Trainspotting, a 1996 film adaptation of the 1993 novel of the same name by Irvine Welsh, adequately encapsulates what it is like to abuse heroin in 80s Scotland. Years later, heroin abuse skyrockets in the state, leaving it alone at the top, with a bigger death toll than other countries in the United Kingdom.

In 2020, there were 1,339 drug-related deaths, the number has doubled in the last 5 years, in fact, they have increased five-fold since 1996. Slovakia, a nation with a population in the likes of Scotland, has recorded only 34 overdose deaths in 2019.

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1,339 deaths a day imply more than three deaths a day. Although the rampant substance abuse could easily be attributed to Trainspotting there is an underlying bed of causes that provides a rationale behind these deaths, it is a state ridden by generations of deprivation, government underinvestment and shifting supply chains

The National agency statics report stated that Scotland has Europe’s highest drug-related death rate per capita. In 2019, it had a death rate of 318 per million of the population (aged 15-64), and the next top countries, Sweden and Norway, each had 77 fatalities per million.

The average age of Scottish drug deaths has consistently grown from 32 to 43 in the last two decades. According to the research, those aged 35 to 54 accounted for nearly two-thirds of all drug-related deaths.

Additional deaths from drug-related causes such as violence, suicide, HIV infection, Hepatitis C, and lung cancer, which could number in the thousands every year, are, however, not included in the report, as per Robertson.

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There are also the people who have gone in and out of treatment and emerged out the other side, according to Austin Smith, a spokesman for the Scottish Drugs Forum. “It’s a credit to their massive resilience and to the health services that they have survived,” he said.

Scotland has recorded the highest number of drug-related deaths since 1996, which is when they started documenting the number every year.