I have been writing about Scotland for a long time now, and there are certain topics where the words come easily. Football, politics, the weather. But this is not one of those topics. This is about the people we are losing, and the uncomfortable truth that most of us would rather look away than face what is happening in our own streets, our own communities, our own families.
In 2024, 1,017 people died from drug related causes in Scotland. That is a slight improvement on 2023, down roughly 13 percent. Politicians were quick to claim credit. The Scottish Government issued statements about progress. But let me put that number in context for you: Scotland’s drug death rate is 191 per million people. The European Union average is 18. We are not just the worst in Europe. We are in a category of our own.
I walked through parts of Glasgow’s east end recently. Not as a journalist or a researcher. Just as a man going about his day. And what I saw has stayed with me since. A young woman, probably not yet thirty, slumped in a doorway at half past ten in the morning. Two men on a bench near Glasgow Green, clearly not present in any meaningful sense. These are not strangers to someone. They are someone’s children. Someone’s siblings. Maybe someone’s parents.
The Numbers Tell a Story, but Not the Whole Story
Glasgow City recorded 185 drug deaths in 2024, with a rate of 41.1 per 100,000 people. Dundee followed at 35.6 per 100,000. Inverclyde matched Dundee’s rate. These are not abstract figures. They represent entire communities where funerals have become a grim routine.
What strikes me most is the deprivation gap. People living in Scotland’s most deprived areas are twelve times more likely to die from drugs than those in the least deprived areas. Twelve times. For general mortality, that gap is roughly two to one. For drugs, it is twelve to one. If that does not tell you this is a poverty crisis dressed up as a substance abuse problem, I do not know what will.
The age profile has shifted too. The average age of someone dying from drugs in Scotland is now 45. In the year 2000, it was 32. We are not losing young people experimenting recklessly. We are losing middle aged men and women who have been trapped in addiction for decades, people the system failed twenty years ago and never went back to help.
Cocaine Is the Silent Escalator
While opioid deaths have dipped slightly, cocaine is now implicated in 47 percent of all drug deaths. That is 479 deaths, matching the record high from 2023. Nobody wants to talk about cocaine because it crosses class lines. It is not just the deprived estates. It is the pub after work on a Friday, the house party in Bearsden, the weekend in Edinburgh’s New Town. The difference is that people with money and stable lives survive their cocaine use. People already on the margins do not.
Benzodiazepines remain in 56 percent of deaths. Opiates and opioids in 80 percent. The toxic drug supply in Scotland is a lethal lottery, and the people buying from street dealers have no idea what they are putting into their bodies.
What Nobody Wants to Say
Here is the part that will make people uncomfortable. We have known about this crisis for over a decade. Scotland first topped the European drug death tables years ago, and the response has been a procession of task forces, strategies, action plans, and ministerial statements. Some good things have happened. Naloxone distribution has expanded. Drug checking services have started. The conversation around safe consumption rooms has moved forward, if painfully slowly.
But the fundamental truth that nobody in Holyrood or Westminster wants to say out loud is this: we chose to let this happen. Not through malice, but through indifference. Through a collective decision that the people dying were somehow less deserving of the urgency we would give to any other public health emergency killing a thousand Scots a year.
Imagine a thousand people dying every year from contaminated water. Imagine a thousand people dying from a building defect. There would be emergency legislation within weeks. But because these are people with addiction, because many of them are poor, because their lives look chaotic from the outside, we have tolerated a death toll that would be considered a national scandal in any other European country.
What Recovery Actually Looks Like
I have spoken to people in recovery over the years. Their stories share common threads: a traumatic childhood, contact with the care system, early exposure to substances, years of cycling through crisis services that treated symptoms but never touched causes. And eventually, if they were lucky, someone who treated them like a human being rather than a problem to be managed.
The 13 percent drop in deaths is welcome. Genuinely. Every one of those 155 people who did not die represents a life that continues, a family spared. But we cannot pretend that 1,017 is acceptable. It is not a number to celebrate. It is a number to be ashamed of.
Scotland is a wealthy, educated, resourceful country. We have universities producing world class research. We have communities with extraordinary resilience. We have people working in addiction services who are nothing short of heroic. What we lack is the political will to match the scale of the crisis with the scale of the response.
Until we find that will, the numbers will keep coming, every August, from National Records of Scotland. And politicians will keep calling them “concerning” while reaching for the next strategy document. And somewhere in Glasgow, in Dundee, in Inverclyde, in small towns across the country, another family will be making funeral arrangements for someone who deserved better from all of us.
