Chamber and committees

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

Assertive outreach is being delivered though the guidance for Medication Assisted Treatment (MAT) standard 3. The aim of MAT standard 3 is to proactively identify people, including through assertive outreach, who are at high risk, and to prevent harms by rapidly providing that individual with appropriate support.

In practice, implementation of MAT standard 3 extends to all substance misuse problems. A significant proportion of support offered to people identified through outreach is for problem alcohol use. Alcohol-specific outreach guidance will feature in wider standards for alcohol and drug treatment following the publication of UK-wide alcohol treatment guidelines.

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

The Prison to Rehab pathway was established in the summer of 2020 to support individuals into residential rehabilitation services during the unprecedented time of the COVID-19 pandemic.

We conducted an internal review of the pathway in 2021-2022 which was complimented by an evaluation from one of our commissioned third sector organisations, the Scottish Recovery Consortium. The published evaluation can be viewed here . The review and the evaluation informed a new version of the Prison to Rehab protocol to ensure it continued to be fit for purpose. This was published in March 2023 and can be viewed here here .

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

Quality improvement methodology is being embedded across Scotland through the implementation of the Medication Assisted Treatment (MAT) standards.

The MAT Standards Implementation Support Team (MIST), based within Public Health Scotland, was set up to support local areas to build improvement-based capacity and capability so that they will be able to implement and sustain the MAT standards locally.

MIST helps local areas with quality improvement work which has focused on establishing that local areas have written procedures in place, have numerical information and data available and have a means in place to gather experiential data. All of which are required to help drive improvement.

Healthcare Improvement Scotland (HIS) is also supporting local areas and works closely with MIST in providing practical quality improvement assistance and advice to local areas.

HIS will shortly begin delivery of its full quality improvement assistance to local areas to build on the first phase of quality improvement work MIST has undertaken. HIS also provides close links between its other relevant workstreams on residential rehabilitation, prison healthcare and mental health and addictions services.

Alcohol remains a priority for Scottish Government and we are treating our policies to reduce alcohol and drug deaths as twin public health emergencies in Scotland.

This is why we established a National Mission to improve and save lives, at the core of which is ensuring that every individual has access to, and choice in the type of recovery and treatment they need.

We are working to ensure people with alcohol use disorder receive the care and support in the same way that people can access for problematic use of drugs. The forthcoming Alcohol Treatment Guidelines will help ensure support for alcohol treatment, in a similar way to how the Medication-Assisted Treatment Standards ensure this for people impacted by opiates.

Following publication of the UK-wide guidelines it is our intention to draft a paper on specific alcohol treatment standards for Scotland.

Through our National Mission we are investing in residential rehabilitation that will benefit people experiencing alcohol and/or drug addiction.

At present, we have no plans to establish and evaluate tests of change for alcohol treatment in the justice system.

The Scottish Prison Service is currently refreshing its Alcohol and Drug Recovery Strategy, this will ensure alcohol intervention and support are included in any recovery pathway planning across our establishments. It is anticipated that the strategy will be published later this year.

We are also supporting the UK Government on reviewing and updating clinical guidelines for alcohol treatment. The guidance will look to introduce new approaches to treatment and will apply to a broad range of settings including justice settings. The guidelines are expected to be published for consultation this year.

Following finalisation of the alcohol treatment guidelines, Scottish Government will review and use these to ensure that our justice systems are providing consistent and good care to those with problematic alcohol use.

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

As part of the National Mission, Public Health Scotland established the Rapid Action Drug Alerts and Response (RADAR) system. The first published report was issued on 11 October 2022 and that has been followed by quarterly publications. It reports on drug-related indicators in order to inform action to prevent drug harms and deaths.

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

The Medication Assisted Treatment standards published on 31 May 2021 and are a set of standards aimed at providing a framework to ensure that MAT is sufficiently safe, effective, acceptable, accessible and person-centred to enable people to benefit from treatment for as long as they need it.

The standards are evidence based and were developed through extensive consultation with multiagency partners that deliver care, and, with the individuals, families and communities with experience of problematic drug use.

The Scottish Government has committed to full and sustained implementation of MAT standards 1-10 in community and justice settings by April 2026. To help local areas achieve this, the MAT Implementation Support Team (MIST), based within Public Health Scotland (PHS) is supporting the roll out of the standards ensuring local areas have systems, protocols and procedures in place to be able to continuously improve services based on evidence.

In order to demonstrate implementation of the MAT standards, local areas provide process, numerical and experiential evidence to MIST which helps to inform an annual National Benchmarking Report, published by PHS. Process evidence includes formularies, clinical guidelines, care pathways, standard operating procedures, policies and other supporting documentation.

The National Benchmarking Report for 2022/2023, published in July 2023 reported that the 29 ADP areas assessed against each of the 10 MAT standards, 66% (96/145) of MAT standards 1–5 were fully implemented and 88% (127/145) of MAT standard 6–10 were partially implemented.

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

The Partnership Delivery Framework to Reduce the Use of and Harm from Alcohol and Drugs which was approved by COSLA Leaders and Scottish Ministers in 2019, sets out clear arrangements for quality assurance and quality improvement work to be undertaken at a local level.

The Drugs Death Taskforce recommended in their final report, Changing Lives , that; The Scottish Government should develop a National Specification outlining the key parts of the treatment and recovery system that should be available in every local area, ensuring it also delivers on the principles of quality, choice, access and parity of treatment with other health conditions.

We have made a commitment in our Cross Government Plan that we agree that a National Specification for services would help set these requirements out more clearly. This would also provide more accountability, particularly for those with lived and living experience and their families who will be able to see clearly what they can expect to be available in the treatment and recovery system.

We are working with partners to scope out the components of a Specification for further development and consultation. This process will need to involve a range of local and national partners and most important amongst those will be people with experience of using the services and their families.

Yes, on 8 November 2021 the Scottish Government published A Review of the Existing Literature and Evidence on Young People Experiencing Harms from Alcohol and Drugs in Scotland.

The review can be found here: A Review of the Existing Literature and Evidence on Young People Experiencing Harms from Alcohol and Drugs in Scotland (www.gov.scot)

In 2021, the Scottish Government formed a working group to develop Action 4 from the Rights, Respect and Recovery Action Plan. The aim of the working group is to ensure that good quality early intervention support services are available across Scotland for young people with emerging problematic drug and alcohol use.

The first phase of this work involved the working group gathering data from a range of sources to understand the size of the problem of younger people using drugs and alcohol as well as risk factors.

In 2022, we commissioned We Are With You to engage with young people in order to learn from their experiences of drug and alcohol use. This engagement has helped the working group to understand young people’s preferences for seeking help and the perceived barriers they face and this insight will aid the development of support for young people at risk from drugs/alcohol harms.

In Spring 2023, the working group began engaging with young people, using a co-design approach, to gather their views of good support. These findings, along with existing international evidence of good practice will be used by the working group to develop standards of support for children and young people.

The working group will outline the minimum principles of support that is required to meet the needs of children and young people and provide early intervention support in a way they want.