Scotland’s drug crisis carries a profound toll, with hundreds of lives lost each year. As well as these human impacts, the crisis imposes considerable financial costs that are likely to shape future decision-making. This report presents new economic analysis of those costs, examining their consequences across the public sector and the wider Scottish economy.
Drawing on qualitative insights from policy experts, service leaders, and clinicians, as well as people who use drugs, the research explores the measures the new Scottish Government can take to alleviate the crisis. It ultimately advocates for a full-spectrum approach, spanning harm reduction and recovery-focused interventions.
KEY FINDINGS
- Scotland’s drug death rate is exceptionally high. The crisis is closely linked to deprivation and structural inequalities, with deindustrialisation, social displacement, and hardship shaping the conditions in which harmful drug environments can develop. It should not be treated as an individual failing.
- In recent years, the crisis has taken on new dimensions, such as the rise of polydrug deaths and the emergence of powerful synthetic opioids.
- People with lived and living experience of drug use in Glasgow and Edinburgh described what is in their view an increasingly pervasive drugs market, alongside concerns that support services are difficult to access.
- New economic modelling estimates that drug harm has a direct cost to the state of up to £1 billion every year in Scotland, including £220 million in healthcare and drug services costs and £320 million on crime and justice.
- Total social and economic costs are estimated to be as much as £5.7 billion annually. As well as public sector impacts, this includes £1.2 billion in lost output from employment and £3.5 billion in social costs from deaths, lost quality of life, and victim costs.
- There is extensive evidence that relatively low-cost interventions can reduce harm and prevent deaths. Needle and syringe programmes and naloxone – an opioid overdose antidote – are highly cost-effective and may even be cost-saving. Interventional evidence also supports drug checking services and safer drug consumption facilities.
RECOMMENDATIONS
- Policymakers should take a primarily public health-led approach to drug harm, prioritising prevention, harm reduction, treatment, and support – a more effective approach than one based on punishment and criminalisation.
- The most immediate priority should be to prevent deaths, through sustaining naloxone and needle and syringe exchange programmes, expanding drug checking services, and rolling out safer drugs consumption facilities.
- These approaches should also work alongside treatment and recovery services to provide a full spectrum of support, including widening Medication-Assisted Treatment (MAT)-style treatments, increasing detox capacity, and closing gaps in residential rehabilitation.
- In terms of longer-term measures, action should include sustained investment from the Scottish Government to back up its new Alcohol and Drugs Plan, including expanding preventative support. The UK Government should carry out a comprehensive review of drugs policy, including the possibility of legislative reform.
Source: https://www.smf.co.uk/publications/scottish-drugs-crisis/