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Improving health
Previously NHS Health Scotland

Misuse of drugs is a significant issue in Scotland and it leads to a variety of social and health problems.

You can find frameworks to help you plan and deliver problem drug use services, and find out about national strategies below.

  • In 2016/17, there were 8,546 general acute hospital stays with a diagnosis of drug misuse. 54% were new patients.
  • The latest assessment (in 2009) of total economic and social costs of illicit drug use in Scotland is estimated at around £3.5bn a year.
  • Drug use disorders are the sixth leading cause of early death in Scotland, and the overall burden is 17 times higher in the most deprived areas compared to the least deprived.
  • Problem drug use can pose a risk to children, family breakdown, unemployment and homelessness.
  • Injecting drugs is associated with the risk of transmission of blood borne viruses such as HIV and hepatitis C.
  • A survey in 2014/15 found that 6% of adults had used illicit drugs during the previous year, compared with 7.6% in 2008/09.
  • The estimated number of individuals with problem drug use in Scotland is 57,300 - almost 1 in 60 of our population aged between 15 and 64.
  • There were 1,187 drug-related deaths in 2018, 253 (27%) more than in 2017. This is the largest number ever recorded, and was 613 (107%) more than in 2008, which was 574.
  • The extent of loss of life to drug-related deaths, particularly among those aged 35 to 55 years, is now a substantial contributor to the worsening life expectancy trends in Scotland.

You can read more data on problem drug use on the Scottish Public Health Observatory (ScotPHO) website (external).

Drug use and health inequalities

People who experience socio-economic disadvantage disproportionately also experience problematic drug use. Council areas with some of the most deprived communities in Scotland have higher rates of problematic drug use than the national estimate.

People with problematic drug use are often amongst the most marginalised in society and can have multiple complex needs due to the circumstances in which they live.

Addressing wider social inequalities, for example in housing and employment, as well as tackling poverty, can play an important role in the prevention of problematic drug use and associated harms.


Drug use – local and national action

Deaths among older people with a drug problem in Scotland are increasing. This group is categorised as those aged over 35 who experience health and social harms related to their own use of drugs.

In consultation with the Scottish Government and other stakeholders we undertook a rapid evidence review of effective interventions to address the specific risks and needs identified for this group.

The purpose of this report is to inform the strategic response and examine the operational implications of engaging with older people with a drug problem, how to encourage them into services and how to keep them in treatment. 

You can read the full report on keeping people safe for more information. 

In November 2018 the Scottish Government published Rights, Respect and Recovery, a new, combined drug and alcohol strategy that takes a public health approach to preventing and reducing alcohol and drug use, harm and related deaths.

The vision for the strategy states that in Scotland “we live long, healthy and active lives regardless of where we come from.Scotland is a country where individuals, families and communities

  • have the right to health and life free from the harms of alcohol and drugs
  • are treated with dignity and respect
  • fully supported within communities to find their own type of recovery.

Delivering this will involve

  • a focus on prevention to reduce the likelihood of alcohol and drug use and related harm
  • actions to tackle health inequalities
  • a continuing whole-population approach to changing Scotland’s relationship with alcohol
  • a human rights based, person-centred response, ensuring a focus on those who are most at risk
  • a focus on taking an improved public health approach in justice settings – reducing use and harm and taking vulnerable people out of the justice system
  • an evidence informed approach.

Clear action plans will be coproduced with partners to detail how the commitments in this strategy will be achieved. 

We have published a Monitoring and Evaluating Rights, Respect and Recovery (MERRR) Framework report to detail how we will assess the implementation, progress and outcomes of the Rights, Respect and Recovery strategy. This report was developed with partners including Scottish Government, Information Services Division, Health Protection Scotland, Alcohol and Drug Partnerships, the third sector and people in our communities with lived experience. This report details

  • an overview of the process involved in the development of the MERRR Framework
  • the governance arrangements required to oversee its implementation
  • the indicators to be analysed and interpreted
  • a list of indicator and evaluation gaps identified as part of the process

We have published the first report for MERRR (Preliminary Baseline Report 2021 for Health and Social Harms Indicators). 

You can view the Preliminary Baseline Report 2021 on the Public Health Scotland website.

We have developed an Outcomes Framework for Problem Drug Use to support Alcohol and Drug Partnerships. The outcomes framework aims to inform effective action and demonstrate progress. It is informed by evidence and is aligned to Scotland’s national drugs strategy.  This online resource has been designed to be an interactive and user friendly way to access the different tools that can be used to plan or help evaluate your service.

It is the responsibility of Scotland's 30 Alcohol and Drug Partnerships to commission treatment services to meet the needs of their resident populations. This is done in line with the Framework for Local Partnerships on Alcohol and Drugs (external website), which clarifies the roles, responsibilities and accountability of all bodies involved in tackling alcohol and drugs problems.

You can contact us to find out more about the work we do around drugs.