How do Scotland’s drug death figures compare to Europe? The drug misuse crisis explained

New figures show a record high number of drug deaths in Scotland – but how bad is the problem and how does it compare to the rest of the UK and wider European continent?

Drug deaths have risen sharply in Scotland since 2013

Drug deaths in Scotland have reached a record high with more than 1,300 people losing their lives in 2020, new figures from the Scottish Government have shown.

The figures further cement the country’s status as the worst-affected nation in Europe, and represent a 5% increase on 2019.

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But just how bad is Scotland’s drug problem, and how does it compare to the rest of the UK and wider European continent?

How does Scotland place in Europe?

Scotland’s headline statistic shows 1,339 people died because of drug misuse in 2020, according to the National Records of Scotland (NRS). This covers all drug-related deaths where the substances involved are controlled in the UK.

There were a further 122 drug poisoning deaths excluded from this count, which could involve uncontrolled substances such as aspirin.

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Different measures need to be used however to compare Scotland’s situation fairly with other countries, to account for differences in recording and definitions.

EU member countries use a definition broadly similar to Scotland’s but with a slightly different list of substances, given controls in various countries differ, and that counts deaths among people aged 15 to 64 only.

By this measure, Scotland recorded 1,161 drug-related deaths in 2020, an increase of 3% from the 1,130 recorded in 2019.

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At 318 deaths per million people, 2019’s figures had placed Scotland far ahead of the pack in the latest EU-wide table, which also includes Norway and Turkey.

Norway and Sweden were tied for the second highest rate, with 77 deaths per million people.

The EU-wide death rate was only 15 per million people – 21 times smaller than Scotland’s.

The majority of countries’ most recent figures – which are published by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) – were also to 2019, although some were from 2018 and a handful from 2016 and 2017.

The EMCDDA does say some caution should be used when comparing countries as there may be issues with categorising causes of death or under-reporting in some states.

NRS said “it has been suggested that better identification and recording of [drug] deaths may be a reason for the drug-death rate appearing to be higher in the UK, and hence Scotland, than in several other countries”.

This includes good communication between pathologists and the NRS, it said.

How does it compare to the rest of the UK?

The latest GB-wide figures by the European definition were to 2017 – at which point the UK stopped validating its figures with the EU – and gave a rate of 76 per million people.

That means Scotland’s rate was more than four times higher than the country as a whole, excluding Northern Ireland which did not provide those figures that year.

But UK nations can be compared using Scotland’s headline measure of 1,339 drug-related deaths among people of all ages, commonly referred to as drug misuse deaths.

The latest figures for England, Wales and Northern Ireland cover to 2019 only.

They show a rate of 87 per million people for Northern Ireland, 52 for Wales, and 48 for England. Scotland’s rate was 234 per million people, more than two and a half times higher than second place and more than three and a half times the rate for the UK as a whole (65 per million).

Scotland’s 2020 figure gives a rate of 245 per million people.

What is the pattern over time?

Deaths in the UK as a whole rose by 2% between 2018 and 2019, rising in every nation except Wales which saw a drop of 21%.

The 4,328 drug misuse deaths recorded in 2019 was a rise of 77% compared to the 2,451 seen in 2010. England saw a rise of 55% and Wales of 2%.

But Scotland’s figures rose by a whopping 164% over the period, from 485 in 2010 to 1,280 in 2019, while Northern Ireland’s rose by 162%, from 63 to 165.

Scotland’s 2020 deaths represent a 176% increase over the decade.

What has the Scottish government said?

Drugs Policy Minister Angela Constance has described the increase in drug-related deaths as “heart-breaking”.

Ms Constance was appointed in December 2020 to try to tackle the “crisis” gripping the nation.

The Scottish Government said its immediate priority was getting more people into treatment, and it would put £100 million towards improving and increasing provision of residential rehabilitation.

Ms Constance said: “Once again, the statistics on drug-related deaths are heart-breaking. I want to offer my sincere condolences to everyone who has lost a loved one through drug use.

“We need to gather as much information as we can about drug use in Scotland and to that end, data on suspected drug deaths will be published quarterly from this September. This will ensure we can react more quickly and effectively to this crisis and identify any emerging trends.

“We are working hard to get more people into the treatment that works for them as quickly as possible. Without treatment, there is little hope of recovery so we are funding as many community and third sector initiatives as we can so that individuals have the widest possible choice and can opt for the support which suits them and their family.”

Drug Deaths Taskforce chair Professor Catriona Matheson said: “Every drug-related death in Scotland is an avoidable tragedy, and these figures serve to remind us of the importance and urgency of our mission to identify the areas of action that can make a sustainable impact against the challenge.”

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