This second annual monitoring report provides an analysis of the progress made between April 2023 and March 2024 on the National Mission to reduce drug deaths and improve lives in Scotland.

Overarching outcome: reduce drug deaths and improve lives - 

• 1,172 people died of a drug death in 2023. Increase of 12% since 2022.
• Drug deaths are lower than at the start of the National Mission but remain at a high level. Measuring progress towards the improving lives aspect of the National Mission is more challenging.

Outcome 1: Fewer people develop problem drug use

• New prevalence data pre-dates National Mission. Relevant data will be available in Spring 2025.
• 1% of people reported having a current problem with their drug use in 2023. Trend analysis not available.
• Progress towards fewer people developing problem drug use cannot be determined at this stage. New prevalence data will provide insight into trends in problem opioid use but there is a need for more work to inform our understanding of problem use of other drugs.

Outcome 2: Risk is reduced for people who take harmful drugs

• 4,505 ambulance service naloxone administrations in 2023/24. Increase of 12% since 2022/23. At a lower level than before the start of the National Mission.
• 182 drug-related hospital stays per 100,000 in 2022/23. Decrease of 23% since 2021/22. Downward trend since before the start of the National Mission.
• There are some indications of improvement in provision of services that aim to reduce risk for people who use opioids. However, interpretation of the data relating to the impact of harm reduction services is challenging, particularly within the context of evolving risks. Data development relating to non-opioid drug related harm will inform this.

Outcome 3: People most at risk have access to treatment and recovery

• 14,869 referrals resulting in treatment starting in 2023/24. Increase of 6% on 2022/23. Broadly similar level to at the start of the National Mission.
• 100% of ADP areas had referral pathways in place in 2023/24 for people who experience a near-fatal overdose. Consistent with 2022/23.
• The metrics present a broadly stable picture of access to treatment and recovery services, with challenges in understanding the extent to which there is unmet need amongst those who are most at risk.

Outcome 4: People receive high quality treatment and recovery services

• 8,034 people starting specialist treatment who had an initial assessment recorded in 2023/24. Increase of 2% since 2022/23. Lower than at the start of the National Mission.
• 29,817 people prescribed opioid substitution therapy in 2023/24. Stable since before the start of the National Mission.
• 940 approved statutory-funded residential rehabilitation placements in 2023/24. Increase of 13% since 2022/23. Upward trend since the start of the National Mission.
• Access to residential rehabilitation treatment has improved but there is no evidence of any increase in the number of people accessing other forms of specialist treatment. MAT standards reporting indicates evidence of implementation, but more is needed to ensure that all service users are receiving the standards.

Outcome 5: Quality of life is improved by addressing multiple disadvantages

• Adults who had used drugs in the last 12 months had a mental wellbeing score of 46.3 in 2023. Small increase since the start of the National Mission.
• People in the most deprived areas are 15.3 times more likely to die of a drug death compared to people in the least deprived areas in 2023. Broadly unchanged since the start of the National Mission.
• Drug-related mortality and hospital stays remain concentrated in the most deprived areas and people who have used drugs continue to report lower wellbeing. There is positive activity at the ADP level, but more insight is needed directly from people using services.

Outcome 6: Children, families and communities affected by substance use are supported

• 77% of ADP areas have an agreed set of activities and priorities to implement the Whole Family Approach Framework. Small increase since 2022/23.
• There are no new data for the percentage of people who would be comfortable (a) living near, (b) working alongside, someone receiving support for problem drug use to provide insight into progress for the other headline metrics for this Outcome.
• Support for children, families and communities appears broadly in line with last year but there has been some variation in relation to specific services and areas. Data limitations restrict assessment of progress and experiential evidence from people with lived and living experience, families and communities would be valuable.