Police drug trends bulletin

The purposes of the Police Scotland’s Statement of Opinion (STOP) bulletin are to raise awareness of drug trends and to demonstrate some of the substances present in Scotland's drugs market.

Xylazine

Officers from the STOP unit are now regularly seeing recoveries of diamorphine (heroin) which has been adulterated with xylazine (a non-opioid veterinary tranquiliser), as well as the usual paracetamol and caffeine. 

These cases were initially few and far between, however they are becoming a more common occurrence.

Street benzos

'Street benzos' is a term used to describe benzodiazepines that are unlicensed or illicitly produced.

The most commonly encountered street benzo is bromazolam. The most common type is a round white tablet with ‘10’ on one side and half score on the reverse, followed by a round white tablet with ‘C/DC’ on one side and blank on the reverse.

There has been a slight increase in street benzos being recovered containing nitazene-type opioids.

Image showing two white, circular, benzodiazepine tablets, one stamped ‘10’, the other with a half score.

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Benzodiazepine tablets: white 10 with half score on reverse

Dimethyltryptamine (DMT)

Officers from the STOP Unit West recently attended an address which was suspected to be used for extracting dimethyltryptamine (DMT) from mimosa hostilis root bark (MHRB). This is uncommon and is only the second recorded incident that the STOP unit are aware of.

DMT is a hallucinogenic drug, of the tryptamine family. It is found in various plants, most commonly ayahuasca and MHRB, as is the case here.

Effects can include altered thinking, reality distortion and a sense of spiritual connection. It is ingested by smoking (commonly in vapes), drinking, snorting and less commonly injection. It is a class A controlled drug under the Misuse of Drugs Act 1971.

RADAR intelligence and reports

69 reports were validated by RADAR between 5 July and 4 October 2024.

RADAR has received over 350 reports of drug-related information and harms through the reporting form and mailbox. Our sincere thanks go to everyone who has contributed reports, enabling a more rapid and effective response to emerging public health harms.

A summary of key trends is shown below. Intelligence reports to RADAR can be filtered by drug type and region 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 July to 4 October 2024, QR9):

• The majority of submissions report polydrug use – the use of more than one substance at a time.
• The most common drugs or drug types reported were benzodiazepines, heroin, nitazenes and cocaine.
  • Benzodiazepines (benzos) were the most commonly reported drug of concern, accounting for 26% of all primary drugs reported. Between QR1 to QR5 (quarter dates shown on chart below), benzos accounted for 34% of all primary drugs reported before decreasing in QR6 and remaining static until QR8 (quarterly average 20%; QR6 to QR8).
  • Heroin accounted for 22% of primary drugs reported, this was stable compared to the previous quarter, but reports have increased throughout the time series, from 5% in QR1.
  • Nitazene/fentanyl-type opioids accounted for 9% of primary drugs reported, similar to the previous four quarters (quarterly average 11%; QR5 to QR8). Nitazenes continue to be the most common novel synthetic opioid detected in toxicology but several submissions reported drugs sold as ‘fentanyl’.
  • Cocaine accounted for 8% of primary drugs reported, a decrease on the 18% average between QR1 and QR8.
• Most concerns were related to adverse effects (seizures, wounds and confusion), overdose (collapse, unconsciousness) and death.
• Several intelligence reports concern drugs having different effects or appearance (colour, texture, shape) than expected.

This stacked bar chart shows the percentage of reports by drug or drug type in submissions received by RADAR. Data is shown in eight quarters from Q1 (July to September 2022) to Q8 (July to September 2024). Percentage is on the y axis and date (by quarter) is on the x axis. The drugs are grouped into six main categories (benzodiazepines, cocaine, heroin, nitazenes/fentanyl, cannabinoids and other). The most common drug type reported in all quarters was benzos. Benzo reports start relatively high at 33% in QR1, reaching a high of 42% in QR4 and then gradually decreasing to 16% in QR8, before increasing to 26% in QR9. Cocaine made up 22% of reports in QR1 and fluctuated between 20-25% up to QR4, followed by a decrease in the later quarters, reaching a low of 8% by QR9. Heroin reports started low (5% in QR2) before trending upwards, with intermittent increases across the quarters, peaking at 22% in QR9. Nitazene/fentanyl-type opioid reports initially appear in QR2 at 5% and then fluctuate through the quarters, reaching its highest point of 13% in QR5. By QR9, it decreased slightly to 9%. There were a low number of cannabinoid reports in the first six quarters. Reports peaked in QR8 at 20%, followed by a drop to 5% in QR9. Reports of ‘other’ drugs fluctuated throughout the series from 20-45%.

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Reports to RADAR by primary drug(s)

Fake medicines

• There has been an increase in the number of overdoses and adverse effects reported from drugs in medicinal packaging. Some of these cases related to fake/counterfeit drugs that are made to look like genuine medicines.
• Legitimate looking packaging (including boxes and blister packs) is not confirmation of the contents and they can contain no active ingredients, or different active ingredients and concentrations than stated or expected.
• Fake medicines and pills can sometimes be of poorer quality than genuine pharmaceuticals but it's not always easy or possible to tell.
• Signs that a medicine is fake can include unsealed boxes, spelling mistakes and missing licensing/pharmacy information, as well as physical defects such as pills that are poorly pressed, discoloured, chipped, broken, powdery or crumbly.
• Reports of fake medicines include tapentadol, pregabalin, alprazolam and diazepam.
• In 2024, seven Scottish samples purchased as diazepam were found to contain bromazolam and metonitazene by WEDINOS:
  • Some were sold in blister packets with brand names including Accord, Martin Dow, Galenika, Bensedin and Actavis.
  • Samples were sent from Greater Glasgow and Clyde (G7, G14), Grampian (AB10, AB11), Lothian (EH41), Argyll and Bute (PA23) and Lanarkshire (ML3).
  • Appearance varied but most were blue tablets (occasionally purple or white). Some were stamped with a half score and ‘C/CD’ or ‘10’.
  • Adverse effects included memory loss, agitation, nausea and sweating.
• For more information, visit the #FakeMeds campaign (external website), by the Medicines and Healthcare products Regulatory Agency (MHRA).

Image showing a blue circular tablet, marked ‘10’, next to plastic and foil packaging

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Pill found to contain bromazolam and metonitazene from Lanarkshire, March 2024, mis-sold as diazepam (photo credit: WEDINOS, W049531)

WEDINOS

WEDINOS (external website) is a harm reduction project, providing an anonymous testing service, to show trends in substance use.

Between July and August 2024, 117 samples from Scotland were tested by WEDINOS. Four samples contained no active components.

Among the 113 samples testing positive for a controlled drug:

• There were 228 detections of 42 individual substances.
• The average number of substances detected per sample was two, with the number of substances ranging from one to nine per sample.
• Over half did not test positive for the intended purchase. Of the 16 samples positive for bromazolam, 56% (9) were purchased as diazepam, 38% (6) as alprazolam and (6%) (1) as heroin. 

The following drugs were the most common:

• bromazolam: 16 (7% of detections, 14% of samples)
• heroin: 16 (7% of detections, 14% of samples)
• 6-MAM: 13 (6% of detections, 12% of samples)
• cocaine: 13 (6% of detections, 12% of samples)
• diazepam: 12 (5% of detections, 11% of samples)
• etizolam: 12 (5% of detections, 11% of samples)

Scottish Drugs Forum (SDF) drug trends

SDF supports groups of people with living experience who meet regularly to offer peer support and information-sharing. An important part of this is learning and sharing information about current drug trends and the related risks and harms. Read the SDF trends report for April to June 2024 (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 reporting form (external website) or by emailing phs.drugsradar@phs.scot.

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