Scotland’s Drug Death Crisis: Hundreds of Deaths Excluded from Official Statistics

Scotland’s drug death crisis may be worse than initially believed, as an investigation by The Scotsman has uncovered that hundreds of deaths are being excluded from official statistics. Campaigners argue that Scotland’s data collection fails to include “secondary” deaths resulting from drug abuse, such as those caused by infections from contaminated drugs.

Unlike England and Wales, Scotland’s drug death data does not account for secondary infections, including bacterial or viral infections linked to drug injection. Scottish statistics also exclude conditions that are considered later complications of drug use, such as organ failure or heart and liver failure. The investigation did not find any new data challenging the earlier report that drug-related deaths significantly decreased from 2021 to 2022.

However, the number of excluded drug deaths has increased in recent years, raising concerns that hundreds of “inconclusive” drug deaths may not be recorded. Between 2011 and 2021, the National Records of Scotland (NRS) excluded an average of 24.4 secondary drug deaths annually. In 2022, the NRS excluded 43 deaths, nearly double the annual average. The exclusion also applies to deaths associated with hepatitis-C and HIV/AIDs resulting from drug use.

Campaigners believe that the true figure could be up to 50% higher than officially reported, adding an estimated 500 extra drug deaths when considering “inconclusive” cases. The NRS policy regarding excluded figures has been in place since the beginning, and the decision on which deaths to include or exclude is made by an advisor at Public Health Scotland.

Scotland currently has a drug death rate more than three times higher than England and Wales, with 248 deaths per million people compared to 84.4 deaths per million. The number of annual drug deaths in Scotland has doubled since 2013, reaching 1,051 deaths in 2022.

The Scottish Government declined to comment, referring inquiries to the NRS. Scottish Conservative shadow health secretary Dr. Sandesh Gulhane described the drug death crisis as “truly heart-breaking” and emphasized the need for urgent action to address this national emergency.