Scotland’s drug and alcohol deaths remain among the worst in Europe despite increased spending to tackle the problems, a significant report by auditors has found.
A national mission on drug deaths was announced in 2021 and last year spending increased to £161.1 million – more than double the figure from 2014.
However Audit Scotland noted there had been no analysis of the cost effectiveness of drug and alcohol services.
Progress in improving services has been mixed, it said, with the workforce coming under “immense strain”.
The auditors warned a further transition plan is needed for when the national mission funding comes to an end in 2026.
While there has been an increase residential rehabilitation beds, which are up by 8% from 2021, the report said it is unclear if the target of 650 beds by 2026 will be enough to meet demand.
In 2023, there were 1,277 alcohol-specific deaths – the highest since 2008.
There were 1,172 drug misuse deaths, the second lowest number in the last six years.
Scotland’s drug-induced death rate is the highest in Europe based on the latest available data.
At 27.7 per 100,000, it is almost three times higher than the next highest country, Ireland.
There have been further challenges in recent years due to changing drug use habits and the growing prevalence of synthetic opioids.
Audit Scotland last formally reviewed drug and alcohol services in 2009, though it published briefings in 2019 and 2022.
The auditors analysed data and conducted interviews with those who have lived experience in the alcohol and drugs fields.
Prof Susanna Galea-Singer, chair of the Addictions Faculty at the Royal College of Psychiatrists in Scotland, said:
“It is Scotland’s shame that drug and alcohol deaths continue to remain the highest in Europe. Every death from addiction is an absolute tragedy for the family and loved ones left behind.
“Alcohol and drug related hospital admissions are high and indicate that this population group is seeking treatment - yet there have been no robust plans to provide addiction care and treatment to such individuals and their families - whilst they're in our hospitals.
“It’s clear from this report that this situation cannot continue, what we need is a bold and consistent plan.
“The Scottish Government must look at realistic and carefully considered drug addiction services for the health, social care and third sector. These vital services also need to be sustainable over time, with ring-fenced funding.
“Above all there needs to be better access, choice and support across the country, as well as joined-up services and treatment options for those who so desperately need them.”
Stephen Boyle, Auditor General for Scotland, said:
“The Scottish Government needs to develop more preventative approaches to tackling Scotland’s harmful relationship with alcohol and drugs. That means helping people before they get to a crisis point.
“Ministers also need to understand which alcohol and drug services are most cost-effective, and plan how they will be funded when the national mission ends in 2026.
“That’s especially important at a time of increasing strain on the public finances.
“With many alcohol and drug workers reporting feeling under-valued and at risk of burn-out, there is also an urgent need to put a timeline against plans to address the sector’s staffing challenges.”
For further information, please contact:
- Email: scotland@rcpsych.ac.uk
- Contact Name: RCPsych in Scotland
- Twitter: @rcpsychscot