Scotland faces growing nitazene threat as it grapples with drugs deaths crisis

Some of the overdoses Saket Priyadarshi and his team witnessed at the end of March weren’t like the others. “People collapsed often with the needles still in their arm. So it was very sudden. There was total respiratory arrest,” he said.

Priyadarshi, a clinician at The Thistle, the Glasgow-based drug consumption room which is the UK’s first, is used to dealing with overdoses and knows what to do. While his team can usually manage opioid overdoses with oxygen and airway management, this cluster needed multiple doses of naloxone, an overdose-reversing drug. “Those have been the most worrying and most severe overdoses that we’ve seen in the service,” said Priyadarshi.

“We’ve managed to get some spoons that were used by service users in The Thistle tested, and they confirmed our suspicion for a cluster of overdoses that we had, that they were nitazenes,” he said.

Drug deaths in Scotland are down to their lowest level since 2017, new annual statistics have revealed, though a toll of 1,017 deaths in 2024 has kept the nation the drugs death capital of Europe. But deaths from nitazenes, a powerful form of synthetic opioids contaminating drugs like heroin, are on the rise.

The figures show 76 deaths involving nitazenes were recorded in Scotland in 2024. But Public Health Scotland data from the first three months of 2025 shows 38 deaths – putting this year on track to see twice as many people dying after taking the drugs. It means in just 15 months, more than 100 people in Scotland have died after taking nitazenes.

Priyadarshi is clear about what would have happened had the overdoses he described, part of a cluster in late March and early April, happened elsewhere. “I’m fairly confident that a number of those overdoses would have led to fatalities if they had occured in public places where naloxone wasn’t available immediately, or in rooms in hostels where naloxone wasn’t available immediately,” he said. “They were so sudden and severe, they needed action absolutely immediately. Luckily, our staff were available, and that’s what the system is for.”

Read more:

• The inside story of nitazenes and the drug deaths crisis rocking Britain: ‘No one is talking about it’
• My son died after taking deadly nitazenes, aged 33. Why did nobody save his life?
• Nitazenes: Use of life-saving overdose drug surges by 50% amid synthetic opioid crisis

The threat in Scotland adds to mounting deaths across the UK. From June 2023 to January 2025, there have been at least 400 deaths in the UK involving nitazenes, with lives lost in every region. As Big Issue reported, ambulance crews’ use of lifesaving drug naloxone has doubled, and deaths happen in clusters, often affecting those living in homeless hostels.

Britain’s new synthetic opioid crisis is not on the scale of the devastation fentanyl has wrought in America – where it is responsible for around 70,000 deaths a year and is the leading cause of death among 18-45 year-olds – but it has sparked a widespread government response, including a push for police forces to equip their officers with naloxone.

But Scotland’s figures show an emerging threat in a country dogged by drug abuse deaths with leaders battling to get the problem under control.

Priyadarshi, an associate medical director and senior medical officer for Glasgow Alcohol and Drug Recovery Services, warned of the consequences if nitazenes added to that picture in a widespread way.

“If nitazenes were added into that mix, then obviously the impact would be devastating,” he said.

”At the moment, it’s far too much but it does seem to be relatively isolated. But if it was introduced and more freely available, then I would be very, very worried.”

Opening in January this year after a decade of legal wrangling, The Thistle is the UK’s first space where people can come to use drugs in a supervised, safe environment. It is part of a harm reduction approach which Glasgow’s authorities hope will reduce the number of drug deaths. Now it finds itself playing a role in dealing with synthetic opioids, not just preventing fatal overdoses but getting samples tested and getting the word out about dangerous drugs.

Yet outside the consumption room, there are calls to move faster on other measures which could stop deaths.

“Scotland does like to blow its own trumpet about how progressive we are, and certainly in terms of drugs policy, on paper we are rights-based, we take a public health model,” said Justina Murray, chief executive officer of Scottish Families Affected by Alcohol and Drugs (SFAD). 

“But actually we have more deaths than anywhere else in the UK or Europe. And when you look at what’s actually being delivered on the ground, it’s not actually rights-based, it’s not a public health model.”

SFAD is one of Scotland’s largest providers of naloxone, handing out 1,230 kits in the first three months of 2025, and runs the country’s only “click and deliver” service for the life-saving drug.

Initially launched targeting family members of those using drugs, the service now has a much wider reach: security guards, housing officers, taxi drivers, and more request naloxone. Family members now make up just 5% of those receiving kits.

Access to the drug – offered as an injection or nasal spray – can be patchy, warned Murray. “There are still issues. We find that pharmacists, for example, some of them are very progressive in terms of issuing naloxone if somebody walks in and asks for it. Other people are like, ‘Oh no, we can’t do that’. So there’s a kind of postcode lottery,” Murray said.

Those dying from nitazenes rarely intend to take them. Instead, the potent synthetic opioids contaminate drugs like heroin and benzodiazepenes. But knowing what is in drugs before they are taken remains difficult. Drug checking sites have been proposed in Glasgow, Aberdeen, and Dundee, with applications made for the Home Office.

“It just seems to have been pretty glacial,” said Murray on the progress made. “If you want to check what’s in your drugs, you have to send them to Wales. That’s the only option until you die and then they’ll tell you which drugs were in your body. That just seems absolutely ridiculous.”

Priyadarshi also said drug checking services could help The Thistle inform its users about what was going round. “The one thing we don’t have in this country that we could benefit from are drug checking services,” he said.

In the meantime, he expected deaths from nitazenes to rise, with updated statistics expected this month. “I’d be very surprised if that doesn’t show quite a high number of, at least, ambulance and non-fatal overdoses, if not suspected drug-related deaths,” he said. “Because we continue to receive reports of these events in the community where ambulance service and others have been called.”

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