The British and Scottish governments will meet in Glasglow this week to hold summits on the public health emergency in Scotland, where a record 1,187 people died in drug-related deaths in 2018, up 27 per cent on the year before.

Scotland has the highest number of drug deaths out of any European nation, largely due to the use of opioids paired with other street drugs, particularly benzos. The country has a similar number of overdoses to Germany, despite the massive difference in population size, 5.5 million compared to 83 million.

The latest figures from 2018 show that Scotland has a drug-death rate of 218 per million, four times higher than that of England and Wales, who reported a death rate of 51 per million, according to the BBC.

It is estimated that there are 60,000 active users of hard drugs in the country, representing 1.6 per cent of the adult population.

Dr Andrew McAuley, senior research fellow at Glasgow Caledonian University, said that Scotland has “proportionately way more drug users than the rest of the UK. That ultimately has an obvious impact on the number of drug-related deaths.”

A majority of the deaths were caused by people combining different substances together, typically a mixture of opioids such as heroin or methadone with benzodiazepines like etizolam, which was tied to 548 of the deaths in 2018.

“We see now people taking handfuls of these pills and sometimes they are stronger than they are expecting, or they re-dose more quickly because the effects do not last as long as prescription benzodiazepines,” said Dr McAuley.

Over the past six years, the proliferation of stronger benzodiazepines, so-called “street valium” has skyrocketed in Scotland, replacing prescription pills as the drug of choice.

“Often people might think they are taking diazepam but it may be other much more potent benzodiazepines such as etizolam. It is particularly dangerous when used in combination with other drugs like heroin and even prescribed methadone,” said Dr Saket Priyadarshi of NHS Greater Glasgow.

In response to the public health emergency, the governments of the UK and Scotland will be holding competing summits in Glasgow. The UK government wants to see a crackdown on drug offenders, while the Scottish government is aiming for an increase in addiction treatments, according to the Financial Times.

The ruling Scottish National Party has called for the decriminalisation of the use and possession of drugs, similar to Portugal. In America, the opioid crisis killed a record 72,287 people in 2017 and another 67,367 in 2018, most of whom died as a result of taking heroin or fentanyl.

Follow Kurt on Twitter at @KurtZindulka