Alcohol and Drug Partnerships: annual survey 2024 to 2025

Executive Summary

Responses were received from all 30 Alcohol and Drug Partnerships (ADPs) in Scotland. The survey included sections relating to cross cutting priorities and outcomes in the National Drugs Mission outcomes framework and covered activity over 2024/25. The key findings are:

Cross cutting priority: Surveillance and data informed

• Most ADPs reported having groups or structures in place at the ADP level to inform surveillance and monitoring of alcohol and drug harms or deaths. These groups or structures were more commonly reported to be in place for drug deaths and harms than for alcohol deaths and harms. This is consistent with findings from last year.
• Most ADPs reported having a drug death review group (or equivalent) in place in 2024/25. Eight in ten ADPs reported having a drug trend monitoring group or early warning system in place, similar to last year. Half of ADPs reported that they had alcohol harms groups in place in 2024/25. Just under a quarter of ADPs reported having an alcohol death review group, similar to last year.

Cross cutting priority: Skilled and resilient and workforce

• As of 31 March 2025, ADPs reported employing an average of 3.4 whole-time equivalent (WTE) staffing resource routinely dedicated to their ADP support team, which is broadly in line with previous years.
• ADPs reported a variety of initiatives to improve employee wellbeing. The most common were the promotion of information and support initiatives, and provision of training on issues including trauma awareness and crisis management.

Cross cutting priority: Lived and living experience

• All ADPs have formal mechanisms for gathering feedback from people with lived and/or living experience who use ADP-funded services. These mechanisms included engagement with recovery communities and experiential data collected as part of the Medication Assisted Treatment programme.
• All ADPs reported having at least one mechanism that enables people with lived and living experience to participate in ADP decision-making, most commonly through an existing ADP group/panel/reference group.
• All ADPs also reported having at least one way to enable family members to participate in ADP decision-making, with the most common approach being through a group or network independent of the ADP.

Cross cutting priority: Stigma reduction

• All ADPs reported that stigma reduction was considered in their ADP strategy, delivery, and/or action plan. There were increases in the percentage of ADPs who reported that they considered stigma reduction in their communication strategy, drug deaths and harms prevention action plan, and in their alcohol deaths and harms prevention action plan.

Outcome 1: Fewer people develop problem substance use

• Online methods continue to be the primary way information on local treatment and support services is provided at an ADP level to a range of groups. There is little variation in how information is targeted across groups.
• Groups most widely targeted were women, people who are experiencing homelessness, people who are pregnant or peri natal. Groups least targeted were non-native English speakers, people with learning disabilities and literacy difficulties, people from religious groups, and people with hearing and/or visual impairments
• ADPs reported funding or supporting a range of education and prevention activities across different age groups, with a more diverse age-appropriate range available for young people and adults than for children. Although activities differed by age group, they most commonly related to harm reduction, mental wellbeing and campaigns/information. With youth activities being the most commonly reported prevention activities for children.
• A notable rise from 2023/24 was seen in the proportion of ADPs reporting funding or supporting education or prevention campaigns/information for children

Outcome 2: Risk is reduced for people who use substances

• As in previous years, naloxone supply was the most frequently reported harm reduction initiative, while injecting equipment provision was the least widely available. Drug services and mobile/outreach services were the most common providers of harm reduction initiatives.
• ADPs reported demand for additional harm reduction initiatives beyond those currently available, including harm reduction advice and support in relation to psychostimulants and drug testing strips.
• Almost all ADPs reported having an adequate supply of naloxone to meet general needs. Seven in ten ADPs also reported adequate supply in the context of a more toxic and unpredictable drug supply where higher naloxone doses may be needed.
• Changes in harm reduction delivery settings arose from service redesign, building restructures, responses to emerging drug trends such as nitazenes, and increased demand for harm reduction services for users of cocaine and crack.

Outcome 3: People most at risk have access to treatment and recovery

• All ADPs reported having documented pathways with both the Scottish Ambulance Service and specialist substance use treatment services to identify individuals who have experienced a near-fatal overdose and provide them with support.
• ADPs most frequently identified workforce capacity, issues around information sharing, lack of staff to support out of hours or extended core business hours and insufficient funds as barriers to implementing near-fatal overdose pathways.
• There has generally been an increase in the number of ADPs reporting that they have worked with justice partners at strategic, operational and service levels since 2023/24.
• ADPs reported supporting activities at all stages of engagement with the justice system, with support most commonly provided on release from prison and least commonly at the in-court stage. Compared with 2023/24, support remained stable or increased at most stages, with a slight decline at the in-court stage. The activities most frequently supported were referrals to drug and alcohol treatment services, harm reduction and Opioid Substitution Therapy (OST).
• The most commonly reported barrier to accessing support for people involved in the justice system was lack of services tailored specifically to people who are on Community Payback Orders, Drug Treatment and Testing Orders, Supervised Release Orders and other community orders. Other barriers reported were services that excluded people convicted of certain offences, housing issues, restrictions around multi-agency public protection arrangements, geographical challenges, and lack of availability of services in court. A quarter of ADPs reported no barriers to accessing support in their area.
• For people going through the justice system on an order or license, drug testing services were reported to be around twice as common as alcohol testing services. For both alcohol and drugs, testing was most commonly reported to be provided by NHS addiction services.

Outcome 4: People receive high quality treatment and recovery services

• All ADPs reported having at least one screening option in place in their ADP area to address alcohol harms. The most common arrangements were for delivering Alcohol Brief Interventions (ABIs) in priority and non-priority settings, and for alcohol hospital liaison. Fewer ADPs reported provision for delivery of ABIs in non-priority settings. Almost half of ADPs reported having fibro scanning in place in their area
• A range of treatment options to address alcohol harms were reported to be in place in all ADP areas, similar to 2023/24. All ADPs reported residential rehabilitation, psychosocial counselling, community-based alcohol detox (including at home), and access to alcohol medication (e.g. Antabuse, Acamprase, etc.) were in place
• All ADPs reported barriers to residential rehabilitation, with the most common being the availability of stabilisation/crisis services and availability of detox services.
• ADPs reported a range of actions being taken to overcome barriers to residential rehabilitation. This includes work with Healthcare Improvement Scotland to review and improve local residential rehabilitation pathways, use of resources to better inform service users and families, and changes in criteria to enable easier access to residential rehabilitation.
• All ADPs reported barriers to implementing the Medication Assisted Treatment standards in their area, most frequently reported were geographical challenges, challenges engaging with GPs, and accommodation challenges.
• ADPs reported a range of treatment and support services specifically for children and young people using alcohol and/or drugs, with the widest variety available for young people. Across all age groups, the most common services were family support services, mental health services, outreach/mobile, information services and diversionary activities.

Outcome 5: Quality of life is improved by addressing multiple disadvantages

• Specific treatment and support services were most commonly in place for women, people involved in the justice system, people who are pregnant or perinatal and people experiencing homelessness. These services were less frequently reported for people with hearing impairments and/or visual impairments, people from religious groups and people who are neurodivergent.
• Eight in ten ADPs reported having formal joint working protocols to support people with co-occurring substance use and mental health diagnoses to receive mental health care.
• ADPs commonly worked with other support services such as welfare advice and housing support to address multiple disadvantages through partnership working,
• Almost all ADPs reported working with other support services via representation on strategic groups or topic-specific sub- through their representation on the ADP board.
• ADPs reported a range of activities aimed at implementing a trauma-informed approach, with most activities increasing compared with last year’s survey.
• Just over nine in ten ADPs reported having a specific referral pathway for people to access independent advocacy, in line with the level reported in 2023/24.

Outcome 6: Children, families and communities affected by substance use are supported

• ADPs reported a range of treatment and support services for children and young people who are affected by a parent or carer’s substance use. The most commonly provided services across age groups were mental health services, family support services, and carer support, while first aid training was the least commonly reported. The widest range of services was on offer to young people (16-24 years).
• Support services for adults affected by another person’s substance use were widely in place. The most commonly reported services included advocacy, support groups, commissioned services and one to one support.
• More than nine in ten ADPs reported having an agreed set of activities and priorities with local partners to implement the Holistic Whole Family Approach Framework in their ADP area – an increase compared with 2023/24.
• Advocacy, advice and social activities were the most widely available services supporting a Family Inclusive Practice or a Whole Family Approach.
• ADPs highlighted that more funding, additional resources and workforce training would be the most helpful to facilitate implementation of a Family Inclusive Practice or a Whole Family Approach.