Reducing drug harms requires all of us to act

The latest figures on drug-use deaths in Scotland are a stark reminder of the harm experienced by individuals, families and communities across the country.

In this blog, Dr Tara Shivaji, Consultant in Public Health at Public Health Scotland (PHS), reflects on what the latest statistics tell us, the changing nature of drug harms and why preventing them requires action across the whole system.

The publication of the National Records of Scotland (NRS) report on drug-use deaths in 2025 is a moment to pause and reflect on Scotland's ongoing public health emergency.

The report showed that 1,133 people lost their lives as a result of drugs in 2025, an 11% increase compared with 2024. Behind each statistic is a person, and every death affects families, friends and communities.

Looking beyond the numbers

There’s no single reason why people experience problematic drug use and no simple solution to reducing drug harms.

Drug harms are shaped by factors such as poverty, homelessness, trauma, inequality and social exclusion.

Stigma and discrimination remain among the most significant barriers. They can prevent people from seeking help and affect access to the support and opportunities that many of us rely on, including housing, employment, financial security and social connections.

Reducing drug harms requires us to address both the immediate risks associated with drug use and the wider circumstances that contribute to harm.

A changing drug market

Alongside these longstanding challenges, Scotland is also experiencing changes in the illegal drug market that are increasing risk.

Through our Rapid Action Drug Alerts and Response (RADAR) system, we've seen evidence of highly potent synthetic drugs, including nitazenes, entering the drug supply. Nitazenes can act in a similar way to heroin but may be significantly stronger, meaning that very small amounts can cause an overdose.

We've identified contamination within the drug supply, where people may be unaware that the substance they’re taking contains synthetic opioids or other harmful substances. This was highlighted in spring 2025 when PHS coordinated a national response following reports of sudden and severe overdoses linked to nitazene contamination in the heroin supply across Scotland. Drug services, third sector organisations and peers worked quickly to share information and provide support. While these actions made a difference, they also highlighted an important reality – drug services alone cannot reduce harm at the scale required.

Working together to save lives

This understanding shaped discussions at the national drug harms summit convened by PHS in June 2026.

The summit brought together senior leaders from across Scotland to consider what more can be done to reduce harm. A key strength of the summit was the involvement of people with lived and living experience, alongside families and carers. Their insights shaped discussions throughout the day and reinforced the importance of involving those closest to the issue in decisions about services and support.

A clear message emerged: preventing drug harms requires a whole-system response. National and local government, health and care services, justice, housing, the third sector, recovery communities, advocacy services and people with lived and living experience all have an important role to play. Reducing drug harm will depend on clear accountability, national leadership and shared responsibility across the system.

Our focus must be on recognising when people may be at greater risk of harm and making it easier for them to get the support they need. At the same time, we must continue to build on the strengths within our communities that help people stay well, resilient and connected.

In summary

People need timely, compassionate support. Communities need strong local services, and information to respond as risks change. By involving families and people with lived and living experience and building on the strengths in our organisations and communities, we can work together to reduce harm, build hope and improve lives.

Further information

Further information about the RADAR programme is available here.

Read the national drug harms summit report here.

View the latest NRS drug-related deaths publication here.