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Sets out the progress made between 1 April 2025 and 31 March 2026 by national government, local government and third sector partners towards reducing drug deaths and improving the lives of those impacted by drugs in Scotland.

Introduction

Overview

On 20 January 2021, the former First Minister Nicola Sturgeon made a statement to Parliament which set out a National Mission to reduce drug deaths and improve lives through a range of improvements to treatment, recovery and other support services.

This fifth and final National Mission annual report sets out the progress made from 1 April 2025 to 31 March 2026 against the National Mission Plan. Annual analytical reports monitoring the progress of the National Mission are published separately.

Every life lost as a result of drugs is a tragedy, affecting families, communities and services across Scotland. The National Mission concluded in March 2026 and has been succeeded by Preventing Harm, Promoting Recovery: Scotland’s Alcohol and Drugs Strategic Plan 2026–2035 (The Strategic Plan), which sets out the Scottish Government and COSLA’s long-term approach to reducing alcohol and drug-related harms. While our future work will be delivered through that Strategic Plan, this report focuses on activity, progress and the wider context during the final year of the National Mission.

This National Mission annual report is structured in line with the six outcomes and six cross-cutting priorities of the National Mission Plan. It also includes updates on finance, reporting, monitoring and evaluation. Outcomes and cross-cutting priority chapters have the following format: an overview providing context to understand the scope and purpose of the mission, followed by an update on progress in 2025-26.

As the National Mission concludes, reporting arrangements will transition to support delivery of the new Strategic Plan. The Scottish Government and COSLA are considering the most effective approach to monitoring and reporting progress under the new Strategic Plan, including the frequency and format of future reporting. Further details will be set out in due course.

National Records of Scotland reported that 1,133 drug misuse deaths were registered in Scotland in 2025. This was an increase of 11% (116 deaths) compared with 2024. Drug deaths are still much more common than they were in 2000. After adjusting for age, there were 21.4 drug-related deaths per 100,000 people in 2025. This is four times as high as when the series began in 2000.

Figure 1: Drug use deaths in Scotland, 2000 to 2025.

Patterns of drug use and supply continue to change. The growing use of cocaine and powerful synthetic drugs is creating new challenges for harm reduction, treatment and support services. Cocaine is now the most commonly reported main drug among people starting specialist drug treatment in Scotland. Drug markets continue to evolve under geopolitical influences, with online platforms and social media facilitating access. The benzodiazepine market continues to evolve, with new types of benzodiazepines regularly being identified. Alerts have also been issued about other emerging substances, including nitazenes, bromazolam and xylazine.

We are increasingly concerned about the dynamic changes in the drug supply and rise in potent synthetic opioids such as nitazenes which pose a substantial risk of overdose, drug-related hospitalisation and drug-related death.

Scotland’s Rapid Action Drug Alert and Response (RADAR) system first issued a warning for nitazenes in March 2023. Since then, detections of nitazenes have continued to rise and further alerts have been issued for nitazenes, bromazolam and xylazine.

The Scottish Government recognises the ongoing threat posed by synthetic opioids and is providing an emergency response. During 2024/25, we continued working with Public Health Scotland (PHS) and the National Drug Death Incident Management Team (NDDIMT), which has now issued guidance on the management of clusters of drug-related harms. We have also been working with partners to understand the efficacy of nitazene test strips to inform national guidance on their use. More information on our approach to synthetics can be found at 4.2.4. We continue to develop our surveillance landscape (see 2.2.2) and to progress drug checking facilities (see 4.2.3).

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