Drug and alcohol deaths in Scotland remain among the worst in Europe, despite increased spending to tackle the problem, according to a major auditors’ report.

A national mission into drug deaths was announced in 2021 and spending increased last year to £161.1 million, more than double the 2014 figure.

However, Audit Scotland noted that there had been no analysis of the cost-effectiveness of drug and alcohol services.

Progress in improving services has been mixed, he said, with the workforce under “immense pressure”.

Auditors warned that another transition plan would be needed when funding for the national mission ends in 2026.

Although there has been an increase in residential rehabilitation beds, which are up 8% from 2021, the report says it is unclear whether the target of 650 beds by 2026 will be sufficient to meet demand.

In 2023, there were 1,277 alcohol-related deaths – the highest since 2008.

There were 1,172 deaths linked to drug abuse, the second lowest figure in the last six years.

Scotland’s drug death rate is the highest in Europe, according to the latest available data.

At 27.7 per 100,000 people, this figure is almost three times that of the next highest country, Ireland.

Additional challenges have arisen in recent years due to changing drug use patterns and the increasing prevalence of synthetic opioids.

Audit Scotland last formally reviewed drug and alcohol services in 2009, although it published briefings in 2019 and 2022.

Auditors analyzed the data and conducted interviews with people with experience with alcohol and drugs.

Stephen Boyle, Auditor General for Scotland, said: “The Scottish Government must develop more preventative approaches to tackling Scotland’s harmful relationship with alcohol and drugs. This means helping people before they reach a crisis point.

“Ministers must also understand which alcohol and drug services are most cost-effective and plan how they will be funded when the national mission ends in 2026.

“This is particularly important at a time when public finances are increasingly strained.

“With many workers in the alcohol and drug sector reporting feeling undervalued and at risk of burnout, there is also an urgent need to set a timetable for plans to address the sector’s staffing challenges.

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