RADAR – An early-warning drugs surveillance system for Scotland

As part of the response to record high drug-related deaths in Scotland, Public Health Scotland (PHS) and partners have developed an early warning system, RADAR – Rapid Action Drug Alerts and Response. This is a national system working with communities and stakeholders to identify and assess potential drug-related risks and harms, which then informs decision making to reduce those harms and save lives.

In this blog post, Vicki Craik, Public Health Intelligence Adviser and lead of the RADAR initiative at Public Health Scotland, explains how the system works, the impact it seeks to have and how to get involved to make a difference.

Drug-related deaths in Scotland are the highest in Europe, with 1,330 people losing their life in 2021, the second highest total on record.

The high levels of harm in Scotland are driven by multiple and interacting reasons, including; societal and economic factors, a dangerous and evolving drug supply and the practice of taking multiple drugs at the same time (polydrug use). To help address this complex issue, an intelligent system-wide response is required which includes improving the quality and accessibility of data.

That’s where RADAR comes in – it’s an early warning system that makes information more available, detects changes and threats quickly, and informs decision making.

Although coordinated by PHS, the national programme has been developed in collaboration with partners from across Scotland. It brings together the collective knowledge of local areas to identify risks, and review what action is required and by whom.

Community members and people with lived experience have been at the heart of our understanding to ensure the system is effective. Michaela Jones from the Scottish Recovery Consortium, told us:

“Involving people with lived experience and from recovery communities in the design of RADAR has ensured it’s fit for purpose to meet the needs of people experiencing harms from drug use. We know there’s a lot of knowledge out there in the community and we know we can prevent drug harms with it. We also know we need to build trust and make sure the actions are understandable for different people involved. It’s all to improve the health and wellbeing of people and our communities.”

How does RADAR work?

RADAR seeks to reduce drug harms using two main methods:

1. Routine information sharing

Good decisions begin with good data, so RADAR aims to regularly provide accessible, up-to-date information on services, harms and emerging drug trends. We combine data from PHS systems with information from healthcare, prison, police and toxicology services, and active reports from organisations and members of the public.

Information will be published every three months in our quarterly report, the first of which is now available to view.

2. Identifying and responding to new and emerging harms

All information collected by RADAR is consistently monitored, validated and assessed to allow for a rapid response to prevent and reduce harm.

Where possible, statistical indicators are added to datasets to signal significant changes; such as applying threshold alarms to indicate if there is a spike in drug-related hospital admissions or suspected deaths. This allows us to more quickly detect and respond to threats to health or changing patterns in drug use.

Valuable information is also collected through services and local communities, who we rely on to share information - such as drug-related incidents, clusters of overdoses, new drugs or changing harms. These are submitted directly to RADAR using our accessible reporting form. By combining routine data collections with reports and intelligence from communities, we can strengthen and optimise our response.

RADAR aims to inform and empower everyone involved, including non-drug-related services. Kaye Forsyth, from the Scottish Borders Housing Association, told us:

“RADAR gives the opportunity for people working in all areas of Scotland to share their knowledge and experience about harms that would be otherwise missed if limited to drug services. Non-specialist audiences, such as my colleagues in the housing sector, have a key role to play as they may encounter drug-related incidents, like overdoses, within their work. Contributing this knowledge to RADAR and communicating known risks to people within our care all contributes towards reducing these harms. That is a system-based approach; working with different partners towards the same goal - to improve the life chances of people in our communities.”

If a report informs us of significant or potentially significant harms, it is evaluated by a national, multi-agency team who consider the level of risk and what type of response or intervention is necessary.

Any required action is then shared with the Network, a wide and inclusive group that collects and shares drug trends and data. The Network is a community that bridges RADAR with the people most at risk of drug harm, so information is shared quickly to those that need it. If required, communications may consist of warnings, alerts, information summaries, risk assessments, detailed reports or educational resources.

Although the system is in the early stages of operation, its already monitoring potential threats and drug market trends, including the changing patterns of stimulant drug use and a rise in the use of ‘fake medicines’.

Ultimately, RADAR seeks to provide a structured way to collect, assess and communicate data and intelligence to prevent harm from drugs; identifying risks and informing action to reduce harm and save lives.

How do people and organisations get involved?

Services and local communities can share information such as details of new substances, drug-related incidents or emerging harms through our RADAR reporting form.

We’re also looking for individuals and organisations that can contribute to sharing and receiving information as part of our Network. If you or your organisation is interested, then please consider signing up.

To find out more about RADAR, you can visit the PHS website, view our leaflet or get in touch at phs.drugsradar@phs.scot.