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Substance Use - Data



What you told us

Read the Consultation and Engagement report for the Strategic Plan 2022-25 (PDF)

What the data tells us


It is estimated that there are 760 problematic drug users in Midlothian - 530 males and 230 (30%) females. The proportion of female users is slightly higher than the national figure of 29% . The additional challenges women face, particularly around stigma and discrimination need to be considered when designing and delivering services to ensure they feel able to access available supports.

For both males and females, the age range 25-34 years has the greatest number of problematic drug users, 350 males and 150 females.

Characteristics of populations most at risk of a drug related death are:

  • Single, unemployed white Scottish men in their early 40s
  • History of long-term poly-substance use (the median number of drugs implicated in 2019 deaths in the Lothians was 4 with a range up to 11)
  • Experienced one or more non-fatal overdoses
  • Multiple co-morbidities
  • History of mental illness
  • Not in contact with treatment services
  • Socially isolated, lived alone, died alone.

Like other areas of Scotland, Midlothian has experienced a marked increase in people using benzodiazepines primarily ‘street benzos’ such as etizolam. Cocaine and other stimulants are also increasing in popularity often with a younger age group most of whom will be in employment. Heroin, cannabis and diazepam were most often reported to have been used in the month prior to assessment.


Number of new clients seeking support to deal with their substance use in Lothian mid and east alcohol & drug partnership (2019-20)

The number of new people seeking help for their substance use in Lothian Mid and East Alcohol Partnership in 2019-20 varied greatly by age.  The highest numbers were in the 25 to 29 and 30 to 34 age groups, with 37 individuals seeking help, followed closely by the 35 to 39 age group, with 35 people seeking help.  The lowest number of people were in the under 20 group, which had 6 seeking help. There were also 22 people in the 20 to 24 age group, 30 people in the 40 to 44 group and 24 people over 45 who sought help in this time period.


Drug-related hospital stays, 3-year aggregates, Midlothian and Scotland

Drug related hospital stays have increased steadily over the period from 2007 to 2020 in both Midlothian and Scotland. Midlothian rates have increased at around the same rate as Scotland and, excluding the period 2012/13 to 2013/4, have always been lower than Scotland. Latest figures for 2017/18 to 2019/20 are 200 drug related hospitals stays per 100,000 in Midlothian in comparison to 221 in Scotland.


Drug related deaths in Midlothian (2009 – 2020)

Drug related deaths in Midlothian increased substantially from 2009 to 2020, with 21 deaths in 2020 compared with 9 deaths in 2009. There was a large jump in 2017, where the number of deaths increased from 8 to 19, and excluding a drop down to 14 deaths in 2018 numbers have continued to rise since.





In 2020 there were 21 drug related deaths in Midlothian, the highest figure ever recorded and more than double the 2016 figure. Of the deaths in 2020, 18 were classified as accidental poisoning. Any opiate or opioid was noted as the drug present in 20 of the deaths. In the period January to December 2020 there was a total of 93 non-fatal overdoses.

Comparably in Scotland drug related deaths have increased over the last 5 years from 868 to 1,339 in 2020. The largest number ever recorded. The five-year average in Midlothian was 7 for 2011-2015 and 16 for 2016-2020.


We have an aging population of people who use drugs who are more likely to be frail and experience multi morbidity requiring increased health and social care support. Services need to reach out and target those most at risk of drug related deaths as we know they are less likely to reach in.



Alcohol related deaths: 17 alcohol related deaths (2016) with a five-year average of 17 (2012-2016). The average age-standardised death rate for the five-year aggregate 2012-2016 was 15 deaths per 100,000 population, which is similar to the average Scotland rate of 21.7.

Nationally statistics are collected on a narrow definition of alcohol related deaths – as those coded to a direct alcohol related cause such as alcoholic cirrhosis. They do not include deaths due to diseases for which alcohol is a risk factor (such as cancer). However, studies suggest that the number of deaths where alcohol was a contributory or risk factor is much larger. The use of this narrower definition ensures that it is easily collectable to demonstrate any trends.

Ten localities are above the Midlothian average for alcohol related deaths including:

  • Newtongrange (average rate of 45.6 deaths per 100,000 population),
  • Loanhead (28.41),
  • Thornybank (26.98),
  • Penicuik Southwest (26.76),
  • Bonnyrigg North (25.53) and
  • North Gorebridge (25.40).
  • Dalkeith (19.88),
  • Mayfield (19.35),
  • Penicuik Southeast (18.61)
  • Gorebridge
  • Middleton (17.86)

Alcohol related hospital stays are the number of general acute inpatient and day case stays with a diagnosis of alcohol misuse in any position: 345 patients had alcohol related hospital admissions (2016/2017).

Ten of Midlothian’s localities sit above the Midlothian average for alcohol related hospital stays including:

  • Dalkeith (rate of 1444 admissions per 100,000 population)
  • North Gorebridge (865)
  • Newtongrange (780)
  • Straiton (719)
  • Loanhead (701)
  • Thornybank (694)
  • Pentland (677)
  • Penicuik Southeast (657)
  • Penicuik East (577)
  • Pathhead and Rural East Midlothian (555).

“In Midlothian, a statistically significant relationship was found between alcohol outlet availability and alcohol-related deaths: neighbourhoods with more places to buy alcohol had higher alcohol-related death rates. Alcohol-related death rates in the neighbourhoods with the most off-sales outlets were 2.4 times higher than in neighbourhoods with the least”

It is reasonable to assume based on national data that alcohol related harm is most acutely felt in Midlothian’s most deprived communities.