Rapid Action Drug Alerts and Response (RADAR) quarterly report
October 2022
A Management Information Statistics publication for Scotland
- Published
- 11 October 2022
- Type
- Statistical report
- Author
- Public Health Scotland
Indicators
Specialist drug treatment referrals
The number of referrals between week beginning 4 April 2022 and week ending 3 July 2022 were 8% lower compared to the previous period between 3 January and 3 April 2022 and 22% lower than expected compared to the same period in 2021.
Background
Specialist drug treatment referrals represent the process of transferring the care of an individual to a health or social care professional within the specialist drug treatment service.
Figures shown are for both drug dependency and co-dependency (people seeking help for both drug and alcohol use) referrals.
Figures include new referrals for treatment and referrals between services where an individual’s type of treatment is changing.
This chart shows the weekly number of referrals from 29 June 2020 to 3 July 2022.
Update
- Weekly number of referrals broadly decreased during the first six months of 2022.
- Weekly number of transactions in June 2022 (354) were around 30% lower compared to the same period in 2021 (490) and 10% lower compared to the same period in 2020 (389).
Additional information
These data are taken from the Drug and Alcohol Information System (DAISy) and its predecessor, the Drug and Alcohol Treatment Waiting Times (DATWT) database.
For more information, or to analyse these data by NHS board, visit the COVID-19 wider impacts dashboard.
PHS also publishes information on waiting times for people accessing specialist drug and alcohol treatment services. The latest data can be viewed in our national drug and alcohol treatment waiting times report.
For details of drug treatment services in your area, visit the Scottish Drug Services Directory. The Medication Assisted Treatment (MAT) Standards are an improvement programme to strengthen access, choice and support within the drug treatment system in Scotland.
Why we use a 3-week moving average
As these data are highly variable over time the 3-week moving average has been included in the graph to account for this variability and provide an average line.
Opioid substitution therapy ePrescribing
The number of prescribed methadone and buprenorphine items remained relatively stable between 1 April and 30 June 2022.
Background
This section summarises information on community prescribing for opioid substitution therapy (OST) drugs, methadone and buprenorphine, in Scotland.
This indicator uses data from eMessage prescriptions and does not include all OST prescriptions.
The methadone statistics relate to prescriptions for methadone 1 mg/1 ml (milligram/millilitre) oral solution.
The buprenorphine statistics relate to prescriptions for 2 mg, 8 mg and 16 mg buprenorphine or buprenorphine and naloxone tablets.
Charts for this indicator are not currently available.
To analyse these data by NHS board, visit the COVID-19 wider impacts dashboard.
A summary of these dashboard statistics for the period between 1 April 2022 and 30 June 2022 is provided here.
Update
Methadone
- The number of methadone items prescribed per month has decreased, from April (28,248) to June 2022 (25,236).
- The quantity of methadone prescribed per item has remained high but stable, from April (1,436.9 mg/ml) to June 2022 (1,421.5 mg/ml).
Buprenorphine
- The number of buprenorphine items prescribed per month increased between April (7,448) and May (7,946), before decreasing in June 2022 (7,390).
- The quantity of buprenorphine prescribed per item was stable between April (203 mg) to June 2022 (203 mg).
- The total quantity of buprenorphine prescribed increased from April (1.5 million mg per month) to May (1.6 million mg per month), before decreasing in June 2022 (1.5 million mg per month).
Additional information
These data are taken from PHS’s Prescribing Information System.
What is ePrescribing data?
These data are based on GP practice eMessage prescriptions for OST medications.
eMessages account for approximately 40% of primary care prescriptions for methadone and 30% for oral buprenorphine.
Primary care accounts for 55% of all OST prescribing. As this only accounts for a sizable minority of OST prescriptions, the patterns described are indicative and should not be assumed to apply to all NHS board areas or prescribers.
Injecting equipment provision
Both the number of transactions and the number of needles and syringes distributed between week beginning 4 April 2022 and week ending 3 July 2022 were similar compared to the previous period between 3 January and 3 April 2022 (1% and 2% increase, respectively).
The number of transactions and number of needles and syringes distributed between April and July 2022 were lower than the same period in the previous two years.
Background
Injecting equipment provision (IEP) is a form of harm reduction that helps to reduce the transmission of blood borne viruses among people who inject drugs. These data relate to the number of transactions at IEP sites in which a needle or syringe is provided and the number of needles and syringes distributed.
This chart shows the weekly number of transactions from 29 June 2020 to 3 July 2022.
This chart shows the weekly number of needles and syringes distributed from 29 June 2020 to 3 July 2022.
Update
- Weekly number of transactions and numbers of needles and syringes were broadly stable during the first six months of 2022, averaging at just under 3,000 and 37,000 each week respectively.
- Average weekly number of transactions were 12% lower in June 2022 (2,877) compared to the same period in 2021 (3,264) and 18% lower compared to the same period in 2020 (3,501).
- Average weekly number of needle and syringes in June 2022 (37,589) were similar to the number distributed in June 2021 (38,753) and were 17% lower compared to the same period in 2020 (45,094).
Additional information
These data are taken from the Needle Exchange Online 360 database (neo360).
The 11 mainland NHS boards use neo360 routinely, but due to missing data for part of the time period presented, NHS Fife and NHS Highland are excluded from the transaction data. NHS Highland is also excluded from the needle and syringe figures.
For more information, or to analyse these data by NHS board, visit the COVID-19 wider impacts dashboard.
For details of injecting equipment providers in your area, visit the Scottish Needle Exchange Directory.
Why we use a 3-week moving average
As these data are highly variable over time the 3-week moving average has been included in the graph to account for this variability and provide an average line.
Emergency naloxone administration
A 17% increase in incidents was recorded between 1 April and 30 June 2022, compared to the period between 1 January and 31 March 2022. Incidents were lower than expected compared to similar time periods in the previous two years.
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.
The chart below shows the weekly number of SAS naloxone incidents from 1 July 2020 to 21 August 2022.
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.
Update
- From early 2022, weekly numbers of naloxone incidents diverged from observed trends, remaining lower than the same time period in previous years.
- SAS naloxone incidents were around 30% lower in August 2022 (284) compared to the same period in 2020 (428) and 2021 (446).
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.
Why we use a 3-week moving average
As these data are highly variable over time the 3-week moving average has been included in the graph to account for this variability and provide an average line.
Scotland’s Take-Home Naloxone Programme
The 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 acute hospital admissions
There was a 4% increase in drug-related hospital admissions between 4 April and 26 June 2022, compared to the period of 10 January to 3 April 2022.
Admissions were considerably lower than the similar time periods in 2020 and 2021.
Background
The data used in these statistics relate to all inpatient and day cases to general acute hospitals (excluding maternity, neonatal, geriatric long stay and admissions to psychiatric hospitals). Data are presented by date of admission.
A drug-related hospital admission is identified by the recording of a drug use diagnosis.
For more information on the drug coding used refer to the drug-related hospital statistics publication methods page.
The chart below shows the weekly breakdown of drug-related admissions in Scotland’s general acute hospitals between 25 May 2020 and 26 June 2022.
Drug-related hospital stays decreased between January and April 2022.
Update
- Hospital admissions continued to decrease in April and June 2022, despite an increase in admissions in May 2022 (777 admissions).
- Overall, the number of admissions was considerably lower than the same period in the previous years, there were 2,066 drug-related hospital admissions between 4 April and 26 June 2022, compared to 3,394 in the same period in 2021.
- The most common drug category recorded in general acute hospital admissions between April and June was opioids, approximately 46% of all admissions. However, the number of opioid-related admissions has been falling since May 2021.
Additional information
These data have been extracted from our SMR01 dataset.
To analyse the latest published information by NHS board or by Alcohol and Drug Partnership (ADP), go to our information on drug-related hospital statistics admissions.
Why we use a 3-week moving average
As these data are highly variable over time the 3-week moving average has been included in the graph to account for this variability and provide an average line.
Drug overdose or intoxication attendances at emergency departments
A 22% increase in emergency department attendances was recorded between 2 May and 31 July 2022, compared to 31 January and 1 May 2022. Attendances were comparable to similar time periods in the previous two years.
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 6 July 2020 and 31 July 2022.
Drug-related attendances at EDs decreased between August 2021 and April 2022 and were at the lowest levels in the time series in April 2022.
Update
- In May 2022, drug-related ED attendances increased sharply, from 87 in week beginning 2 May, to 123 in the week beginning 16 May. Further investigations are ongoing to understand the causes of this increase.
- Drug-related ED attendances decreased throughout June and July 2022.
- Overall, there were 1,137 drug-related ED attendances between 2 May and 31 July 2022.
Additional information
These data are taken from our Accident and Emergency Data Mart.
Data limitations
Diagnosis/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 therefore 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 the 3-week moving average has been included in the graph to account for this variability and provide an average line.
ASSIST: A Surveillance Study in Illicit Substance Toxicity
New project: Clinical characterisation and toxicological analysis of emergency department presentations at the Queen Elizabeth University Hospital in Glasgow.
Background
This new pilot conducted by the emergency department (ED) at the Queen Elizabeth University Hospital (QEUH) aims to assess the feasibility of prospective surveillance of ED presentations due to acute illicit drug toxicity.
The use of the term 'illicit drug' encompasses any substance that is not prescribed to the individual and is a controlled drug as per the Misuse of Drugs Act 1971 and Misuse of Drugs Regulations 2001.
The purpose of this feasibility research is to establish the introduction of a robust ED toxicology surveillance system.
ASSIST collects anonymised data through audits of standard of care clinical data for patients attending the ED due to illicit drug toxicity.
The pilot also collects anonymous surplus blood samples for full toxicological analysis. This allows for drug profiling and the identification of emerging drug trends, to inform appropriate harm reduction measures and public health responses.
Evaluation of reported/presumed drug consumed versus analysis will also be assessed.
This pilot will run in the QEUH adult ED from August 2022 to August 2023, followed by a three-month follow up period.
There is potential for this surveillance to be continued beyond this date at the QEUH and expanded to other hospitals in Scotland.
Update
- The pilot commenced on 19 August 2022 and is on its fifth week of recruitment.
- 103 discreet ED attendances related to illicit drug use have been identified.
- Anonymous toxicological analysis was requested for 42 surplus samples.
79 patients had data available at the time of this report.
This found:
- Five patients were admitted to an intensive care unit or high dependency unit, 18 were admitted to a ward, five were transferred to a psychiatric unit, 10 were discharged to police custody and 41 went home.
- Of the 79 patients with available data:
- a median time of four hours per patient was spent in the ED (range 0.27 – 12 hours)
- the total number of hours spent in ED was 367
Admission data was available for 39 patients.
This found:
- The median length of stay from first ED attendance to discharge from hospital was 5.5 hours (range 0.27 to 415 hours).
- Total number of hours for this group was 1,361 hours in hospital.
- Polydrug use is a prevailing feature. This is known to hold higher risk to the individual than single drug use.
Additional information
PHS was provided with this information by QEUH, NHS Greater Glasgow and Clyde (GGC).
The ASSIST trial is registered with Clinical Trials UK (ID: NCT05329142).
Ethical approval has been granted by West of Scotland Research Ethics Service (IRAS ref: 313616) and surplus sampling methodology through Biorepository Ethics (ref 22/WS/0020).
This study is sponsored by NHS GGC Research and Innovation and is funded by the Scottish Government.
Further information on the study can be found at Clinical Trials UK.
Forensic toxicology testing for controlled substances
The proportion of post-mortem tests detecting benzodiazepines decreased between 1 April and 30 June 2022 and was lower than expected compared to the previous year. In cases testing positive for controlled drugs, multi-drug detection remains the norm.
Background
This analysis is based on toxicology testing data completed at post-mortem.
This testing is performed by the Forensic Toxicology Service based within Forensic Medicine and Science (FMS) at the University of Glasgow, on behalf of the Crown Office and Procurator Fiscal Service.
The range of substances routinely analysed by this service is extensive and includes the detection of alcohol, prescribed medicines and controlled drugs.
The charts below provide an indication of controlled drugs found present at post-mortem in deaths occurring between 1 January 2020 and 30 June 2022, presented by calendar year/quarter.
Update
The most commonly detected controlled substances or substance types in the Q2 of 2022 were:
- opioids (74% of all cases)
- benzodiazepines (59%)
- gabapentin/pregabalin (31%)
- cocaine (30%)
Toxicology cases testing positive for opioids have remained relatively stable throughout the time series.
The trend in benzodiazepines has generally been decreasing, from 73% in the fourth quarter of 2020 to 59% in the second quarter of 2022.
The percentage of deaths testing positive for gabapentin/pregabalin or cocaine have remained relatively stable.
530 toxicology cases were analysed in Q2 2022, similar to the average number of cases typically analysed in a quarter (531).
Update
- Following a reduction in cases testing positive for etizolam and methadone, the most commonly found substance in Q2 of 2022 was heroin/morphine.
- The percentage of deaths involving clonazolam decreased in early 2022 and has remained low (2% of cases in Q1 and 3% of cases in Q2), from a high at the end of 2021 (10% in Q4).
- There has been a small increase in the number of cases where fentanyl was detected, from three deaths in Q1 of 2022 to 10 deaths in Q2 of 2022.
Additional information
PHS was provided with these data by FMS, University of Glasgow.
Detailed interpretation of the levels of drugs found present, drug interactions, co-morbidities or other factors relating to death are outside the scope of this analysis. This analysis does not imply that specific drugs were implicated in deaths nor that deaths were classified as ‘drug-related’ and does not include consideration of wider causes of death.
The data above is for deaths occurring in the west, east and parts of the north of Scotland. Apart from a very small number of cases analysed at the University of Glasgow, post-mortem toxicology testing for deaths occurring in Aberdeen and the far north of Scotland is conducted by a similar service at the Aberdeen Royal Infirmary (ARI). Results from the ARI are not included in the analysis above.
Glossary
- Clonazolam
Clonazolam is a Class C benzodiazepine, first detected in Europe in 2015. In high doses effects include sedation (reduced energy levels), amnesia (memory loss) and respiratory depression (slowed breathing and heart rate).
Clonazolam is often available as white or blue circular pills. The EMCDDA reports that a common dose of clonazolam is 0.2 to 0.4 milligrams (mgs). 0.2 mgs of clonazolam is approximately equivalent to 1 mg of etizolam or 10 mgs of diazepam.
Visit NHS inform for information on benzodiazepines.
For guidance on how services can strengthen responses to benzodiazepine harms, visit the Drug Deaths Taskforce website.
- Fentanyl
Fentanyl is a strong opioid, thought to be at least 80 times more potent than morphine.
It is a widely used medicine in the UK, but when taken without a prescription it is a Class A drug. It is an analgesic drug and effects include pain relief, sedation (reduced energy levels), nausea and respiratory depression (slowed breathing and heart rate). For more information, visit EMCDDA.
Scottish Prison Service drug analysis project
Synthetic cannabinoid is the most prevalent drug type detected in seizure analysis. There was a 10% increase in samples testing positive for cocaine between 1 January and 31 March 2022.
Background
The Leverhulme Research Centre for Forensic Science (LRCFS) is currently undertaking research with the Scottish Prison Service (SPS) to address the changing characteristics of synthetic drugs, including synthetic cannabinoids, often referred to as ‘spice’.
The programme began by focusing on synthetic cannabinoids and in September 2020 expanded to analyse all types of drugs seized by the SPS. This change is highlighted below.
The chart below shows the monthly breakdown of results from analysis of drugs seized in Scotland’s prisons between 1 March 2020 and 31 March 2022. The results are shown as the percentage of all samples tested, broken down by the top five drug types reported.
An overall decreasing trend in the proportion of samples testing positive for synthetic cannabinoids has been observed between July 2021 and January 2022. There has been a slight increase in the proportion of samples testing positive for cocaine since March 2021.
120 substances were analysed in Q1 of 2022, similar to the average number of cases typically analysed in a quarter (137), but less than those analysed in Q4 of 2021 (251) and Q3 of 2021 (235).
The second chart shows the monthly breakdown of the types of samples seized within Scotland’s prisons between 1 March 2020 and 31 March 2022. For the purposes of analysis only the top four sample types have been included in the chart below.
Update
- Overall, the number of samples testing positive for synthetic cannabinoids remained stable between January and March 2022. 28% of all samples tested in February 2022 tested positive for a synthetic cannabinoid, followed by a decrease to 20% in March.
- Cocaine was detected in samples during both February and March with approximately 1 in 10 samples testing positive for the drug.
- The three most commonly detected drugs between January and March 2022 were etizolam, ADB-BUTINACA (synthetic cannabinoid) and cocaine.
- Overall, in Q1 an increasing trend was observed in the percentage of powder and paper samples seized and a decrease in those of tablet and card.
In 2022, this drug analysis project detected five drugs for the first time in prisons in Scotland, demonstrating a constantly evolving drugs market:
- metonitazene (synthetic opioid)
- CH-PIATA (synthetic cannabinoid)
- bromonordiazepam (benzodiazepine)
- 5F-BZO-POXIZID (synthetic cannabinoid)
- BZO-4en-POXIZID (synthetic cannabinoid)
Additional information
PHS was provided with these data by SPS and LRCFS.
The Scottish Prisons Non-Judicial Drug Monitoring Project is a collaboration between the SPS and the LRCFS at the University of Dundee.
An initial pilot project ran between September 2018 and January 2021.
The project has been directly funded by SPS since February 2021.
Glossary
- Synthetic cannabinoids
'Synthetic cannabinoids' is a term used to describe over 200 lab-made drugs that interact with the endocannabinoid system.
The prevalence of synthetic cannabinoids in seizures is higher in prisons than in the general population.
People working and living in prisons should be aware of the harmful effects and risks of synthetic cannabinoid use.
Visit NHS inform for more information on synthetic cannabinoids.
- Multiple
Samples classed as 'multiple' are seizures that contain more than one drug, such as a piece of paper with both a cannabinoid and benzodiazepine, or two different benzodiazepines.
Almost 20% of seizures tested positive for more than one drug and this is concerning as polydrug consumption is a risk factor for overdose and death.
'Multiple' drug results will be analysed in more detail in the next publication.
- Sedatives/hypnotics
Sedatives are a category of drugs with depressant effects (reduce heart rate and breathing) that includes anti-psychotics (quetiapine and olanzapine) and benzodiazepines (most notably etizolam, but also flubromazepam, bromazolam, diazepam and flualprazolam).
Suspected drug-related deaths
There were 562 suspected drug deaths during the first six months of 2022. This was 22% (160) lower than during the same period of 2021.
Suspected drug-related deaths
Suspected drug-related death (DRD) figures are based on reports from police officers attending scenes of death.
Following post-mortem and toxicology testing, these ‘suspected’ DRDs are either ‘confirmed’ or determined ‘not to be a DRD’. This can take several months so suspected figures are used to provide a timely indication of trends and inform prevention activity.
Data on suspected drug deaths in Scotland is provided by Police Scotland and published quarterly by the Scottish Government. The latest report shows there were 562 suspected drug deaths during the first six months of 2022. This was 22% (160) lower than during the same period of 2021.
We plan to include analysis of the occurrence of suspected DRDs over time in future quarterly reports.
Drug-related deaths
The information above is management information and not subject to the same validation and quality assurance as Official Statistics. National Statistics on drug-related deaths in 2021 and earlier years – broken down by age, sex, substances implicated and NHS board and council areas – are published annually by the National Records of Scotland.
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.
National Drug-Related Deaths Database
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.
Police Scotland drug trends bulletin
This indicator contains photos of drugs.
This update shows images of tablets including MDMA (ecstasy) and street benzos (benzodiazepines).
These images have been provided by Police Scotland’s STOP Unit to raise awareness of drug appearance and to demonstrate some of the substances present in Scotland’s drugs market.
Ecstasy tablets
These are images of MDMA (3,4-Methylenedioxymethamphetamine) tablets, commonly known as ecstasy tablets, which have been recovered in the west of Scotland by the Drug Collection Scheme.
This scheme is a collaboration between an events centre and the Police Scotland STOP Unit West.
Drugs found at the conclusion of events within the centre are passed to the STOP Unit for information purposes and then destroyed.
The amount of MDMA in tablets can vary widely and it is common for tablets in Scotland to contain more than one dose.
Visit NHS inform for more information on MDMA.
Street benzo tablets
'Street benzos' is a term used to describe benzodiazepines that are unlicensed or illicitly produced.
High demand for street benzos continues.
Etizolam is still the most common active ingredient used to produce these tablets.
Tablets vary in colour and design.
Appearance is no guarantee of contents and ingredients can vary widely, even between tablets that look the same.
Most commonly recovered
White ‘10’ with a half score on the reverse is still the most commonly recovered street benzodiazepine tablet.
Second most commonly recovered
White 'ROCHE 10' with a half score on the reverse is the second most commonly recovered street benzodiazepine tablet.
Other variations
The following are images of other variations of recovered tablets containing etizolam.
Deaths
In 2021, street benzos were implicated in 842 drug-related deaths in Scotland (National Records of Scotland (NRS), 2022).
772 of these deaths involved etizolam.
In most of these deaths, street benzos were implicated alongside other drugs, for example heroin, methadone, gabapentin and cocaine.
Taking benzodiazepines in high doses or mixing them with other drugs is dangerous.
Other street benzodiazepines implicated in Scottish drug deaths include:
- clonazolam
- alprazolam
- flualprazolam
- flubromazolam
- diclazepam
- flubromazepam
- clonazepam
Visit NHS inform for more information on benzodiazepines.
Additional information
This information is provided to PHS by Police Scotland.
Police Scotland interim drug bulletin (10 November 2022)
N-pyrrolidino etonitazene (synthetic opioid) found in blue pills sold as oxycodone in Aberdeen – October 2022
"Police Scotland have released an interim drug trend bulletin to highlight a current drug-related issue that may affect local communities.
Since late 2021, sporadic intelligence around the UK suggested that illicit oxycodone tablets containing metonitazene were in circulation. These have caused adverse effects including overdose and death.
A recent recovery of tablets bearing oxycodone markings in the Aberdeen area were found to contain N-pyrrolidino etonitazene."
N-pyrrolidino etonitazene (etonitazepyne or NPE) is a potent synthetic opioid of the nitazene/2-benzyl benzimidazole family. It’s estimated to be 20 times more potent than fentanyl and over 600 times more potent than heroin. A lethal dose is the equivalent of a few grains of salt.
Identifying features
- blue tablet
- breakline
- number 30 imprinted on one side
- letter M imprinted on the other
These are visually similar to genuine oxycodone. Tablets that are of poor quality or crumble easily may be an indicator that they have been illicitly produced, but it’s difficult to distinguish between genuine and counterfeit medication.
Any medicine obtained without a prescription should be treated with caution.
Due to its potency, it’s almost impossible to dose correctly and the dose can vary widely between tablets.
PHS strongly recommends people do not take non-prescribed oxycodone tablets.
It’s important to remind people at risk of harm about the information on NHS inform - drugs: what you need to know.
Additional information
This information is provided to PHS by Police Scotland and added to this publication on 10 November 2022.
Reports of drug harms to RADAR
Eight reports were validated by RADAR between 1 July and 23 September 2022.
This indicator contains photos of drugs.
A summary of validated reports is shown below for informational purposes.
These were received through our online reporting form and mailbox.
These reports have been collected as part of intelligence gathering.
PHS recommends the widespread use of the following harm reduction messages and interventions across Scotland.
Be cautious
Drugs in circulation can vary widely
- The drug purchased may not always be the drug that it’s expected to be.
- It may contain adulterants, be mis-sold or contain a different amount than anticipated.
Test before use
- Drug contents cannot be confirmed by the way it looks, smells or tastes.
- People in Scotland can get their drugs tested by using the free, anonymous postal service provided by WEDINOS.
Mixing drugs is dangerous and should be avoided
- Mixing drugs increases the risk of drug harms and death – this includes mixing alcohol with other drugs.
- Those taking medicines should research any potential interactions between their medicines and the drugs they are taking.
- The risk of overdose is also increased if someone takes drugs alone, takes drugs after a break, takes higher purity drugs than expected or injects drugs.
Get help in an emergency
- If someone needs medical help, call 999, ask for an ambulance and stay with the person until help arrives.
- If the person is non-responsive and displaying the signs of an overdose (unconsciousness, shallow breathing, snoring, blue lips, pale skin, pin-point pupils), administer naloxone.
Be informed
General drug information
Harm reduction information
Technical or scientific information
Report 1
- Local authority
Aberdeenshire
- Reason for report
Mis-sold drug, suspected death
- Drug
Etizolam
- Appearance
White circular pill with break line and ’28|30’ marking
- Summary
Drug sold as diazepam suspected in death, sample tested by WEDINOS and confirmed as etizolam.
Report 2
- Local authority
City of Edinburgh
- Reason for report
Adverse effects, new drug, overdose
- Drug
Pregabalin
- Appearance
Red and white capsule with no markings, contents of capsule grainy with distinct aroma
- Summary
Drug sold as pregabalin (assumed 'fake'), purchased cheaply in bulk, suspected in near-fatal overdoses and caused adverse effects including:
- anxiety
- confusion
- depression/low mood
- hallucinations
- loss of consciousness
- psychosis
- dilated pupils
- unusual behaviour
Report 3
- Local authority
Scottish Borders
- Reason for report
New drug
- Drug
Tapentadol
- Appearance
Red circular pills, sold in blister packs
- Appearance
Tapentadol (synthetic opioid) detected in post-mortem toxicology (alongside other drugs).
Services report that it is referred to as 'red apples' and sold as 'super royal – 225'.
Report 4
- Local authority
City of Edinburgh
- Reason for report
New trend
- Drug
Cocaine
- Appearance
Unknown
- Summary
Cocaine cut with mephedrone ('magic').
Report 5
- Local authority
East Lothian
- Reason for report
Suspected death
- Drug
MDMA
- Appearance
Gummy bear shaped pill
- Summary
Suspected in death.
Reports of multiple pills taken, possible polydrug use.
Report 6
- Local authority
City of Edinburgh
- Reason for report
New trend
- Drug
Cocaine
- Appearance
Unknown
- Summary
Injecting cocaine ('prop') reported in previous non-regular users.
Report 7
- Local authority
Highland
- Reason for report
Suspected deaths
- Drug
Bensedin
- Appearance
Branded packets of Bensedin. Drugs consumed by person. Appearance of packet contents unknown.
- Summary
Drug suspected in deaths.
Bensedin is used as a brand name for diazepam but it’s not a brand prescribed in Scotland.
Report 8
- Local authority
City of Edinburgh
- Reason for report
Adverse effects
- Drug
Xanax
- Appearance
Rectangular green/blue pill, 'XANAX' on one side and '3' on other
- Summary
Two taken. Felt nothing from first. Anxiolytic (tranquilising, anti-anxiety) effect from second.
Reporting drug harms
Share information on trends, incidents and harms related to drugs, such as:
- adverse effects
- routes of administration
- testing data
Make a report by using our reporting form or by emailing phs.drugsradar@phs.scot