Cocaine injecting overtakes heroin in Scotland’s cities

Cocaine injecting is now more prevalent than heroin in Scotland’s biggest cities, sparking calls for urgent action to prevent soaring drug deaths.

Experts have warned cocaine powder is “much more available and affordable than it’s ever been”, as cheap, high-grade cocaine is flooding streets across Scotland for as little as £10 a bag.

Researchers said increased availability means cocaine is no longer a ‘party’ drug as more turn to it for a cheaper hit than heroin, fuelling a rapid rise in use.

Cocaine-related drug deaths shot up from 45 in 2014 to 459 in 2020 dropping to 371 in 2022, according to the latest figures.

Deaths remain “exceptionally high”, scientists said, ahead of new figures due out next month on deaths since 2023.

Professor Andrew McAuley from Glasgow Caledonian University said: “Since 2014 there’s been a huge surge in cocaine injecting and parallel to that a rise in cocaine- related deaths which increased 10-fold between 2014 and 2020.

“This is a fairly new phenomenon and quite unique to Scotland. Cocaine injecting prevalence overtaking heroin in some areas is symbolic for a country like Scotland, which has had a largely heroin-driven drug epidemic since the 1980s.”

“Powder cocaine is much more available and affordable than it’s ever been. The market has changed over the last fifteen years ago when it was mostly targeted at recreational party users, now it’s targeted at all aspects of society including those people who already have a drug dependence and history of injecting.

“It’s easily available, people can get a deal for as little as £10 bag on a street corner. There’s a broader spectrum of quality too from low purity cocaine to more expensive high purity drugs, catering to a range of users.”

Cocaine injecting is rife in Glasgow and Edinburgh and has overtaken heroin, making it a ‘major national issue’, he said.

Drug users in Edinburgh told researchers exploring a safe drug consumption facility (SDCF) pilot that cocaine injection had “become widespread” in the Capital.

They reported injecting more often after the high quickly wears off, up to ten times a day or more.

“Compared to opioids like heroin, people take it more often, because it’s a stimulant so the hit and the effects wears off more quickly, so many are injecting up to six to ten times a day or more. These patterns of use put people at increased risk of harms including infections and overdose, as well as mental health issues.”

“With people who are injecting more frequently, their ability to access clean and sterile equipment for every injection is compromised so that certainly puts people at risk.”

A rise in cocaine injecting and homelessness were behind a 10-fold increase in HIV infection among drug users in Glasgow between 2011 and 2018 – the biggest outbreak of its kind in the UK in 30 years.

Professor McAuley said it has continued to spread: “Over the last decade, a new cohort of people injecting cocaine has emerged, including people with experience of homelessness in cities like Glasgow and Edinburgh.

“People who are homeless and inject cocaine have reported both euphoric and practical reasons for using the drug such as that it helps keep them warm and more alert so they can defend their patch.”

He’s calling for more services to prevent overdose deaths, including safe consumption rooms like the one due to open in Glasgow in summer.

“Addiction to cocaine injection can cause acute physical and mental harm. It can cause soft tissue infections which if not treated quickly can lead to amputation. The risk of overdose increases which is clear from the mortality rates. And the impact on mental health of maintaining a habit at those levels is huge.”

“The rapid increase in levels of cocaine injecting has reached levels where it is has to be dealt with urgently. Drug consumption rooms are one way to do this but this will only have impact in the areas they are localocated, and this is now a national issuel.

“Evidence tells us the best approach is through psychosocial therapies to tackle the mental health impacts. There’s not the same pharmaceutical interventions available like there are for opioid dependence such as a methadone, equivalent so treatment is options are limited and challenging. Harm reduction services like needle exchanges are essential but tackling this is a major public health challenge that needs more.”

Kirsten Horsburgh, CEO of Scottish Drugs Forum said: “The rise in the use of cocaine is obvious from a range of evidence. Some people who have previously been using mainly heroin and benzodiazepines are now often using cocaine as well. This involves more frequent injecting and has been linked to harms including injecting injuries and infections.

“There has also been a significant rise in the smoking of crack cocaine. Mixing drugs in this way increases the risk of fatal overdose. As well as there being an urgency for the availability of harm reduction equipment such as inhalation devices for crack cocaine, treatment services need to recognise the changing nature of drug use, offer treatment across all substances and support with the real issues people face in terms of their health and wider well-being.”

Drugs and Alcohol Policy Minister Christina McKelvie said: “A key part of our £250 million National Mission on drugs is to get people into the treatment and recovery that is right for them and the Scottish Government will continue to work closely with people and families to ensure care and support for cocaine users is available.

“I discussed these issues, including the shift to cocaine injecting, with Professor Andy McAuley of PHS and GCU yesterday and a number of potential actions are being explored.

“Funding for Alcohol and Drug Partnerships rose to a record £112 million in 2023-24, while our national Mission funds have now backed more than 300 grassroots projects.

“As part of a wide range of measures, we’re also backing a Safe Drug Consumption Facility pilot in Glasgow and are committed to delivering drug-checking facilities which would enable us to respond faster to emerging drug trends. Licence applications for Aberdeen and Dundee facilities have been submitted.”

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