The English figures that show Scotland’s drug-deaths rate really is a national disgrace

Scotland’s drug-deaths rate is three times that in England because of bad management of the problem

This is my column, published in today's Scotsman (10 November 2026).

Forgive me for quoting statistics from South of the border. I appreciate that many think of us as somewhat unique up here, but of course in most ways we are not.

In our struggle against the terrible harm caused by illegal substances we have all too much in common with our neighbours in England and Wales. Our drug deaths are far worse than theirs only because we have managed the problem poorly over the last twenty years, not because of any material difference in drug taking.

Which brings me to the news that for the first time the drug Cocaine has overtaken our old enemy Heroin as the major killer.

Last year there were over five thousand drug related deaths in England and Wales, slightly down on last year, and accounting for 92.4 deaths per million of the population. Compare that with Scotland’s ratio of 277 deaths per million, and you see the extent of our problem. Just think about that. We have a drug death ratio, almost three times greater than our neighbours. And forget the ‘poverty’ excuse. People are just as poor in many parts of England that have much lower death rates.

Our drug death rates are not only a national disaster, but a national disgrace.  And things are changing, Cocaine was associated with over a quarter of the deaths in England & Wales, apparently due to the greater purity of the drug now available. The hugely addictive ‘dinner party’ drug is proving to be a stone-cold killer. Likewise, the veterinarian drug Ketamine is also now killing more with resultant deaths multiplying.  ‘Ket’, a particular favourite of the young, not only kills but heavy use can destroy your bladder.

Then there’s the new threat of ‘Nitazenes’ - synthetic Opiates of enormous strength that are becoming increasingly popular. 

And of course our old enemy Heroin remains, perhaps slipped from the top spot of killers, but ‘H’ and other Opiates continue to kill in numbers, as they have for fifty years.Then there’s Cannabis, now almost ignored as a harmless recreational drug. The new ‘Super Strength’ Skunk variety is a time bomb waiting to explode . The evidence is growing that heavy use of strong Cannabis, especially by the young is associated with later development of Psychosis, and incurable mental illness.

It’s a bleak picture, particularly here in Scotland, where our response has been so inadequate, but perhaps there are signs of improvement.  The Glasgow based safe consumption room ‘The Thistle ‘is at least a bold attempt to address a particular issue of injecting drug users in the city centre.  Much heralded as a ‘Scottish First ‘in fact safe consumption rooms have a long history in other parts of the world.

The evidence is clear. Safe consumption rooms are effective in addressing local problems, provided they are surrounded by support services, health, mental health, social care, housing and employment. If these services are clustered round then The Thistle project will work.

But let’s not be confused, The Thistle Project cannot simply be transplanted in other parts of Scotland.  The patterns of drug misuse across Scotland varies enormously. One size will never fit all. Most Cocaine and Ketamine is not injected and Glasgow’s problems are not Scotland’s.

We face a long uphill struggle to address our drug problems but the latest data from England and Wales should serve as a wakeup call. The drug trade does not stand still. To succeed we must be clear sighted, and follow the evidence.

You can also read my column on the Scotsman's website (click here).