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The Royal College of Pharmacy (RCPharm) has criticised the Scottish Government for failing to fully implement the recommendations the professional leadership body made in its 2021 report highlighting pharmacy’s role in reducing harm and preventing drug deaths.

In the wake of figures published yesterday by the National Records of Scotland showing an 11 per cent increase in deaths between 2024 and 2025, the RCPharm told Independent Community Pharmacist (ICP) that while some of the 14 recommendations “have been partially implemented,” the Government should take it “further to enhance patient safety”.

Last year, 1,133 people died compared with 1,017 in 2024, although mortalities were lower than in 2020 when there were 1,339 deaths. There were 21.4 drug use deaths per 100,000 people last year, four times higher than in 2000.

Opioids were the most common type of drug implicated in drug use deaths, making up 78 per cent or 881 mortalities in 2025.

Cocaine was implicated in 52 per cent of deaths, a 23 per cent increase on 110 deaths in 2024, while nitazenes, a group of potent synthetic opioids, were implicated in 22 per cent of deaths. Etonitazene was the most common nitazene implicated with 215 deaths. 

RCPharm: Still work to do on all the recommendations in our policy

The RCPharm said the Government failed to meet its call for all pharmacists to have access to shared patient records and “clear communication pathways with other health care professionals involved in the care of people who use drugs”. 

“We believe there is still work to do on all the recommendations in our policy,” its director for Scotland Laura Wilson said. “Some have been partially implemented, and we believe that this could be taken further to enhance patient safety. 

“Access to records would enable pharmacists and other teams working with patients to share information, interventions and concerns more easily.

“Our policy also highlights the need for clear referral pathways so that people transferring between settings, such as leaving prison or hospital, are not lost and can access the support they need at these high-risk times.”

Other RCPharm recommendations included making naloxone available from every community pharmacy and training staff to use it, giving pharmacy teams in all settings “the tools to prevent and identify possible dependence on prescribed or over the counter medicines” and expanding pharmacy support through depot buprenorphine injection clinics, independent prescribing and deprescribing.

Wilson said the RCPharm is “ready to work with Scottish Government and all other partners to ensure that our recommendations are implemented in full”.

“Every death from drug misuse is a tragedy for the individual as well as family, friends, and their wider community. We are shocked to see such an increase in drug related deaths,” she said.

“We are committed to working with Scottish government and partners to reverse this trend. Nitazenes and other synthetic opioids being mixed with existing drugs are causing serious harm, and this could be a significant factor which explains the rise in drug deaths.”

ICP has contacted the Scottish Government for a response.