Rapid Action Drug Alerts and Response (RADAR) quarterly report
October 2023
A Management Information Statistics publication for Scotland
- Published
- 24 October 2023
- Type
- Statistical report
- Author
- Public Health Scotland
Harm indicators
Naloxone administration by Scottish Ambulance Service
The average weekly number of naloxone administration incidents increased between June (89) and August 2023 (95). The total number of incidents during this time period (1,298) was 26% higher than in the previous time period (1,033). The number of incidents was 20% lower than the same period in 2021 (1,631) and 22% higher than in 2022 (1,062).
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 31 May 2021 to 3 September 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).
National update
For the most recent time period (29 May to 3 September 2023):
- 1,298 SAS naloxone incidents were recorded, at an average of 93 per week. Weekly numbers of incidents generally increased throughout this period.
- The total number of incidents was 26% higher than in the previous 14-week period (20 February to 28 May 2023) when 1,033 incidents were recorded, at an average of 74 per week.
- The total number of incidents was 20% lower than the same time period in 2021 (1,631, weekly average 117) and 22% higher than in 2022 (1,062, weekly average 76).
Local update
For the most recent time period (29 May to 3 September 2023), the number of naloxone administration incidents varied across mainland NHS Boards, compared to the previous time period:
- Incidents increased in eight areas: NHS Ayrshire and Arran (15%), NHS Fife (18%), NHS Grampian (18%), NHS Borders (20%), NHS Greater Glasgow and Clyde (29%), NHS Lothian (45%), NHS Highland (51%) and NHS Lanarkshire (63%).
- Incidents decreased in NHS Dumfries and Galloway (33%).
- Incidents were broadly stable in the remaining NHS Boards.
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 June and August 2023, drug-related attendances at emergency departments increased by 13%, compared to the previous time period. A total of 1,403 attendances were recorded in this period – similar to the same time period in 2021 (1,433) and 22% higher than in 2022 (1,149).
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 31 May 2021 and 28 August 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 August 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 then decreased and remained stable, averaging 83 per week from June 2022 to March 2023.
National update
For the most recent time period (29 May to 3 September 2023):
- 1,403 ED attendances were recorded, at an average of 100 per week. This was 13% higher than the previous 14-week period (20 February to 28 May 2023, 1,244, weekly average 89).
- Attendances were similar to 2021 (1,433, weekly average 102) and 22% higher compared to the same time period in 2022 (1,149, weekly average 82).
Local update
- For the most recent time period (29 May to 3 September 2023), the number of drug-related ED attendances varied across mainland NHS Boards, compared to the previous time period:
- Attendances increased in eight areas: NHS Greater Glasgow and Clyde (11%), NHS Dumfries and Galloway (13%), NHS Lothian (16%), NHS Lanarkshire (26%), NHS Fife (29%), NHS Highland (31%), NHS Borders (33%) and NHS Forth Valley (45%).
- Attendances decreased in two areas: NHS Ayrshire and Arran (6%) and NHS Tayside (10%).
- Attendances were broadly stable in NHS Grampian.
To analyse these data 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
The average weekly number of drug-related hospital admissions increased between April (695) and June 2023 (905). The total number of admissions in this time period (2,378) was 26% higher than in the previous time period (1,886). The number of admissions was 28% lower than the same time period in 2021 (3,287) and 6% higher than in 2022 (2,242).
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 29 March 2021 to 2 July 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 in April and May 2022, before decreasing again in June and remaining relatively stable between July and December 2022. Admissions then began to increase, from 118 in the week beginning 26 December 2022, to 151 in the week beginning 27 March 2023.
- The long-term decreasing trend in admissions observed in 2022 differs markedly from previous years, which have generally been characterised by lower numbers during winter months and higher numbers during summer months. The data can be explored further on our dashboard (external website).
- This decreasing trend should not be interpreted as a reduction in harms. The number of admissions may be affected by issues accessing urgent care services and by the capacity of hospital services.
- In January to March 2023, the most common drug category recorded was opioids (48% of admissions), followed by cannabinoids (20%).
National update
For the most recent time period (3 April to 2 July 2023):
- 2,378 drug-related hospital admissions were recorded, at an average of 183 per week.
- Admissions generally increased throughout this period, from 158 in the week beginning 10 April, to 182 in the week beginning 26 June.
- The total number of admissions in this time period (2,378) was 26% higher than in the previous 13-week period (1,886).
- The total number of admissions was 28% lower than in 2021 (3,287, weekly average 253) and 6% higher than in 2022 (2,242, weekly average 172).
- The most common substance type recorded continued to be opioids. These were recorded in an average of 46% of admissions per month, which was broadly consistent over the time series. Admissions recording cocaine and multiple/other drugs increased to a monthly average of 19% each.
Local update
- For the most recent time period (3 April to 2 July 2023), the number of drug-related hospital admissions increased in all 11 mainland NHS Boards compared to the previous 13-week period – ranging from 5% in NHS Fife, to 51% in NHS Lothian.
To analyse these data further, please visit the RADAR dashboard (external website).
Additional information
These data have been extracted from our Scottish Morbidity Records acute (SMR01).
The data presented on drug type are based on ICD-10 diagnostic codes and are not confirmed by toxicology analysis.
The most recent 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 increased between June (22) and August 2023 (25), averaging 23 per week. The total number of suspected drug deaths was 307. The number of deaths was similar to the same time period in 2021 (317) and 7% higher compared to 2022 (286).
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 the national statistics published by the National Records of Scotland (NRS) 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 31 May 2021 to 27 August 2023.
Summary
Historic trend
- Between March and July 2021, the average weekly number of suspected drug deaths ranged from 21 to 37 deaths per week.
- There was a sustained decrease in the number of deaths per week in August 2021. Between August 2021 and February 2023, the average weekly number of suspected drug deaths fluctuated considerably but remained within a range of 17 to 29 deaths per week.
Update
For the most recent time period (29 May to 27 August 2023):
- There were 100 suspected drug deaths in June, 89 in July and 118 in August. The number of suspected deaths in August was the highest monthly total observed since November 2022 (118).
- There was a total of 307 suspected drug deaths, similar to the previous time period (309). This was similar to the same time period in 2021 (317) and 7% higher than in 2022 (286).
- The average weekly number of suspected drug deaths decreased at the end of May and remained broadly stable until the end of August 2023.
- For the most recent time period, an average of 23 suspected drug deaths were recorded per week. This weekly average was the same as the previous time period (23), and similar to the same periods in 2021 (24) and 2022 (22).
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. PHS will continue to publish data on suspected drug deaths in future RADAR releases. The Scottish Government, together with PHS and partners, are currently considering the future of the ‘Suspected drug deaths in Scotland’ report.
The information above is management information and not subject to the same validation and quality assurance as official statistics. The data provided in this release should not be viewed as indicative of the annual deaths reported by NRS.
National 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 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.