Scotland is bracing for a new wave of drug deaths as highly potent synthetic opioids begin to take hold, health experts have warned. The alert comes just as official data showed a drop in drug-related fatalities last year — a fall many hoped signalled progress in tackling Scotland’s longstanding drugs crisis. But campaigners and researchers now fear that new substances, particularly nitazenes, could drive the death toll sharply back up.
Deaths Fell in 2024 — But Danger Ahead
Figures released by the National Records of Scotland showed drug-related deaths fell by 13% in 2024 to 1,017, the lowest level since 2017. The decline has been linked to expanded use of the overdose-reversing drug naloxone by police and paramedics, along with increased funding for addiction treatment and recovery programmes. Scotland has long had the highest drug death rate in Europe, and these measures were seen as a step in the right direction.
Yet the Scottish Drugs Forum (SDF) cautioned against reading too much into the figures. Its chief executive, Kirsten Horsburgh, said early reports from 2025 show a sharp rise in fatalities, driven by the rapid spread of nitazenes — synthetic opioids hundreds of times stronger than heroin or morphine. “We’re very concerned. For us, this feels like a crisis on top of a crisis,” Horsburgh said.
Surge in Nitazene-Linked Fatalities
Data shows nitazene-linked deaths in Scotland tripled in 2024 to 76 cases, compared with the previous year. Public Health Scotland reports suggest at least 38 deaths in the first quarter of 2025 involved the drug, indicating numbers may be on track to double again. Experts warn the true figure could be higher because nitazenes are difficult to detect in toxicology tests, with up to 360 variants circulating. Organised crime groups are also mixing them into other street drugs without users’ knowledge, further increasing the risk of accidental overdoses.
Similar patterns have been reported in England, where nitazenes were detected in 179 deaths between June 2023 and May 2024. In several cases, multiple variants were found in a single victim.
Government Response Under Pressure
Scotland’s drug and alcohol policy minister, Maree Todd, acknowledged the progress made in reducing overall deaths but admitted the country faces a dangerous new challenge. “People in deprived areas are 12 times more likely to die from drug misuse than those in wealthy areas,” she said. “It is welcome that we have seen progress, but I know there is still work to be done, particularly as we face new threats from synthetic opioids like nitazenes.”
Calls for Stronger Measures
Experts argue that current policy efforts are not enough. Professor Catriona Matheson, a drug misuse specialist at the University of Stirling, said the 2024 figures showed targeted interventions were starting to work. But she warned the drug supply chain is now increasingly contaminated with synthetic opioids and even animal tranquilisers. “This highlights that we really do need further actions still, including drug checking services and supervised consumption sites across the country,” she said.
A Crisis That Keeps Evolving
Scotland’s drug death crisis has proved one of the hardest public health challenges to reverse. After years of climbing fatalities — compounded by funding cuts in 2015 — any signs of progress are fragile. With nitazenes spreading rapidly, campaigners fear the country could be on the verge of another deadly surge unless urgent action is taken to protect vulnerable communities.
