In the same year as Glasgow and Scotland saw its drug-related death figures rocket to record levels, a city region in America has achieved a remarkable drop in deaths.

Drug-related deaths in Scotland increased by 27 per cent to 1187 last year. In Glasgow the figure was 280 deaths, a rise of more than 40 per cent.

In Southwestern Pennsylvania, in 10 counties around the City of Pittsburgh, drug deaths increased steadily to a peak in 2017.

Figures for just three of the counties show 1027 died from overdoses in 2017. Then, last year, the figures showed a 40 per cent drop, down to 630.

In the largest county, Allegheny, which has a population of 1.2million, which includes Pittsburgh City, the drop was from 737 to 432.

The preceding years had seen an increase in Fentanyl, a synthetic heroin that was present in the majority of overdoses. Health officials led by the State Physician General decided that a massive upscaling of the effort to identify and treat people was required.

Kami Anderson, is executive director of the Armstrong-Indiana-Clarion Drug and Alcohol Commission, working in three counties in the region.

She said: “The first thing we did was place a huge order for Naloxone and flooded the counties with it.

“We made sure all the first responders, police and fire, all had naloxone kits. Everyone on treatment left with a naloxone kit. Our goal was to stop the deaths.”

The naloxone initiative was coupled with a drive to get people into treatment and an accompanying upscaling in resources to cope.

Ms Anderson said: “We started to put our staff into the Emergency Rooms in hospitals across the counties to speak to people who were brought in.”

She said the success rate from the ER initiative was high, with 82 per cent agreeing to go into treatment.

It was recognised that there needed to be more investment in care services to realise the ambition of treating more people.

Ms Anderson added: “We appointed case managers to get people into the right level of care.”

For those agreeing at Emergency Rooms, she said: “We got them into a detox centre that day. We increased the number of beds for the providers so they were able to cope with the increase in demand for assistance.”

An overdose task force was established with top level officers from the 911 services to meet once a month to look at the fatality numbers and cases to assess what actions were taken and to identify what else would have been done.

The experience of southwestern Pennsylvania has similarities with Glasgow. In Glasgow the street benzodiazepines, street Valium, is causing serious harm. In the Pittsburgh area it was fentanyl.

Both cities also had a number of people coming out of prison and suffering an overdose within days.

Ms Anderson said: “We had a lot of people coming out of jail and then overdosing.

“They had a reduced tolerance to drugs.

“So we gave them a shot of vivitrol to offset the cravings.”

Ms Anderson said: “It all cost a lot of money but everybody you ask said the naloxone had the biggest impact. We try to stop people dying, then get them into services.”

Laura Drogowski, critical communities initiatives manager for the City of Pittsburgh, said treating the person is crucial instead of focusing on supply.

She said: “A lot of people have died. It was unacceptable.”

She said: “We don’t believe they’re are fewer people taking drugs, they just have the tools to take them more safely.”