Rapid Action Drug Alerts and Response (RADAR) quarterly report
October 2024
Management information
- Published
- 29 October 2024
- Type
- Statistical report
- Author
- Public Health Scotland
Harm indicators
Naloxone administration by Scottish Ambulance Service
The average weekly number of naloxone administration incidents (excluding NHS Fife and NHS Tayside*) decreased between June (73) and August 2024 (62). The total number of incidents during this period (861) was 7% higher than the previous quarter (802). This was similar to the same period in 2022 (839) and 20% lower than in 2023 (1,077).
*Due to issues with a clinical IT system update, data for NHS Fife and NHS Tayside are incomplete for the most recent quarter (3 June to 1 September 2024). Therefore, all NHS Fife and NHS Tayside data have been excluded from naloxone administration figures in this report. Anecdotal data provided by the Scottish Ambulance Service indicates stable naloxone administrations for both boards for the most recent time period.
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, excluding NHS Fife and NHS Tayside, from 30 May 2022 to 1 September 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.
Summary
Historic trend
- Excluding NHS Fife and NHS Tayside, the average weekly number of naloxone incidents was broadly stable at 63 per week between June and November 2022. The average number of weekly incidents decreased to 47 in the week beginning 26 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 (50) to May 2023 (69).
- Between June and August 2023, the average weekly number of naloxone incidents remained broadly stable at around 82 per week, after which there was a decreasing trend to January 2024.
- Between January and March 2024, the number of weekly incidents fluctuated within a range of 37 to 74.
- In May 2024, the average number of weekly incidents remained higher and stable (72).
National update
For the most recent 13-week period (3 June to 1 September 2024):
- Excluding NHS Fife and NHS Tayside, 861 SAS naloxone incidents were recorded, at an average of 66 per week. Average weekly numbers fluctuated but generally decreased between June (73) and August 2024 (62).
- The total number of incidents was 7% higher than the previous 13-week period (4 March to 2 June 2024) when 802 incidents were recorded, at an average of 62 per week.
- The number of incidents was similar compared to the same period in 2022 (839, weekly average 65) and 20% lower than in 2023 (1,007, weekly average 83).
Local update
Comparing the most recent period (3 June to 1 September 2024) to the previous quarter, the key changes observed across mainland NHS boards (excluding NHS Fife and NHS Tayside) were:
- Incidents increased in four areas: NHS Greater Glasgow and Clyde (20%), NHS Lanarkshire (22%), NHS Ayrshire and Arran (23%) and NHS Dumfries and Galloway (94%, 16 more incidents).
- Incidents decreased in three areas: NHS Lothian (10%), NHS Grampian (14%) and NHS Forth Valley (17%).
- Incidents were broadly stable in NHS Borders and NHS Highland.
To analyse these data further, please visit the RADAR dashboard (external website).
Additional information
PHS was provided with these data by SAS.
Due to issues with a clinical IT system update, data for NHS Fife and NHS Tayside are incomplete for the most recent quarter (3 June to 1 September 2024). Therefore, NHS Fife and NHS Tayside have been excluded from SAS naloxone administration figures in this report. Scotland-level data for 1 January 2018 to 2 June 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 June and August 2024, the number of drug-related attendances at emergency departments (1,067) was similar to the previous quarter (1,033). This was similar to the same period in 2022 (1,065) and 19% lower than in 2023 (1,313).
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 30 May 2022 and 1 September 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.
Summary
Historic trend
- The number of drug-related ED attendances per week was broadly stable between June 2022 until March 2023 (weekly average 82). Attendances generally increased between April and June 2023, with the highest weekly level in the series observed in June 2023 (142).
- From July 2023 to January 2024, despite variations in the number of attendances per week, an overall decreasing trend was observed, from an average of 93 in July 2023, to an average of 69 in January 2024.
- A gradually increasing trend was observed from an average of 80 in February 2024, to an average of 85 in May.
National update
For the most recent 13-week period (3 June to 1 September 2024):
- 1,067 emergency department attendances were recorded, at an average of 82 per week. This was similar to the previous 13-week period (4 March to 2 June 2024, 1,033 attendances, weekly average 79).
- Attendances were similar to the same period in 2022 (1,065 attendances, weekly average 82) and 19% lower than in 2023 (1,313 attendances, weekly average 101).
Local update
Comparing the most recent period (3 June to 1 September 2024) to the previous quarter, the key changes observed across mainland NHS boards were:
- Attendances increased in five areas: NHS Fife (8%), NHS Greater Glasgow and Clyde (14%), NHS Borders (19%), NHS Tayside (19%) and NHS Dumfries and Galloway (43%).
- Attendances decreased in four areas: NHS Grampian (6%), NHS Forth Valley (11%), NHS Lanarkshire (15%) and NHS Highland (24%).
- Attendances were broadly stable in two areas: NHS Ayrshire and Arran and NHS Lothian.
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 April and June 2024, 2,188 drug-related hospital admissions were recorded, 5% higher than the previous quarter (2,086). Admissions were similar to the same period in 2022 (2,247) and 12% lower than the same period in 2023 (2,498).
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 28 March 2022 to 30 June 2024. Data are taken from Public Health Scotland's - Scottish Morbidity Record (SMR). PHS expects to receive SMR data six weeks following the end of the month of discharge/clinic date and therefore the period presented here differs from our other harm indicators and 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.
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 an increase in admissions during April and May 2022, before an uneven decreasing trend between June and December 2022.
- This decrease should not necessarily 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 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, before decreasing in October 2023.
- Between November 2023 to March 2024 admissions remained broadly stable averaging 162 per week with a seasonal decrease during the week beginning 25 December 2023 to the week beginning 22 January 2024.
- 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 April 2022 and December 2023), before a slight decrease to 45% of admissions between January and March 2024.
- The second most common drug category was cocaine, with percentages increasing across the series from 15% between April to June 2022, to 20% between January to March 2024.
National update
For the most recent period (1 April to 30 June 2024):
- 2,188 drug-related hospital admissions were recorded, at an average of 168 per week. This was 5% higher than the previous 13-week period (2,086 admissions, weekly average 160).
- The total number of admissions was similar to the same period in 2022 (2,247, weekly average 173) and 12% lower than in 2023 (2,498, weekly average 192).
- Opioids continued to be the most common substance type. These were recorded in an average of 42% of admissions per month, a decrease compared to 45% in the previous quarter. Admissions for cocaine (20%) were stable compared to the previous quarter (20%).
Local update
Comparing the most recent period (1 April to 30 June 2024) to the previous quarter, the key changes observed across mainland NHS boards were:
- Admissions increased in five areas: NHS Fife (8%), NHS Dumfries and Galloway (19%), NHS Grampian (24%), NHS Lothian (25%) and NHS Highland (30%).
- Admissions decreased in three areas: NHS Lanarkshire (14%), NHS Forth Valley (18%) and NHS Borders (53%).
- Admissions were broadly stable in three areas: NHS Ayrshire and Arran, NHS Greater Glasgow and Clyde and NHS Tayside.
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 (3 June to 25 August 2024), the total number of suspected drug deaths was 225, averaging 19 per week. The average weekly number of deaths decreased between June (22) and August 2024 (17). The total number of deaths was 10% lower than the previous quarter (249), 13% lower than the same period in 2022 (258) and 25% lower than in 2023 (301).
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 23 May 2022 to 25 August 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.
Summary
Historic trend
- Between May 2022 and May 2024, the average weekly number of suspected drug deaths fluctuated considerably but generally remained within a range of 18 to 27 deaths per week.
Update
For the most recent complete months (1 June to 31 August 2024):
- There were 243 suspected drug deaths, 92 in June, 80 in July and 71 in August.
For the most recent period (3 June to 25 August 2024):
- There were 225 suspected drug deaths, 10% lower than in the previous 12-week period (249). This was 13% lower than the same period in 2022 (258) and 25% lower than in 2023 (301).
- The average weekly number of deaths decreased from June (22) to July (18) and remained roughly the same in August 2024 (17).
- An average of 19 deaths were recorded per week. This was 10% lower than in the previous period (21), 14% lower than in the same period in 2022 (22) and 24% 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) 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.