Naloxone administration by Scottish Ambulance Service

The average weekly number of naloxone administration incidents increased between March (62) and May 2024 (84). The total number of incidents during this period (926) was slightly higher (5%) than the previous quarter (885). This was slightly lower (5%) than the same period in 2022 (974) and 6% lower than in 2023 (988).

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 28 February 2022 to 2 June 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 by the Scottish Ambulance Service. The number of incidents is on the y axis and the date, between 6 December 2021 and 3 March 2024, is on the x axis. An uneven slightly decreasing trend was observed from December 2021 until April 2022. Following an isolated increase in April 2022, the number of naloxone incidents followed a gradual decreasing trend from May to December 2022. An increasing trend was observed from January to May 2023. Between June and August 2023, the average weekly number of naloxone incidents remained broadly stable at around 93 per week, after which the weekly number of incidents followed a generally decreasing trend to January 2024, although an isolated increase was observed in week beginning 30 October (108).

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Naloxone administration by Scottish Ambulance Service

Summary

Historic trend

• During 2022, the seasonal pattern of lower numbers during winter months and higher numbers during summer months, was less pronounced than in previous years. Despite an increase in April, incidents followed a gradual decreasing trend from May to December 2022.
• During 2023, the normal seasonal pattern was observed again, with an increasing trend in the average weekly number from January (60) to May 2023 (79).
• Between June and August 2023, the average number of incidents remained high and broadly stable (93).
• Weekly incidents were highly variable between September and December 2023, ranging from 63 to 108.
• Between January and March 2024, the average number of weekly incidents ranged from 44 to 80.

National update

For the most recent 13-week period (4 March to 2 June 2024):

• 926 SAS naloxone incidents were recorded, at an average of 71 per week. Average weekly numbers fluctuated but generally increased between March (62) and May (84).
• The total number of incidents was slightly higher (5%) than the previous 13-week period (4 December to 3 March 2024) when 885 incidents were recorded, at an average of 68 per week.
• The number of incidents was slightly lower (5%) than the same period in 2022 (974, weekly average 75) and 6% lower than in 2023 (988, weekly average 76).

Local update

For the most recent period (4 March to 2 June 2024), naloxone administration incidents increased across most mainland NHS boards, compared to the previous quarter:

• Incidents increased in six areas: NHS Forth Valley (5%), NHS Grampian (6%), NHS Fife (9%), NHS Ayrshire and Arran (14%), NHS Tayside (19%) and NHS Highland (59%).
• Incidents decreased in two areas: NHS Lanarkshire (7%) and NHS Dumfries and Galloway (26%).
• Incidents were broadly stable in three areas: NHS Borders, NHS Greater Glasgow and Clyde and NHS Lothian.

To analyse these data 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.

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 March and May 2024, the number of drug-related attendances at emergency departments (1,032) was similar to the previous quarter (1,010). This was similar to the same period in 2022 (1,038) and 12% lower than in 2023 (1,173).

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 28 February 2022 and 2 June 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 28 February 2022 and 2 June 2024, is on the x axis. Following a decreasing trend in March and April 2022, attendances increased sharply, peaking at 123 in the week beginning 16 May 2022. The number of attendances decreased and remained broadly stable at 82 per week between June 2022 and March 2023. Between April and June 2023, the number of attendances gradually increased, peaking at 142 in the week beginning 19 June 2023. An overall decreasing trend was observed from July 2023 to January 2024. This was followed by a generally increasing trend to the end of May 2024.

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Drug-related attendances at emergency departments

Summary

Historic trend

• Following a decreasing trend during March 2022, the lowest level in the series was observed in April 2022 (53). Attendances then increased sharply and peaked in May 2022 (123) before decreasing and remaining stable until March 2023 (weekly average 82).
• Between April and June 2023, attendances generally increased with the highest weekly levels in the series observed in June 2023 (142).
• From July 2023 to January 2024, despite large variations in the number of attendances per week, an overall decreasing trend was observed, from an average of 93 in July 2023 to 69 in January 2024.

National update

For the most recent 13-week period (4 March to 2 June 2024):

• 1,032 emergency department attendances were recorded, at an average of 79 per week. This was similar to the previous 13-week period (4 December 2023 to 3 March 2024, 1,010 attendances, weekly average 78).
• Attendances were similar to the same period in 2022 (1,038 attendances, weekly average 80) and 12% lower than in 2023 (1,173 attendances, weekly average 90).

Local update

For the most recent period (4 March to 2 June 2024) the number of emergency department attendances varied across the mainland NHS boards, compared to the previous quarter:

• Attendances increased in four areas: NHS Fife (6%), NHS Lothian (13%), NHS Grampian (20%) and NHS Highland (42%).
• Attendances decreased in four areas: NHS Greater Glasgow and Clyde (6%), NHS Dumfries and Galloway (22%), NHS Ayrshire and Arran (24%) and NHS Borders (30%).
• Attendances were broadly stable in three areas: NHS Forth Valley, NHS Lanarkshire and NHS Tayside.

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 January and March 2024, 1,906 drug-related hospital admissions were recorded, 11% lower than the previous quarter (2,138). Admissions were 8% lower than the same period in 2022 (2,081) and stable compared to 2023 (1,899).

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 December 2021 to 31 March 2024. Data are taken from Public Health Scotland's Scottish Morbidity Record (SMR).

PHS expects to receive SMR data six weeks after the end of the month of discharge/clinic date and therefore the period presented here differs from our other harm indicators. This should be taken into consideration when interpreting trends. 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 December 2021 to 31 March 2024, is on the x axis. There was a brief increase in admissions in January 2022, before decreasing until April 2022. Admissions briefly increased again in April and May 2022 (peak of 201 admissions during the week beginning 16 May), before following an uneven decreasing trend from June to December 2022. Admissions increased between January and July 2023, reaching a peak in the week beginning 10 July (223), remaining relatively stable until September before following a decreasing trend until December 2023. Following a brief increase in January 2024, there was a decreasing trend to 31 March 2024.

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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 

• There was a brief increase in admissions in January 2022, before decreasing until April 2022. Admissions increased between April and May, before following an uneven decreasing trend between June and December 2022.
  • This decrease should not necessarily solely be interpreted as a reduction in harms. Admissions may have been affected by issues accessing urgent care services and by the capacity of hospital services.
• Admissions then increased, from 119 in the week beginning 26 December 2022, to 223 in the week beginning 10 July 2023. Admissions then remained relatively stable until September 2023, when the trend began to decrease until December 2023.
• Between October to December 2023, the most common drug category recorded was opioids (46% of admissions), followed by cocaine (18%).

National update

For the most recent period (1 January to 31 March 2024):

• 1,906 drug-related hospital admissions were recorded, at an average of 147 per week. This was 11% lower compared to the previous 13-week period (2,138 admissions, weekly average 164).
• Admissions generally decreased throughout this period, from 150 in the week beginning 1 January 2024, to 123 in the week beginning 25 March 2024.
• The total number of admissions was stable compared to 2023 (1,899, weekly average 146) and 8% lower than in 2022 (2,081, weekly average 160).
• 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 recorded for cocaine (20%) were stable compared to the previous quarter (18%).

Local update

For the most recent period (1 January to 31 March 2024), the number of drug-related hospital admissions varied across mainland NHS boards, compared to the previous quarter:

• Admissions increased in two areas: NHS Lanarkshire (5%) and NHS Dumfries and Galloway (27%).
• Admissions decreased in three areas: NHS Ayrshire and Arran (7%), NHS Greater Glasgow and Clyde (14%) and NHS Lothian (17%).
• Admissions were broadly stable in five areas: NHS Borders, NHS Forth Valley, NHS Grampian, NHS Highland and NHS Tayside.

Due to completeness levels for the most recent period being below 90%, NHS Fife has been excluded from the above narrative. The data can be found on our dashboard (external website). Caution is advised when interpreting local trends for this board and comparing to other areas.

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 (4 March to 26 May 2024), the total number of suspected drug deaths was 267, averaging 22 per week. The average weekly number of deaths decreased between March (26) and May (23). The total number of deaths was 8% lower than the previous quarter (291), 6% lower than the same period in 2022 (283) and 11% lower than in 2023 (300).

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 28 February 2022 to 26 May 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 28 February 2022 to 26 May 2024, on the x axis. Between March 2022 and the end of May 2024, the average weekly number of deaths fluctuated considerably but generally remained within a range of 18 to 28 deaths per week.

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Suspected drug deaths

Summary 

Historic trend 

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

Update 

For the most recent complete months (1 March to 31 May 2024):

• There were 291 suspected drug deaths, 116 in March, 77 in April and 98 in May.

For the most recent period (4 March to 26 May 2024):

• There were 267 suspected drug deaths, 8% lower than in the previous 12-week period (291). This was 6% lower than the same period in 2022 (283) and 11% lower than in 2023 (300).
• The average weekly number of deaths decreased sharply from March (26) to April (18) and increased in May (23).
• An average of 22 deaths were recorded per week. This was 9% lower than in the previous period (24), 9% lower than in the same period in 2022 (24) and 14% lower than in 2023 (25).

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). Data for 2023 is due to be published on 20 August 2024.

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.