National Mission: annual report 2024-2025

4. Outcome 2: Risk is reduced for people who take harmful drugs

4.1 Overview

People have a right to support that reduces the harms associated with drug use regardless of where they are on their recovery journey. This includes promoting safer drug consumption practices, preventing overdoses, and reducing risks when they do occur by addressing the harms caused by drug use.

4.2 Progress in 2024-25

4.2.1 National Naloxone Programme

Efforts to maximise the provision and availability of naloxone (medication that can reverse the effects of an opioid overdose), particularly amongst emergency responders, has been a key focus in this year. According to PHS official statistics, published in June 2025, at the end of December 2024, the ‘reach’ of the National Naloxone Programme (percentage of people at risk of opioid overdose who have been supplied with take home naloxone) was estimated to be 80.6%.

Naloxone continues to be distributed across Scotland through a number of partners. The SFAD Click and Deliver service continues to be one of the leading routes of distribution to the public and through funding provided to Scottish Drugs Forum significant progress has been made to establish and embed high quality peer supply of naloxone within prisons while also connecting with all peer naloxone projects across Scotland.

Police Scotland completed their naloxone roll out in 2023 with more than 12,500 police officers now routinely carrying naloxone. As of December 2024, Police Scotland officers had administered naloxone 630 times since March 2021.

In December 2024, the UK Government introduced a statutory instrument expanding the existing exemption to allow a wider range of drug treatment services to supply take-home naloxone directly. This legislative change enables the future establishment of a new registration service, which will give newly registered services the same authority to supply take-home naloxone. This registration service will become operational in 2025 as systems and infrastructure are developed to support its implementation.

This change builds on the previous position, where the Lord Advocate’s 2020 amendment to prosecution guidelines had permitted organisations other than alcohol and drug services to distribute naloxone during the pandemic. That interim measure enabled significant expansion, including the introduction of the click and deliver service, which continues to prove effective in distributing kits widely. That measure remains valid but is under review given the recent legislative change.

Positive engagement with UK Ministers has supported this progression, providing a sustainable basis for wider naloxone access beyond emergency pandemic measures. Also work continues with Community Pharmacy Scotland to ensure naloxone kits are available for emergency use in every community pharmacy across the country.

Following funding provided to the Scottish Prison Service (SPS) for the initial purchase and supply of Intranasal Naloxone (Nyxoid) for SPS staff use, has brought the total face-to-face staff Naloxone training to 1147.

4.2.2 Safer Drug Consumption Facilities

In September 2023, the Lord Advocate set out her response to the proposal on a Safer Drug Consumption Facility, confirming that it would not be in the public interest to prosecute users of that facility for simple possession offences committed within the confines of the facility. Following this, Glasgow HSCP progressed essential work, including local community engagement, recruitment, building works, and collaboration with individuals with lived and living experience to shape the design and delivery of the facility, which led to the successful opening of The Thistle on 13 January 2025.

Engagement continues with Glasgow colleagues around the operation and evaluation of the facility. Interest in the facility from Scotland and more widely in the UK has been significant and the facility has hosted visits and events for a number of individuals and organisations including the First Minister, the Advisory Council on the Misuse of Drugs and the British Irish Council.

Scottish Government officials are also continuing to engage with colleagues from Edinburgh who are progressing their own plans for a safer drug consumption facility following the completion of their feasibility study.

4.2.3 Drug Checking

The Scottish Government has continued to progress work to support the implementation of a pilot drug checking service in Scotland, with city-based point of care facilities, supported by a National Testing Laboratory which will deliver a research function.

The work to implement this pilot follows on from the Drug Checking Research Project, a two-year programme funded by the Drug Deaths Taskforce and taken forward by the University of Stirling, to explore how best to establish drug checking in Scotland.

In 2024-25, we have continued to support the facilities to develop Standard Operating Procedures and take forward licence applications with the Home Office. We also agreed additional funding to expand the pilot to Edinburgh, which will join the existing pilot cities of Aberdeen, Dundee and Glasgow.

4.2.4 Other Harm Reduction Work

With the increased detection of synthetic opioids, work has also been undertaken to explore the effectiveness of nitazene testing strips. Research by colleagues at Dundee University will help to inform Scottish guidance on their use.

Evidence from across Scotland also highlights the increased use of cocaine with numerous areas reporting increasing prevalence of crack smoking and the injecting of cocaine. Harm Reduction officials have continued to engage with Crown Office colleagues, along with colleagues from the UK Government and the Welsh and Northern Irish Governments to try and progress the provision of safer inhalation devices as an essential harm reduction tool for those using cocaine.

In November 2024, the National Drug Deaths Incident Management Team published, via Public Health Scotland, guidance on the management of clusters of drug related harms. This guidance was subsequently used in response to a trend of increasing non-fatal overdoses and suspected drug-related deaths in certain health board areas over the first few months of 2025.

Beginning in January 2025, the RADAR early warning system received reports of short-lived, geographically localised clusters of drug harms, with rapid onset cardio-respiratory collapse following drug ingestion. In line with the guidance, a series of Problem Assessment Groups and Incident Management Teams were convened to assess the situation and consider response measures. Testing indicated the presence of nitazene compounds in these clusters.