Naloxone administration by Scottish Ambulance Service

The average weekly number of naloxone administration incidents decreased between September (61) and November 2024 (47). The total number of naloxone administration incidents (700) was 30% lower than the previous quarter (998). This was 24% lower than the same period in 2022 (917) and 34% lower than in 2023 (1,058).

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 in Scotland from 22 August 2022 to 24 November 2024.

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.

The chart shows the number of emergency naloxone incidents attended by the Scottish Ambulance Service, from 22 August 2022 to 24 November 2024. The average number of incidents was broadly stable between August and November 2022, at 77 per week, before decreasing during December 2022 (weekly average 66). An increasing trend was observed from January (weekly average 67) to May 2023 (weekly average 86). Between June and August 2023, incidents remained broadly stable (weekly average 103), after which there was a decreasing trend to January 2024 (weekly average 68). Incidents then increased and remained stable at around 86 per week from April to July 2024. Since then, a generally decreasing trend has been observed, from 76 incidents per week on average in August, to 47 incidents per week on average in November.

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Naloxone administration by Scottish Ambulance Service

Summary

Historic trend

• The average weekly number of naloxone incidents was broadly stable, at 77 per week between August and November 2022. The average number of weekly incidents decreased to 66 per week in December 2022.
• During 2023, the normal seasonal pattern of lower numbers during winter months and higher numbers during summer months was observed, with an increasing trend in the average weekly number from January (67) to May 2023 (86).
• Between June and August 2023, incidents remained broadly stable at around 103 per week, after which there was a decreasing trend to January 2024.
• Between January and April 2024, the average number of weekly incidents fluctuated within a lower range of 47 to 86.
• Following a sharp increase in early May, the average number of weekly incidents remained stable at a higher level (90) between May and July 2024.
• During August 2024, a decreasing trend in the average weekly number of incidents was observed (76).

National update

For the most recent period (2 September to 24 November 2024):

• 700 SAS naloxone incidents were recorded, at an average of 58 per week. Average weekly numbers decreased between September (61) and November 2024 (47).
• The number of incidents was 30% lower than the previous 12-week period (10 June to 1 September 2024) when 998 incidents were recorded, at an average of 83 per week.
• The number of incidents was 24% lower than the same period in 2022 (917, weekly average 76) and 34% lower than in 2023 (1058, weekly average 88).

Local update

Comparing the most recent period (2 September to 24 November 2024) to the previous quarter, decreases in incidents were observed in all mainland NHS boards:

• NHS Lanarkshire (16%), NHS Lothian (21%), NHS Borders (25%), NHS Ayrshire and Arran (29%), NHS Greater Glasgow and Clyde (31%), NHS Grampian (35%), NHS Highland (35%), NHS Tayside (35%), NHS Forth Valley (36%), NHS Fife (44%) and NHS Dumfries and Galloway (53%).

To analyse these data further, please visit the RADAR dashboard (external website).

Additional information

PHS was provided with these data by SAS.

Scotland-level data for 1 January 2018 to 24 November 2024 are available on the RADAR dashboard (external website).

Information on the carriage of naloxone by Police Scotland officers can be found on Police Scotland’s website.

Information on take-home naloxone distribution can be found in the National Naloxone Programme Scotland Quarterly Monitoring Bulletin, published by PHS.

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 2024, the number of drug-related attendances at emergency departments (977) was 10% lower than the previous quarter (1,090). This was 14% lower than the same period in 2022 (1,130) and 16% lower than in 2023 (1,162).

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 in Scotland between 29 August 2022 and 1 December 2024.

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.

The chart shows the number of drug-related emergency department attendances. The number of attendances is on the y axis and the date, between 29 August 2022 and 1 December 2024, is on the x axis. The average number of attendances was broadly stable at 84 per week, between September 2022 and March 2023. Between April and June 2023, the number of attendances gradually increased, peaking at 144 in the week beginning 19 June 2023. An overall decreasing trend was observed from June 2023 to October 2023. From November 2023 to September 2024, the number of attendances has been broadly stable in the range of 60 to 100 attendances per week. Since then, attendances have been roughly stable at an average of 76 attendances per week.

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Drug-related attendances at emergency departments

Summary

Historic trend

• The number of drug-related ED attendances per week was broadly stable between September 2022 until March 2023 (weekly average 84). Attendances generally increased between April and June 2023, with the highest weekly level in the series observed in June 2023 (144).
• From June 2023 to October 2024, despite variations in the number of attendances per week, an overall decreasing trend was observed, from an average of 106 in June 2023, to 91 in October 2023.
• From November 2023 to August 2024, the number of attendances has been broadly stable in the range of 60 to 100 attendances per week.

National update

For the most recent 13-week period (2 September to 1 December 2024):

• 977 emergency department attendances were recorded, at an average of 75 per week. This was 10% lower than the previous 13-week period (3 June to 1 September 2024, 1,090 attendances, weekly average 84).
• Attendances were 14% lower than the same period in 2022 (1,130 attendances, weekly average 87) and 16% lower than in 2023 (1,162 attendances, weekly average 89).

Local update

Comparing the most recent period (2 September to 1 December 2024) to the previous quarter, the key changes observed across mainland NHS boards were:

• Attendances increased in six areas: NHS Forth Valley (8%), NHS Dumfries and Galloway (10%), NHS Borders (21%), NHS Highland (21%), NHS Grampian (35%) and NHS Ayrshire and Arran (75%).
• Attendances decreased in four areas: NHS Lanarkshire (16%), NHS Tayside (22%), NHS Lothian (23%) and NHS Fife (24%).
• Attendances were broadly stable in NHS Greater Glasgow and Clyde.

To analyse further, please visit the RADAR dashboard (external website).

Additional information

These data are taken from our Accident and Emergency Activity Data.

Due to the quality of the data available, it is not possible to accurately report total attendances for specific conditions using the national Accident and Emergency dataset. The diagnosis or reason for attendance can be recorded in a variety of ways, including in free text fields and not all NHS boards submit this information. The numbers presented in this report are based on an experimental definition of drug-related ED attendances and have not been subject to extensive quality assurance. Therefore, they are provisional and may be subject to change in future releases. Further details can be found in the metadata and the Accident and Emergency Activity Data.

Drug-related acute hospital admissions

Between July and September 2024, 2,071 drug-related hospital admissions were recorded, 8% lower than the previous quarter (2,253). Admissions were similar to the same period in 2022 (2,024) and 20% lower than in 2023 (2,577).

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 27 June 2022 to 29 September 2024. Data are taken from Scottish Morbidity Record (SMR) records held by Public Health Scotland (PHS). PHS expects to receive complete SMR data six weeks after the end of the month of discharge/clinic date. Therefore, the period presented here differs from our other harm indicators - this should be taken into consideration when interpreting trends. Data for the most recent quarter are provisional and may change in future publications. For further information, see the data management section on our website.

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.

The chart shows the number of drug-related hospital admissions in Scotland’s general acute hospitals. The number of admissions is on the y axis and the date, between 27 June 2022 to 29 September 2024, is on the x axis. Between July 2022 and March 2023, admissions remained broadly stable averaging 147 per week, with a slight seasonal decrease during the end of December and beginning of January. Admissions increased between April and July 2023 (averaging 203 per week) and remained relatively stable until September before following a decreasing trend until October 2023. Between October 2023 and June 2024, admissions were roughly stable averaging 167 admissions per week. Admissions decreased between July to October (weekly average 159 per week).

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Drug-related hospital admissions

A further chart showing the top five drug types associated with admissions is available on the RADAR dashboard (external website).

Summary 

Historic trend 

• Between July 2022 and March 2023, admissions remained broadly stable averaging 147 per week, with a seasonal decrease during December and January.
• Admissions then increased until July 2023 (averaging 203 per week), remaining relatively stable until September 2023, followed by a decrease in October 2023.
• Between October 2023 and June 2024, admissions were roughly stable averaging 167 admissions per week.
• Opioids were the most common drug category recorded. The percentage of admissions where opioids were recorded remained relatively stable until the end of 2023 (average 47% between July 2022 and December 2023), before following a decreasing trend to 40% in June 2024. 
• The second most common drug type was cocaine, with admissions gradually increasing from 17% in July to September 2022, to 20% in April to June 2024. 

National update

For the most recent period (1 July to 29 September 2024):

• 2,071 drug-related hospital admissions were recorded, at an average of 159 per week. This was 8% lower than the previous 13-week period (2,253, weekly average 173).
• The total number of admissions was similar to the same period in 2022 (2,024, weekly average 156) and 20% lower than in 2023 (2,577, weekly average 198).
• Opioids continued to be the most common drug type. These were recorded in an average of 41% of admissions per month, a decrease from 43% in the previous quarter. Admissions for cocaine increased to 23%, from 20% in the previous quarter.

Local update

Comparing the most recent period (1 July to 29 September 2024) to the previous quarter, the key changes observed across mainland NHS boards were:

• Admissions increased in three areas: NHS Borders (11%), NHS Forth Valley (11%) and NHS Greater Glasgow and Clyde (11%).
• Admissions decreased in three areas: NHS Lanarkshire (11%), NHS Dumfries and Galloway (22%) and NHS Highland (22%).
• Admissions were broadly stable in three areas: NHS Ayrshire and Arran, NHS Lothian and NHS Tayside.

Due to completeness levels for the most recent period being below 90%, NHS Fife and NHS Grampian have been excluded from this local update. 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, therefore patterns in substance type should be interpreted with caution.

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

In the latest period (2 September to 24 November 2024), the total number of suspected drug deaths was 215, averaging 18 per week. The average weekly number of deaths decreased between September (21) and November 2024 (14). The total number of deaths was 10% lower than the previous quarter (238), 20% lower than the same period in 2022 (268) and 15% lower than in 2023 (254).

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 22 August 2022 to 24 November 2024.

An interactive version of this chart can be found in the RADAR dashboard (external website). The dashboard also allows users to download the data.

The chart shows the weekly number of suspected drug deaths in Scotland on the y axis and the date, between 22 August 2022 and 24 November 2024, on the x axis. Between September 2022 and the end of August 2024, the average weekly number of deaths fluctuated considerably but generally remained within the range of 18 to 28 deaths per week. Between September and November 2024, the average weekly number of deaths followed a decreasing trend to a low of 14 in the week beginning 11 November 2024.

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Suspected drug deaths

Summary 

Historic trend 

• Between September 2022 and August 2024, the average weekly number of suspected drug deaths fluctuated considerably but generally remained within the range of 18 to 28 deaths per week.

Update 

For the most recent complete months (1 September to 30 November 2024):

• There were 237 suspected drug deaths, 92 in September, 84 in October and 61 in November.

For the most recent 12-week period (2 September to 24 November 2024):

• There were 215 suspected drug deaths, 10% lower than in the previous 12-week period (238). This was 20% lower than the same period in 2022 (268) and 15% lower than in 2023 (254).
• The average weekly number of deaths decreased from September (21) to October (18) and decreased further in the first three weeks of November 2024 (14).
• An average of 18 deaths were recorded per week. This was 10% lower than in the previous period (20), 18% lower than in the same period in 2022 (22) and 14% lower than in 2023 (21).

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) 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 1,172 drug-related deaths in Scotland in 2023. This was a 12% increase compared to 2022 (1,051).

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 registered in 2019 and 2020, with trend data from 2012.