Rapid Action Drug Alerts and Response (RADAR) quarterly report
January 2024
Management information
- Published
- 30 January 2024
- Type
- Statistical report
- Author
- Public Health Scotland
Harm indicators
Naloxone administration by Scottish Ambulance Service
The average weekly number of naloxone administration incidents decreased between September (84) and November 2023 (75). The total number of incidents during this time period (1,017) was 17% lower than in the previous period (1,220). The number of incidents was 14% higher than the same period in 2022 (890) and 19% lower than in 2021 (1,249).
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 6 September 2021 to 27 November 2023.
An interactive version of this chart can be found in the RADAR dashboard (external website). The dashboard also allows users to download the data and filter by NHS board.
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, despite an increase in April, followed a gradual decreasing trend from May to December 2022.
- An increasing trend in the average weekly number of incidents was observed from January (60) to the end of May 2023 (79).
- Between June and August 2023, the average number of incidents remained broadly stable (96).
National update
For the most recent 13-week period (4 September to 3 December 2023):
- 1,017 SAS naloxone incidents were recorded, at an average of 78 per week. Weekly numbers of incidents generally decreased throughout this period, although an isolated increase was observed in week beginning 30 October (108 incidents).
- The total number of incidents was 17% lower than in the previous 13-week period (5 June to 3 September 2023) when 1,220 incidents were recorded, at an average of 94 per week.
- The total number of incidents was 19% lower than the same period in 2021 (1,249, weekly average 96) and 14% higher than in 2022 (890, weekly average 68).
Local update
For the most recent period (4 September to 3 December 2023), the number of naloxone administration incidents decreased across most mainland NHS boards, compared to the previous period:
- Incidents increased in NHS Fife (8%) and NHS Dumfries and Galloway (44%).
- Incidents decreased in eight areas: NHS Lothian (10%), NHS Greater Glasgow and Clyde (19%), NHS Forth Valley (23%), NHS Grampian (23%), NHS Ayrshire and Arran (23%), NHS Borders (25%), NHS Highland (31%) and NHS Lanarkshire (33%).
- Incidents were broadly stable in NHS Tayside.
To analyse further, please visit the RADAR dashboard (external website).
Additional information
PHS was provided with these data by SAS.
Information on take-home naloxone distribution can be found in the National Naloxone Programme Scotland quarterly monitoring bulletin, published by PHS.
Police Scotland have also trained and equipped all operational officers up to and including the rank of Police Inspector with intra-nasal naloxone kits. New data published by Police Scotland (external website) brings the total number of administrations by the police (since naloxone was first provided to officers as part of a national test of change in March 2021) to at least 353. This should be taken into consideration when interpreting the data shown above.
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 (such as unconsciousness, shallow breathing, snoring, blue lips, pale skin and 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 (external website).
Naloxone is very easy to administer. You can learn more about administering naloxone in a free e-learning module 'Overdose Prevention, Intervention and Naloxone (external website)' created by the Scottish Drugs Forum.
Drug-related attendances at emergency departments
Between September and November 2023, drug-related attendances at emergency departments decreased by 13%, compared to the previous time period. A total of 1,138 attendances were recorded in this period, similar to the same period in 2021 (1,130) and 2022 (1,101).
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 30 August 2021 and 3 December 2023.
An interactive version of this chart can be found in the RADAR dashboard (external website). The dashboard also allows users to download the data and filter by NHS Board.
Summary
Historic trend
- An overall decreasing trend was observed in drug-related attendances at EDs between October 2021 and April 2022, with the lowest weekly levels in the time series observed in the week beginning 4 April (53).
- Drug-related ED attendances increased sharply and peaked in May 2022, to 123 in the week beginning 16 May.
- Attendances decreased and remained stable from June 2022 to March 2023, averaging 82 per week.
- Between April and August 2023 attendances generally increased, averaging 98 per week.
National update
For the most recent 13-week period (4 September to 3 December 2023):
- 1,138 ED attendances were recorded, at an average of 88 per week. This was 13% lower than the previous 13-week period (5 June to 3 September 2023, 1,313, weekly average 101).
- Attendances were similar to the same periods in 2021 (1,130, weekly average 87) and 2022 (1,101, weekly average 85).
Local update
For the most recent period (4 September to 3 December 2023), most mainland NHS boards saw a decrease in the number of drug-related ED attendances, compared to the previous period:
- Attendances increased in two areas: NHS Borders (13%) and NHS Ayrshire and Arran (34%).
- Attendances decreased in eight areas: NHS Greater Glasgow and Clyde (5%), NHS Forth Valley (7%), NHS Lanarkshire (10%), NHS Tayside (14%), NHS Lothian (15%), NHS Fife (27%), NHS Dumfries and Galloway (47%) and NHS Grampian (64%).
- Attendances were broadly stable in NHS Highland.
To analyse further, please visit the RADAR dashboard (external website).
Additional information
These data are taken from our Accident and Emergency Activity Data.
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.
Drug-related acute hospital admissions
Between July and September 2023, 2,423 drug-related hospital admissions were recorded, similar to the previous quarter (2,484). Admissions were 16% lower than the same period in 2021 (2,889) and 20% higher than in 2022 (2,021).
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 28 June 2021 to 1 October 2023.
An interactive version of this chart can be found in the RADAR dashboard (external website). The dashboard also allows users to download the data and filter by NHS board.
A further chart showing the top five drug types associated with admissions is available on the RADAR dashboard (external website).
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 between April and May 2022, before following an uneven decreasing trend between June and December 2022. Admissions then increased, from 118 in the week beginning 26 December 2022, to 209 in the week beginning 26 June 2023.
- The long-term decreasing trend in drug-related hospital admissions observed in 2022 differed from previous years, which have generally been characterised by lower numbers of admissions during winter months and higher numbers during summer months. The decrease seen in 2022 should not necessarily be interpreted as a reduction in harms. Hospital admissions may have been affected by issues accessing urgent care services and by the capacity of hospital services.
- Between April to June 2023, the most common drug category recorded was opioids (47% of admissions), followed by cocaine (19%).
National update
For the most recent period (3 July to 1 October 2023):
- 2,423 drug-related hospital admissions were recorded, at an average of 186 per week. This was similar to the previous 13-week period (2,484 admissions, weekly average 191).
- Admissions generally decreased throughout this period, from 204 in the week beginning 3 July 2023, to 144 in the week beginning 25 September 2023.
- The total number of admissions was 16% lower than in 2021 (2,889, weekly average 222) and 20% higher than in 2022 (2,021, weekly average 155).
- Opioids continued to be the most common substance type. These were recorded in an average of 45% of admissions per month, which was broadly consistent over the time series. Admissions recording cocaine remained stable (20%).
Local update
For the most recent period (3 July to 1 October 2023), the number of drug-related hospital admissions varied across mainland NHS boards, compared to the previous quarter:
- Admissions increased in four areas: NHS Greater Glasgow and Clyde (11%), NHS Grampian (18%), NHS Ayrshire and Arran (22%) and NHS Borders (60%).
- Admissions decreased in two areas: NHS Dumfries and Galloway (11%) and NHS Tayside (27%).
- Admissions were broadly stable in three areas: NHS Forth Valley, NHS Lothian and NHS Lanarkshire.
Due to completeness levels below 90% for the most recent time period for both NHS Fife and NHS Highland, the boards have been excluded from the above narrative. The data can be found on our dashboard. Caution is advised when interpreting local trends for these boards and comparing to other areas.
To analyse further, please visit the RADAR dashboard (external website).
Additional information
These data have been extracted from our Scottish Morbidity Records (SMR01 acute).
The data presented on drug type are based on ICD-10 diagnostic codes and are not confirmed by toxicology analysis.
The most recent Accredited Official Statistics on drug-related hospital care, includes a range of further information on drug types and patient demographics. For details, see our information on drug-related hospital statistics (DRHS). Please note, our DRHS dashboard presents data by date of discharge, so figures will differ to those shown above.
Suspected drug deaths
The average weekly number of suspected drug deaths remained stable between September (19) and November 2023 (19), averaging 21 per week. The total number of suspected drug deaths between September and November 2023 was 267. The number of deaths was 8% lower than in the same time period in 2021 (290) and 6% lower compared to 2022 (285).
Background
A suspected drug death is a death where controlled drugs are suspected of being involved. Suspected drug-death figures are based on reports, observations and initial enquiries from police officers attending scenes of death.
The details of these events are recorded by Police Scotland and shared with Public Health Scotland (PHS).
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 those published by the National Records of Scotland (NRS: external website) 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 30 August 2021 to 26 November 2023.
An interactive version of this chart can be found in the RADAR dashboard (external website). The dashboard also allows users to download the data.
Summary
Historic trend
- Between September 2021 and August 2023, the average weekly number of suspected drug deaths fluctuated considerably but remained within a range of 17 to 30 deaths per week.
Update
For the most recent period (September to November 2023):
- There were 80 suspected drug deaths in September, 105 in October and 82 in November.
- There was a total of 267 suspected drug deaths, 19% lower than the previous period (330). This was 8% lower than the same period in 2021 (290) and 6% lower than in 2022 (285).
- The average weekly number of suspected drug deaths decreased throughout September and remained broadly stable through October and November 2023.
- There was an average of 21 suspected drug deaths recorded per week. This weekly average was 13% lower than the previous period (24), and similar to the same periods in 2021 and 2022 (both 22).
To analyse these data further, please visit the RADAR dashboard (external website).
Additional information
Data on suspected drug deaths are provided by Police Scotland.
The Scottish Government produce a quarterly report (Suspected drug deaths in Scotland (external website)) 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.
The information above is management information and not subject to the same validation and quality assurance as accredited official statistics. The data provided in this release should not be viewed as indicative of the annual deaths reported by NRS.
Accredited official statistics on drug-related deaths are published annually by the NRS during the summer and provide information broken down by age, sex, substance implicated and geographical area. The latest NRS publication (external website) reported that there were 1,051 drug-related deaths in Scotland in 2022. This was a 21% decrease compared to 2021 (1,330).
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 PHS drug-related deaths report describes deaths that occurred in 2017 and 2018, with trend data from 2009.