A survey of deaths of chronic drug abusers who came to medico-legal autopsy in the South-east of Scotland revealed a total of 179 fatalities in the six-year period between 1989 and 1994 inclusive. There was an almost linear increase in the number of such deaths reported to the Procurator Fiscal per year over this period, rising from 14 in 1989 to 45 in 1994. The majority of deaths (86%) were seen in males and the peak age at death was in the third decade of life. In the majority of cases (60%) death was deemed to be accidental and most were due to accidental drug overdoses, with methadone being the drug most commonly detected on toxicological analysis. The number of HIV-positive cases peaked in the years 1991 and 1992 with a decline over the subsequent two years.