Public Health Scotland (PHS) has launched an early warning system using data from a mix of sources to identify trends to try to reduce drug-related harm in Scotland.

The Rapid Action Drug Alerts and Response (RADAR) programme was launched at the NHS Scotland Conference alongside training for delegates on how to administer overdose reversing drug naloxone.

PHS says it believes that, by monitoring and assessing Scotland’s drug landscape and responding to new trends and threats, the NHS can use data to help lower Scotland’s high death rate from drugs.

RADAR presents a “structured way to collect, assess and communicate information about drugs, identifying risks quickly and informing rapid action”, to minimise harm caused by drugs in Scotland. To do this, RADAR collects, validates and analyses information about a drug’s use, availability and incidents related to harm to inform action.

In a presentation to mark the launch of RADAR, Public Health Intelligence Adviser for the Drugs Team at PHS, Vicki Craik, explained that the team have consulted and drawn upon lived experience and knowledge of people impacted by drugs harm in the development and implementation of the programme. While coordinated by PHS, several groups have been involved in the co-design of RADAR – the team say that collaborative approach will continue, to ensure that RADAR “meets the needs of the people and places it serves”.

PHS says there is an important role for RADAR to capture and address the “evolving drug supply, the use of multiple drugs at the same time, and changes to treatment services”.

The team also highlighted that social and health inequalities contribute to increased rates of drug deaths in Scotland and that community awareness and different levels of support are needed. the creation of the RADAR Network – which works with individuals, public and third sector organisations – aims to connect RADAR to key services and the public to share information and deliver effective support across Scotland.

The emergence of etizolam

Scotland’s rate of drug-related deaths is more than three times that of the UK as a whole. In 2020 alone there were 1,339 drug-related deaths recorded in Scotland with the highest increase in a single drug associated with drug-related deaths being of etizolam, a type of street benzodiazepine.

Etizolam is a relatively new street drug, first identified in 2012. Its increasingly harmful impact in Scotland since 2015 shows, Ms Craik told delegates, how important it is to get ahead of new drug use trends:

“It has gone from a drug that we’ve never heard of before just over ten years ago to now the highest contributor to drug-related deaths in Scotland.”

Implicated in 58 drug-related deaths in 2015, etizolam's impact had increased 15-fold since then to the 879 identified in 2020.

Ms Craik said RADAR hopes that continued monitoring and their development of guidance packs to be distributed to community organisations to provide support will help. She added that one simple measure is widespread understanding of naloxone for overdoses.

At their conference stall, the PHS Drugs Team and partners provided naloxone administration training to the public and encouraged health staff to learn about, and carry, naloxone.

Community pharmacies, police and homelessness teams now carry naloxone routinely. Last month Edinburgh’s biggest taxi company announced it had begun working with the local ambulance service and  Alcohol and Drug Partnership to train its cab drivers how to safely carry and administer naloxone to those in need.

The data challenge

As drugs remain criminalised in Scotland, the stigma around use and reporting remains, and the RADAR system aims to remove some of barriers to providing and accessing support. Ms Craik said the reporting system for incidents of drug overdose requires minimal personal information which enabled anonymity, but still allows the recording of vital data on drug use, area and impact.

However, challenges remain within RADAR as the system is relatively new. PHS’s Vicki Craik explained the organisation is  still working on streamlining its recording system to avoid inaccurate numbers in their reporting.

Looking forward, the PHS team say continued collaboration and work in communities to support people as well as monitor drug use are priorities for RADAR.

Read more: Edinburgh cabbies to carry naloxone; Pharmacists reassess role in preventing drug deaths; Family rehab pilot site secured

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