Rapid Action Drug Alerts and Response (RADAR) quarterly report
July 2024
Management information
- Published
- 30 July 2024
- Type
- Statistical report
- Author
- Public Health Scotland
Trends
Police drug trends bulletin
The purposes of the Police Scotland’s Statement of Opinion (STOP) bulletin are to raise awareness of drug appearance and to demonstrate some of the substances present in Scotland's drugs market. There is no new information for the latest time period (March to June 2024).
For previous police bulletins, please see our previous reports.
For information on RADAR drug trends, please see our intelligence and reports section.
RADAR intelligence and reports
85 reports were validated by RADAR between 5 April and 4 July 2024.
So far, RADAR has received over 290 reports of drug-related information and harms through the reporting form and mailbox.
A summary of key trends is shown below. Validated intelligence reports to RADAR can be found on the dashboard (external website).
Please note, many of these reports have not been confirmed by toxicology and should be considered anecdotal.
Trends by primary drug type
In the latest period (5 April to 4 July 2024):
- The most common drugs or drug types reported were benzodiazepines, cocaine and heroin, broadly in keeping with the previous quarter.
- Reports of synthetic cannabinoids and THC vapes increased to 13, up from four in the last quarter.
- Most concerns were related to adverse effects. In the last quarter, there was an increase in the number of reports of overdose clusters, public overdoses, sudden collapse and wounds and infections (see below).
- RADAR has received several reports regarding young people. Some of these reports include adverse effects, hospitalisations and mental health concerns.
- The drug supply appears increasingly toxic and unpredictable. We have received reports and toxicology data highlighting that a range of drugs are suspected to be adulterated – meaning a substance is added to a drug product to either intentionally or unintentionally change its composition, quality or strength.
Synthetic drugs
- Reports to RADAR suggest the ongoing presence of new synthetic drugs.
- This is supported by increasing detections of nitazenes (most commonly metonitazene and protonitazene) and xylazine through toxicology and drug analysis since autumn 2023:
- Based on post-mortem toxicology testing, nitazenes have been detected in 63 deaths and xylazine has been detected in 18 (to 31 March 2024).
- They have been detected in 40 Scottish samples tested by WEDINOS in the last two years. 75% of detections were made in the last four months (February to May 2024), where nitazenes and xylazine were detected in samples sold as heroin, and bromazolam and metonitazene were detected in samples mis-sold as diazepam. Note: detections below have been simplified for the purpose of the chart. Other substances were detected in the mix on occasion including bromazolam, nitrazolam, MDMA, ketamine, cocaine, diphenhydramine and thebacon.
- Most common reports of xylazine and nitazenes in the last quarter concerned overdose clusters, sudden collapse, reduced consciousness, infections and wounds.
Image caption
Synthetics in Scottish samples tested by WEDINOS
Other reports
- In the last quarter, RADAR received an increased number of reports related to infections. The most commonly mentioned drugs in these reports are cocaine and heroin.
- Infections include soft tissue damage such as wounds, abscesses and bruises, sometimes resulting in gangrene, necrotising fasciitis and amputations; as well as other body infections such as pneumonia, endocarditis, sepsis and septic embolisms.
- In a survey conducted by RADAR in March 2024, local areas were asked to rate wound harm levels compared to average:
- wounds taking longer to heal (higher 61%, same 39%, lower 0%)
- cellulitis (higher 50%, same 39%, lower 11%)
- wounds at injecting site (higher 45%, same 55%, lower 0%)
- bacterial infections (higher 37%, same 53%, lower 10%)
- tissue necrosis (higher 37%, same 44%, lower 19%)
- Xylazine is associated with the development of severe wounds and skin damage. Detections are increasing in Scotland and RADAR published an alert on xylazine in May 2024.
- Resources on wounds are available from the Scottish Drugs Forum (external website). A PDF detailing information on xylazine-associated wounds is available from the Philadelphia Department of Public Health (external website).
- Cannabinoids are substances that interact with the endocannabinoid system, which is involved in regulating processes including movement, motor skills, mood, appetite and pain.
- The market has diversified in 2024, with detections of THC (tetrahydrocannabinol), delta-8 THC, synthetic cannabinoids and semi-synthetic cannabinoids.
- THC vapes are increasingly reported to RADAR from areas across Scotland. The majority of these reports relate to young people using THC vapes at school and experiencing adverse effects, with some requiring hospitalisation. There have also been similar reports from London and Northern Ireland.
- Adverse effects reported include feeling unwell, respiratory decline, intoxication, pale skin, feeling lightheaded and vomiting.
- There have been several Scottish WEDINOS results in the same time period showing THC and CBD (cannabidiol) vapes adulterated with more potent synthetic cannabinoids (including MDMB-4en-PINACA, 4F-MDMB-BINACA and 5F-ADB).
- A PDF harm reduction resource on THC vapes has been created by Crew (external website).
- Synthetic cannabinoids (also known as spice) is a term used to describe over 200 lab-made drugs that mimic the effects of cannabis, but often have more harmful and unpredictable effects.
- Adverse effects reported include difficulty breathing, chest pains, psychosis, seizures, severe nausea and vomiting and unconsciousness.
- Synthetic cannabinoids are the most common detected drug type in prisons (most commonly MDMB-4en-PINACA and MDMB-INACA).
- Since early 2024, RADAR has received several reports regarding the use of synthetic cannabinoids in the community, including ‘herbal spice’, ‘crystal spice’ and THC vapes adulterated with synthetic cannabinoids.
- Semi-synthetic cannabinoids are compounds that are derived from naturally occurring cannabinoids but are modified in the laboratory to enhance or alter their effects. There has been a small number of detections of HHC (hexahydrocannabinoil) in resin and powder form in Scotland.
- Several areas continue to report concerns about the prevalence of ketamine use and an increase in harms among young people, from 13 to 25 years of age.
- Ketamine-related incidents have occurred in schools and use is commonly reported at festivals.
- Adverse effects reported include mouth ulcers, heart palpitations, reduced coordination, unconsciousness, feeling lightheaded, vomiting and feeling unwell.
- Ketamine use has been reported in multiple overdoses, ambulance call outs and hospitalisations.
- Several reports concern long term urinary tract damage, difficulty urinating and abdominal pain, as well as concerns about mental health including depression, anxiety and de-personalisation.
- For harm reduction information, visit Crew (external website).
- For clinical information on the management of ketamine harms, visit Neptune Clinical Guidance, chapter 4 (external website).
Reporting drug harms
Please encourage people and services in your area to share information on trends, incidents and harms related to drugs, such as:
- adverse effects including overdose and wounds
- routes of administration
- new substances or patterns of use
- testing data.
The information in the regional breakdown can be used by local areas for their own drug trend surveillance.
Anyone can make a report by using our new reporting form (external website) or by emailing phs.drugsradar@phs.scot.