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Sources & methods↗
Sources and methods

Sources and Evidence Library

Selected publications and guidance behind UK drug intelligence, organised by subject. Follow each link to the original evidence and read the geographical scope alongside its findings.

01

Drug prevalence and patterns of use

02

Drug-related deaths and harms

03

Treatment and recovery

04

Emerging threats and drug checking

05

Drug markets, seizures and county lines

06

Wastewater and drug monitoring

07

Drug legislation and clinical guidance

08

Scientific research and evidence reviews

09

Understanding the evidence

Different sources answer different questions. Read the definitions, population and period before comparing findings.

Population surveys
Estimate reported use within defined populations. Sampling, excluded groups and self-reporting limit what the results can represent.
Mortality statistics
Describe recorded drug-related harms. Definitions, registration periods and toxicology practices differ; several substances may be recorded in the same death.
Drug checking and toxicology
Identify substances in submitted or tested samples. Selected samples do not necessarily represent the wider drug market, and co-detection alone does not establish causation.
Frontline and professional intelligence
Identify emerging concerns and questions for investigation. Local observations alone cannot establish national trends.
Evidence confidence
Reflects the strength, relevance and consistency of supporting evidence, rather than the seriousness of a possible threat. A TD assessment is distinct from an official public health alert.

Treatment records describe people in contact with services; hospital records may count several episodes for one person. Wastewater measures substances in selected catchments and cannot count users or establish national prevalence. Differences in coverage and definitions limit comparisons between nations and years.

Scottish evidence and reporting context

Scotland: 2025 registrations

NRS recorded 1,133 drug use deaths (21.4 per 100,000, age-standardised); the increase from 19.1 in 2024 was not statistically significant. There were 830 male and 303 female deaths; average age was 46. Rates were highest at ages 35–44 and 45–54 and around 15 times higher in the most deprived than the least deprived areas. Deaths rose in 20 council areas, fell in 10 and were unchanged in two. Five-year rates (2021–2025) exceeded the Scotland average in Glasgow City, Dundee City, North Ayrshire, Inverclyde, West Dunbartonshire and East Ayrshire.

Substances implicated: opioids 881; heroin/morphine 468; methadone 338; nitazenes 247 (etonitazene 215); cocaine 589; benzodiazepines 433 (street benzodiazepines 300; bromazolam 103); gabapentin and/or pregabalin 330; alcohol 132; amphetamines 38; ketamine 33; ecstasy-type drugs 24; xylazine 4. More than one drug was implicated in 78% of deaths. Counts overlap and implication does not establish sole causation. Expanded nitazene testing, including etonitazene from May 2025, and routine xylazine testing only since 2024 limit trend comparison. For four-country drug-poisoning comparisons the latest common year is 2024: NRS reports Scotland at about 2.4 times England, 1.6 times Northern Ireland and 1.5 times Wales. Registration delays and nation-specific definitions require care.

NRS release and tables ↗
Scottish harm reduction and treatment evidence

PHS reported 388 injecting equipment outlets, 131,931 attendances, approximately 2.3 million needles and syringes and 1.6 million foil items in 2025–26. Its naloxone bulletin recorded 7,729 take-home kits in January–March 2026 and 36,955 across 2025–26. These count service activity, not people using drugs or deaths; attendance definitions changed in 2023 and reporting completeness varies. PHS also published a residential rehabilitation programme evaluation (15 September) and a drug-harms summit report (22 September). Neither provides a like-for-like mortality revision.