The European Union Drugs Agency (EUDA) publish data on the number and rate of drug-induced deaths for European Union (EU) Member States, Norway, and Türkiye in their annual European Drug Report.
On the basis of the information available, Scotland has a higher rate of drug-induced deaths than the countries reported by EUDA. However, the EUDA advise caution when interpreting their data due to differences in coverage, availability of detailed toxicological information and coding practises between countries.
The EUDA state that their data on drug-induced deaths represent minimum estimates due to methodological limitations. NRS receive detailed information on drugs involved in deaths in Scotland and record all substances involved for statistical purposes. Therefore, better identification and recording of the drugs involved in deaths in Scotland may be a reason for the higher rate of drug-induced deaths in Scotland compared with other countries.
More information on the methods and definitions of drug-induced deaths can be found on the EUDA website.
The latest number and rates of drug-induced deaths aged 15-64 for Scotland and countries reported by the EUDA can be found in the Extra Tables (Table 2X) at the links below.
Definitions and further information
There are two main definitions of drug-related deaths covered in these statistics: drug poisoning deaths and drug use deaths.
Drug poisoning deaths
A death classified as a drug poisoning must have an applicable International Classification of Diseases (ICD) code assigned as the underlying cause of death. This is determined by international coding rules from the condition or conditions reported by the certifier, as recorded on the death certificate.
Drug poisoning deaths include all deaths where the underlying cause was either:
Mental and behavioural disorders due to psychoactive substance use, excluding alcohol and tobacco (ICD-10 codes F11-F16, F18-F19).
Poisoning by drugs, medicaments, and biological substances, whether the death was accidental, intentional, of unknown intent, or as a result of assault (ICD-10 codes X40-X44, X60-X64, Y10-Y14, X85).
Drug use deaths
Drug use deaths are a subset of drug poisoning deaths. They must meet the same criteria as drug poisoning deaths, and in addition:
If the underlying cause was poisoning, then a substance controlled under the Misuse of Drugs Act 1971 must be involved.
Drug use must lead directly to the death.
You can read about how we define drug use deaths in our blog post.
More detailed information can be found in the methodology annexes linked below.
Comparability across the UK
The definitions are used across the UK, although there are differences in the terminology and comparability as shown below. More detail on the comparability of drug related death statistics across the UK is available from the Analysis Function website.
Table 1: Definitions in use in the UK
NRS terminology | Alternative terminology | Comparability |
Drug poisoning deaths | Drug-related deaths (Northern Ireland) | Figures are comparable across the UK. |
Drug use deaths | Drug misuse deaths (England, Wales, and Northern Ireland) | Not comparable due to differences in information collected and recorded. |
Change in terminology
In our previous set of these statistics published in September 2025, NRS asked for feedback around the terminology used in our drug-related death statistics, particularly the term “drug misuse” deaths. This was due to feedback received about this term and concerns that it is stigmatising language.
A summary of the feedback received can be found on the NRS website. Following consideration of the feedback received, NRS made the decision to change the terminology used in these statistics from “drug misuse deaths” to “drug use deaths”. This change does not impact the underlying definition used in these statistics.
Future developments
The definition used to identify drug use deaths was defined by a Advisory Council on the Misuse of Drugs (ACMD) cross UK working group in 2000. The ACMD have recently initiated a working group to review the current definition and NRS have representation on this group. We anticipate this may lead to changes to the underlying definition in future years as a result of this work.
The review is expected to conclude by the end of 2026. Once this has concluded, NRS will share the outcome with users of these statistics. If you would like receive updates on NRS statistics, you can register to receive updates about Demography from the Scottish Government ScotStat mailing system.
Links to related statistics
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