Rapid Action Drug Alerts and Response (RADAR) quarterly report
April 2023
A Management Information Statistics publication for Scotland
- Published
- 25 April 2023
- Type
- Statistical report
- Author
- Public Health Scotland
Harm indicators
Naloxone administration by Scottish Ambulance Service
The average weekly number of naloxone administration incidents was broadly stable between December 2022 and February 2023 (61 incidents per week). The total number of incidents during this time period was lower (793) compared to the same time periods in 2020 (998) and 2021 (920).
Background
Naloxone is a medicine used to prevent fatal opioid overdoses. These data relate to the number of incidents in which naloxone was administered by Scottish Ambulance Service (SAS) clinicians.
While these data count multiple overdose patients at the same incident separately, multiple naloxone administrations to the same patient at the same incident are not counted separately.
The chart below shows the weekly number of SAS naloxone administration incidents from 28 November 2020 to 26 February 2023.
Summary
Historic trend
- Until winter 2021/22, the average weekly number of SAS naloxone administration incidents was similar to previous years, which have generally been characterised by lower numbers of incidents during winter months and higher numbers during summer months.
- In spring 2022, the trend diverged from previous years and, in spite of an increase in April, has followed a gradual decreasing trend from May 2022 onwards.
Update
For the most recent time period (28 November 2022 to 26 February 2023):
- 793 SAS naloxone incidents were recorded, at an average of 61 per week. Weekly numbers of incidents were generally stable throughout this period.
- The total number of incidents was 5% lower than in the previous time period (5 September to 27 November 2022) when 832 incidents were recorded, at an average of 69 per week.
- The total number of incidents was 21% lower than expected compared to the same time period in 2020 (998 attendances, average of 77 per week) and 14% lower than in 2021 (920 attendances, average of 71 per week).
Additional information
PHS was provided with these data by SAS.
For more information, or to analyse this data by NHS Board, visit the COVID-19 wider impacts dashboard.
Police Scotland is in the process of training and equipping all operational officers up to and including the rank of Police Inspector with intra-nasal naloxone kits. This roll-out began in August 2022 and is expected to be complete in early 2023. This should be taken into consideration when interpreting the data shown above. More information on the carriage of naloxone by Police Scotland is available on their website.
Why we use a 3-week moving average
As these data are highly variable over time, a 3-week moving average has been included in the graph to aid interpretation of trends over time.
Scotland’s Take-Home Naloxone Programme
The national Take-Home Naloxone Programme was launched by the Scottish Government in 2011 to prevent fatal opioid overdoses.
Naloxone is a medicine that can temporarily reverse the effects of an opioid overdose. It can be given to anyone who is non-responsive and displaying the signs of an overdose (unconsciousness, shallow breathing, snoring, blue lips, pale skin, pin-point pupils).
Anyone in Scotland can carry naloxone. It can be accessed through most local drug services or pharmacies and it can also be delivered to your home through the charity Scottish Families Affected by Alcohol and Drugs.
Naloxone is very easy to administer.
You can learn more about administering naloxone in a free e-learning module created by the Scottish Drugs Forum.
Information on take-home naloxone distribution can be found in the substance use section of the COVID-19 wider impacts dashboard and in the National Naloxone Programme Scotland Quarterly Monitoring Bulletin, both published by PHS.
Drug-related attendances at emergency departments
The average weekly number of drug-related attendances at emergency departments was stable between December 2022 and February 2023. A total of 1,118 attendances were recorded in this period – 13% lower than in the same time period in 2020/21 (1,284), but 11% higher than in 2021/22 (1,010).
Background
A drug-related emergency department (ED) attendance is an attendance for a drug intoxication or overdose, either alone, or combined with alcohol intoxication.
The chart below shows the weekly number of drug-related ED attendances between 16 November 2020 and 5 March 2023.
Summary
Historic trend
- An overall decreasing trend was observed in drug-related attendances at EDs between August 2021 and April 2022, with the lowest weekly levels in the time series observed in the week beginning 4 April 2022 (53).
- Drug-related ED attendances then increased sharply and peaked in May 2022, with the highest weekly levels in the time series observed in the week beginning 16 May 2022 (123).
- Attendances then decreased and remained stable, averaging 84 attendances per week from June to November 2022.
Update
For the most recent time period (28 November 2022 to 5 March 2023):
- 1,118 ED attendances were recorded, at an average of 80 per week. This was 5% lower than the previous 14-week time period (22 August to 27 November 2022: 1,179 attendances, an average of 84 per week).
- Attendances were 13% lower compared to the same time period in 2020/21 (1,284 attendances, an average of 86 per week) and 11% higher than in 2021/22 (1,010 attendances, an average of 72 per week).
Additional information
These data are taken from our Accident and Emergency Data Mart.
Diagnosis and reason for attendance can be recorded in a variety of ways, including in free text fields. Therefore, the numbers presented in this report only give a high-level indication of attendances over time.
For more information, or to analyse these data by NHS Board, visit the COVID-19 wider impacts dashboard.
Why we use a 3-week moving average
As these data are highly variable over time, a 3-week moving average has been included in the graph to aid interpretation of trends over time.
Drug-related acute hospital admissions
The average weekly number of drug-related hospital admissions decreased between October and December 2022. The total number of admissions in this time period (1,815) was considerably lower than expected, compared to the same time period in 2020 (2,736) and 2021 (3,244) (decreases of 34% and 44% respectively).
Background
The data used in these statistics relate to all inpatient and day case admissions to general acute hospitals (excluding maternity, neonatal, geriatric long stay and admissions to psychiatric hospitals) where drug use was recorded as a diagnosis at some point during the patient’s hospital stay. Data are presented by date of admission.
The chart below shows the weekly number of drug-related admissions to Scotland’s general acute hospitals from 26 September 2020 to 1 January 2023.
The chart is interactive, allowing users to view data points on the chart as well as download the data. This is being piloted as an alternative to the static charts and if useful may be rolled out across other indicators.
The second chart shows the top five drug types associated with admissions as a percentage of all drug-related admissions between 28 September 2020 to 1 January 2023.
The data presented on drug type is based on ICD-10 diagnostic codes and is not confirmed by toxicology analysis.
Summary
Historic trend
- There was a long-term decreasing trend in the weekly number of drug-related hospital admissions from June 2021 to April 2022. Admissions briefly increased in April and May 2022 (peak of 208 during the week beginning 16 May), before decreasing again in June 2022. The average weekly number of drug-related hospital admissions remained relatively stable between July and September 2022.
- The long-term decreasing trend in drug-related hospital admissions observed since June 2021 differs markedly from previous years, which have generally been characterised by lower numbers of admissions during winter months and higher numbers during summer months.
- The most common drug category recorded in general acute hospital admissions was opioids:
- The percentage of opioid-related admissions decreased from 50% in November 2020 to 46% in August 2022, before increasing to an average of 50% of attendances between September and October 2022.
- The percentage of sedative/hypnotic admissions decreased across 2022 (17% of admissions in January, falling to 11% in December 2022).
Update
For the most recent time period (26 September 2022 to 1 January 2023):
- 1,815 drug-related hospital admissions were recorded, at an average of 130 per week.
- Admissions followed a downward trend throughout this period, from 182 in the week beginning 12 September 2022 to 81 in the week beginning 26 December 2022.
- The total number of admissions was lower than expected compared to previous years:
- 44% lower than the same period in 2020 (3,244, an average of 232 per week)
- 34% lower than the same period in 2021 (2,736, an average of 195 per week)
Reasons for the decrease in numbers have not been examined. This decreasing trend should not be interpreted as a reduction in harms. The number of hospital admissions may be affected by issues accessing urgent care services and by the capacity of hospital services.
- The most common substance type recorded in drug-related general acute hospital admissions was opioids. These were recorded at an average of 50% of admissions per month, which was broadly consistent over the time series.
Additional information
These data have been extracted from our SMR01 dataset.
For more information on diagnostic coding, please refer to the drug-related hospital statistics publication methods page.
To analyse the latest published information on drug-related hospital discharges by NHS Board or by Alcohol and Drug Partnership (ADP), go to our information on drug-related hospital statistics admissions.
Please note our drug-related hospital statistics dashboard presents data by date of discharge, so figures will differ to those shown above. For more information, please see the metadata.
Why we use a 3-week moving average
As these data are highly variable over time, a 3-week moving average has been included in the graph to aid interpretation of trends over time.
Glossary
- Opioids
Opioid drugs act on opioid receptors to produce sedative and painkilling effects. They are respiratory depressants (reduce heart rate and breathing). Opioids include synthetic (lab-made) drugs such as methadone and buprenorphine, as well as opiates (drugs made from opium) such as heroin and morphine.
- Cannabinoids
Cannabinoids are compounds that interact with the endocannabinoid system. They are found in the cannabis plant (such as THC) or can be produced synthetically in a laboratory (synthetic cannabinoids).
- Cocaine
Cocaine is a short-lasting stimulant drug that increases heart rate and breathing. This group includes powder cocaine and crack cocaine.
- Sedatives/hypnotics
Sedatives/hypnotics are drugs that induce sedation and depress the central nervous system, which also decreases heart rate and breathing. They are also known as depressants. This group of drugs includes ‘prescribable’ benzodiazepines (drugs such as diazepam), ‘street’ benzodiazepines (such as etizolam and alprazolam) and z-hypnotics (such as zopiclone).
- Multiple/other
The ‘multiple/other’ drugs category includes volatile substances or solvents (such as glue, gases or aerosols) and multiple drug use. This category may also be used to indicate multiple drug use when individual substances are not known or cannot be coded using existing diagnosis (ICD10) codes.
Suspected drug deaths
The average weekly number of suspected drug deaths was broadly stable from December 2022 to the end of February 2023, compared to the fluctuating trends observed in October and November 2022. There was an average monthly total of 96 suspected drug deaths in December 2022 to February 2023. This was the same average monthly total of suspected drug deaths as in December 2021 to February 2022.
Background
Suspected drug death figures are based on reports from police officers attending scenes of death. The details of these events are recorded by Police Scotland and shared with Public Health Scotland.
Following further investigation, these suspected drug deaths are either confirmed as a ‘drug-related death’ or determined ‘not to be a drug death’. This can take several months.
Suspected drug death figures are used to provide a timely indication of trends and to detect any potential recent changes or clusters of harm to inform prevention activity. These figures are different to the National Statistics published by the National Records of Scotland (NRS) and do not provide a robust indication of the numbers of drug-related deaths occurring each year.
The chart below shows the weekly number of suspected drug deaths in Scotland from 25 October 2020 to 25 February 2023.
Summary
Historic trend
- Following a large increase in suspected drug deaths in Scotland during December 2020, there was a decreasing trend in the average weekly number of deaths until May 2021. The number of suspected drug deaths increased during summer 2021, peaking at 34 in the week beginning 7 June 2021.
- Between July 2021 and October 2022, the average weekly number of deaths fluctuated considerably but remained within a range of 17 to 28 deaths per week.
Update
For the most recent time period (28 November 2022 to 28 February 2023):
- An average of 22 suspected drug deaths were recorded per week (ranging between 17 and 27). This weekly average was lower than the same 13-week period in 2020/21 (33 deaths per week) and similar to the same period in 2021/22 (23 deaths per week).
- The average weekly number of suspected drug deaths was broadly stable from December 2022 to the end of February 2023, compared to the fluctuating trends observed in October and November 2022. There were 116 suspected drug deaths in November 2022, 93 in December 2022, 108 in January 2023 and 86 in February 2023.
- There was an average monthly total of 96 suspected drug deaths in December 2022 to February 2023. This was the same average monthly total of suspected drug deaths as in December 2021 to February 2023.
Additional information
Data on suspected drug deaths in Scotland are provided by Police Scotland.
The Scottish Government produce a quarterly report (Suspected drug deaths in Scotland) that presents Police Scotland data on suspected drug deaths and describes the age, sex and geographical location of deaths in each quarter. The analysis in this RADAR release is provided for the purpose of real-time detection and prevention of harms and is not comparable with the Scottish Government publication.
PHS will continue to publish data on suspected drug deaths in future RADAR releases. The Scottish Government, together with PHS and partners, are currently considering the future of the Suspected drug deaths in Scotland report.
The information above is management information and not subject to the same validation and quality assurance as Official Statistics. The data provided in this release should not be viewed as indicative of the annual deaths reported by NRS.
National statistics on drug-related deaths are published annually by the NRS during the summer. The latest report provides information on drug-related deaths in 2021 and earlier years, broken down by age, sex, substance implicated and the NHS Board and council areas.
Detailed information on drug-related deaths is presented in the National Drug-Related Deaths Database, which is published by PHS every two years. The latest report describes deaths that occurred in 2017 and 2018, with trend data from 2009.
Why we use a 3-week moving average
As these data are highly variable over time, a 3-week moving average has been included in the graph to aid interpretation of trends over time.
Glossary
- Drug-related death
A drug-related death (also referred to as drug-misuse death) is a death where the underlying cause was confirmed to be drug poisoning and where any of the substances that were implicated or potentially contributed to the death are controlled in the UK. National statistics on drug-related deaths are published by NRS. In 2021, there were 1,330 drug-related deaths in Scotland. This was a small decrease compared to 2020 (1,339), which saw the highest annual total on record.
- Suspected drug death
A suspected drug death is a death where controlled drugs are suspected of being involved. This operational measure used by Police Scotland is based on the reports, observations and initial enquiries of officers attending the scene of death.