Scotland’s Drug Problem Then and Now

Scottish ambulance

One of the key reasons Scotland is experiencing rising drug-related deaths is not being discussed enough. Heroin use became a major drug of choice in the 1990s, a sudden trend then-dubbed ‘Trainspotting.’ Irvine Welsh’s 1993 novel Trainspotting and the 1996 film adaptation starring Ewan McGregor focused on this crisis and created broad public awareness of the growing problem.

Sadly, the population of Scottish people who used heroin in the 1990s is now much older, and those who didn’t get treatment then, are dying now. The data bears this truth out. While drug overdoses in Scotland are up for all age groups, drug deaths have skyrocketed for Scots in the 35 to 55 age bracket, many of whom were young drug users in the 1990s.

A big part of Scotland’s recent surge in overdose deaths is due not just to a rapid spread of drug use throughout the country today but also to a generation of addicts now getting older, more prone to overdoses, and more prone to drug-caused health problems.

There is a lesson here. The last 30+ years of public health responses in Scotland have failed to produce a workable solution when the addicts who started using drugs 20-30 years ago are now dying in droves. The lesson here is that, now more than ever, Scotland must take a treatment-first approach to helping addicts get off of drugs for good.

No approach but that of treating addicts with qualified drug rehab can halt this crisis.

The Station - sign

Trainspotting Defined

Trainspotting is the practice of watching trains, particularly as a hobby. At least, that is the historical origin of the term. In the 20th century, the term earned a slang application in the United Kingdom. In this newer definition, the term refers to heroin use or to being obsessed with heroin (addicted to it), much like trainspotting hobbyists were obsessed with watching trains.

In its slang application, the term trainspotting rose to prominence in late-20th century Scotland. Hence, the teens and young adults of that period who were addicted to heroin became known as the ‘trainspotting generation.’

How Trainspotting Connects to Scotland’s Drug Problem Today

The ‘trainspotting generation’ are deeply entwined in Scotland’s recent surge in drug fatalities. According to the National Records of Scotland, the sharpest spikes in drug overdoses between 2000 and 2020 occurred among Scots in the 35-44 age group and the 45-54 age group. And even more concerning, while the deaths for those 35-44 are beginning to level off, deaths among the 45-54 age group (the trainspotting generation) are still increasing.

The reporting shows that Scotland’s average age of a resident who dies from an overdose has changed considerably. The average age of an individual who suffers a fatal overdose was 32, but now it is 43. In 2020, about 63% of overdose deaths in Scotland occurred among people between the ages of 35 and 54, with deaths in this age group being nearly ten times higher than 20 years ago. Those in the trainspotting generation who didn’t get help for addiction and who still use drugs are now dying from overdoses at shockingly high rates.

But many other critical factors contribute to Scotland’s serious drug problem beyond the fact that the trainspotting generation is getting older and less likely to survive drug use.

Statistics Show a Deepening, Multi-faceted Crisis in Scotland

Scotland drug deaths

Scotland’s drug-related death rate is the highest in Europe. It outstrips the next closest countries by a wide margin. Scotland’s death toll is five times that of England, a country with which it shares a border and many of the same laws and policies. Scotland loses about 234 residents to drug overdoses for every million people living there. Next up are Sweden and Norway, which don’t even come close to that figure at 77 deaths per million. All in all, between 1,200 and 1,300 Scots are now dying from drug overdoses each year, with the death toll more than doubling in just five years.

UK drug deaths by area

While soaring deaths among the trainspotting generation in Edinburgh, Glasgow, and other major Scottish cities have certainly played a role in the country’s public health crisis, experts say there is more to the problem. The nation’s opioid epidemic (which has affected all age groups) was partially caused by generations of economic deprivation, government underinvestment in treatment and education, shifting supply chains, and job outsourcing.

Drug overdoses tend to grab all of the attention and media headlines. But these are not the only drug-related problems. Other factors on the rise in Scotland that do not receive full attention from the media or public health officials are the additional deaths from drug-related causes such as violence, suicide, HIV infection, Hepatitis C, and lung cancer. According to some experts, these deaths could be as high as 1,000 fatalities per year, putting the true death toll from drug-related causes at over 2,300.

Yet another factor to consider is that almost all Scottish drug users today are using opioids that have been mixed with other drugs. According to reports, 93% of fatal overdoses had more than one drug involved in the overdose. And while opioids were involved in 89% of deaths, benzodiazepines were found in a huge percentage of cases (15 times more cases than just five years ago). Quoting Austin Smith, spokesperson for the Scottish Drugs Forum, “Maybe in the morning they’ve been using heroin, and then in the afternoon they’ve been using benzodiazepines, and it’s the combined effects of those drugs that kill people.” This is yet another factor contributing to soaring lethality in Scotland’s drug addiction epidemic.

Scotland’s public health officials have also connected intergenerational poverty to the rising drug problem. Again quoting Austin Smith, “They were brought up in poverty. They’re not in poverty because they spent all their money on drugs – they’ve never had money.” Scotland’s poor health outcomes and poor economic condition even earned the country the nickname ‘Sick Man of Europe.’

In summary, many factors have led to a skyrocketing crisis of drug overdose deaths in Scotland. Yes, the trainspotting generation now reaching their 40s and 50s is a big part of the problem. But what most officials are failing to see is that the trainspotting generation (and every other generation of drug users in Scotland) would not be dying from drug overdoses and drug-related harm if they had access to quality drug treatment.

What’s Needed to Reverse Scotland’s Fatal Opioid Epidemic

Family addiction help

The fact that the Scottish addicts who were addicts in the 1990s are still addicts today and are now dying in numbers is a sad indictment of the failures of Scottish public health programs and the overall inability of the country to respond effectively to its drug crisis. Residents who struggle with drug addiction need treatment; qualified, residential drug treatment at rehab centers that will help recovering addicts learn the skills they need to stay off drugs for life.

Family members and loved ones of addicts cannot sit idly by and wait for changes in public health policy, economic policy, or government approaches to help their loved ones get better. Those who have loved ones struggling with addiction must do everything they can to get them help at qualified treatment centers.

Drug rehab programs offer clear pathways out of addiction. Such programs help recovering addicts address the underlying issues that pushed them towards drug use in the first place. Such programs also help recovering addicts build strategies and garner tools and life skills needed for facing life without drugs.

If you have a family member or loved one addicted to drugs, don’t wait until it is too late, until they contribute to the high death toll. Contact a drug rehab center today.


Reviewed by Claire Pinelli; ICAADC, ICCS, LADC, RAS, MCAP, LCDC



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.