Why cheap, super-strong synthetic drugs threaten to kill Scots in vast numbers
After deaths from synthetic opioids called nitazenes treble in a year, Scotland could be sleepwalking into a public health emergency
Today’s drug death figures represent a relatively positive shift in the right direction, with a 13 per cent decrease in 2024 based on the previous year. However 1,017 is still far too many deaths, and Scotland remains the drug-death capital of Europe.
There is also cause for alarm within the figures as deaths from nitazenes – potent, synthetic opioids which can be stronger than fentanyl and are up to 500 times stronger than heroin – have more than trebled from 23 in 2023 to 76 in 2024. Furthermore, RADAR suspected overdose data, which is recorded separately and is more up to date, shows that there was a further rise in nitazene deaths for the first three months of 2025, with 38 people dying compared to 25 the year prior.
Cranstoun, the social justice charity I work for, published a report in August 2023 which warned of the dire consequences of nitazenes seeping into the drug supply. The report was backed by over a dozen Scottish MPs and MSPs, as well as leading experts, and some of the evidence-based measures we recommended have been adopted by the government.
These include the piloting of the first sanctioned overdose prevention centre in the UK, where people can inject illicit drugs under medical supervision. As of last month, the service had been used 5,299 times, with 3,554 injections taking place. There have been 48 medical emergencies, but crucially no one has died.
This demonstrates the life-saving capabilities of centres like the Thistle in Glasgow for any potential nitazenes outbreak, as at least some of these overdoses may have been fatal without medical intervention.
However, despite some commendable steps being taken by the Scottish Government, much more must be done to stop us walking into a potential public health emergency.
70,000 died in US in one year
Synthetic opioids have wreaked havoc in the US and Canada, with a public health emergency being declared in both countries. At the apex of the crisis in 2022, a shocking 70,000 people died in the US from fentanyl alone and the Secretary for Homeland Security at the time described synthetic opioid overdoses as “the single greatest challenge we face as a country”.
Scotland already has a well-documented drug crisis but an influx of cheap, extremely potent synthetic opioids could manufacture an emergency situation many times worse than the peak of drug-death crisis here in 2020. Kirsten Horsburgh, chief executive of the Scottish Drug Forum, today described the nitazenes situation as “a crisis on top of a crisis” and the worst is likely still to come.
A recent United Nation report reported that opium production in Afghanistan – the precursor to producing heroin – is at its lowest level in over two decades. Synthetic, lab-made opioids like nitazenes are likely to fill this void and we must brace ourselves for the worst-case scenario.
In doing so, the Scottish and UK Governments must work together and follow the global evidence to minimise the scale of a potential crisis.
Key examples include drug-checking centres, where people can test their drugs to ensure no nitazenes are present. There are solutions, but without faster and bolder action, we could be sleepwalking into a public health emergency.
Ant Lehane is policy lead at Cranstoun, a charity that provides services for people with drugs, alcohol and other problems