Scotland’s drug deaths remain almost three times higher than for the UK as a whole, despite the country recording its largest fall in fatalities last year, as campaigners warn of the emerging threat of synthetic opioids prompted by Taliban disruption of the global drugs trade. Data from National Records of Scotland (NRS) showed there were 1,051 deaths due to drug misuse in 2022 – a drop of 279 on the previous year, when then first minister, Nicola Sturgeon, announced a “national mission” to tackle the country’s chronic and epidemic fatality rates. But the latest figures come as Scotland’s leading drugs charity criticised the Scottish government’s “inadequate response to the ongoing public health emergency”. Scottish Drugs Forum warned that the country was not prepared for a potential flooding of the market with dangerous synthetic opioids after the Taliban’s crackdown on heroin production in Afghanistan. Its chief executive, Kirsten Horsburgh, urged ministers to focus on “huge challenges ahead”. She said: “If the trend towards the presence of synthetic opioids in the heroin supply becomes more prevalent, we know from elsewhere that this will lead to higher risks of harms and deaths.” The drug policy minister, Elena Whitham, welcomed the fall in the number of deaths, but said that ministers would “never underestimate the scale of the challenge we continue to face, including responding to new threats such as synthetic opioids and stimulant use”. But Horsburgh called for a change in “attitude and approach” from ministers, saying that the number of people in treatment had “barely changed” since 2016. “We have had small scale pilots and some local change but we need a nationwide concerted effort to make an adequate response. Treatment rates remain around two-thirds of those in England”. She added that the Scottish government had to “follow through on promises to treat this as a public health issue”, suggesting that anyone found in possession of drugs who is vulnerable or experiencing drug problems should automatically be offered support, including treatment. She added: “We have the power to change policing now.” Last month, Whitham challenged the UK government to decriminalise all drugs for personal use, arguing that current drugs legislation – which is reserved to Westminster – is 50 years old and that criminalising addicts further marginalises them. Downing Street immediately dismissed these calls, and Scottish agencies pointed out changes were already being made in areas where ministers did have powers, including the extension of recorded warnings for drug possession, policing arrangements and Scotland’s world-leading take-home programme for the overdose antidote naloxone. The NRS report made clear that, while the number of deaths linked to drugs misuse is at its lowest since 2017, that the rate of deaths was still much higher than it was when records began in 1996. It found that “after adjusting for age, there were 3.7 times as many drug misuse deaths in 2022 as in 2000”. Opioids, such as heroin and methadone, were involved in 867, or 82%, of the deaths in 2022, the data showed, while benzodiazepines – such as diazepam – were implicated in 601 deaths, and cocaine was involved in 371. Scotland had 19.8 drug misuse deaths for every 100,000 people in the country in 2022, according to the data, down from 25 in 2021. Death rates were almost 16 times higher in the most deprived parts of the country, at 52.4 for every 100,000 people, compared with 3.3 for every 100,000 in the most affluent areas.