Drug deaths in Scotland: the deprivation divide

Drug deaths are not spread evenly across Scotland. In 2024, the age-standardised rate in the most deprived fifth of neighbourhoods was about 12 times the rate in the least deprived fifth. Glasgow City also had the highest council-area rate in the latest reliable comparison.

That makes this part of Scotland's poverty story. It does not mean poverty alone caused every death, or that everyone who died had a low income. The official statistics show a very strong inequality between places. They do not turn an area-level pattern into a diagnosis of any individual life.

The answer in three numbers

The deprivation divide is not a small difference

Scotland is split into five equal population groups using the Scottish Index of Multiple Deprivation. The rate falls at every step from the most deprived fifth to the least. This is a gradient across the whole distribution, not simply one unusually high group.

Almost half of all deaths, 484 of 1,017, were among people living in the most deprived fifth of neighbourhoods. The rate is the fairer comparison because each fifth contains the same share of Scotland's population and the calculation adjusts for different age profiles.

The relationship is still more complicated than “poverty causes drug deaths”. Scottish Government evidence describes poverty and disadvantage interacting with trauma, poor mental health and other risks. Those factors can accumulate. The mortality statistics show where the burden lands; they cannot separate every route that brought a person there.

Where Glasgow sits

NRS combines five years of deaths for council comparisons. On that matched measure, Glasgow City recorded an age-standardised rate of 41.1 per 100,000 in 2020–2024, compared with 22.5 across Scotland. Glasgow's estimate is therefore about 1.8 times the national rate for the same period.

The city's annual count did improve in 2024: it fell from 246 to 185, a reduction of 61 deaths and the largest numerical fall of any council area. Counts are affected by population size, however, so the five-year age-standardised rate is the right measure for comparing places.

This belongs beside Glasgow's wider record on life expectancy, neighbourhood deprivation and the evidence on why poverty hits the city so hard. It is not proof that one measure explains all the others. It is evidence that severe health harm and deprivation are concentrated in many of the same places.

A fall in 2024 is real. It is not the end of the crisis.

The direction matters and the reduction should not be talked away. But the age-standardised rate of 19.1 per 100,000 was still 3.6 times the rate at the start of the NRS series in 2000. The number peaked at 1,339 in 2020 and has generally fallen since, apart from an increase in 2023.

The age profile also challenges the idea that this is mainly a story about young people. The average age was 45 in 2024, and 63% of deaths were among people aged 35 to 54. Scotland is dealing with a long-running, ageing public-health crisis as well as new drug threats.

What the substance figures mean

The headline substance rows are useful for understanding the drug supply and treatment challenge, but they are not separate causes that can be ranked and added. More than one drug was implicated in 80% of deaths.

The safe way to compare Scotland with the UK

Scotland, England and Wales, and Northern Ireland publish different headline definitions. Putting their 2024 totals in one league table would mix drug misuse, drug poisoning and drug-related deaths. NRS instead uses the common drug-poisoning definition and the latest year available across all countries, which was 2023 when this release was prepared.

On that consistent measure, Scotland's rate was about 2.8 times the rates in England and Northern Ireland, and 1.9 times the rate in Wales. This comparison is one year older than the main Scotland analysis because accuracy matters more than forcing unlike 2024 totals into the same chart.

What the figures can and cannot prove

• •They can show that drug deaths are far more common in deprived areas and that Glasgow has the highest recent council-area rate.
• •They cannot tell us an individual's income from the deprivation score of the neighbourhood where they lived.
• •They cannot prove that deprivation alone caused a death. Trauma, mental and physical health, the drug supply, treatment, housing and social isolation can interact.
• •They cannot turn every detected substance into a separate death or show that one listed drug acted alone.
• •They can settle one narrower question: drug mortality is a profound health inequality, so it belongs in any honest account of poverty in Scotland.

You can download the original NRS workbook served unchanged, or read the official publication through the source list below. Every rate on this page comes from that workbook; none was modelled or inferred from the chart.