National Mission: annual report 2024-2025

2 Cross-Cutting Priorities

2.1 Overview

There are six priorities which cut across all our work. This chapter outlines the progress made in 2024/25 for each priority, and the next steps in delivery.

2.2 Progress in 2024-25

2.2.1 Lived and living experience (LLE)

Lived and living experience continues to be at the heart of what we do. To support this £0.5 million in funding for Alcohol and Drug Partnerships (ADPs) has continued to support ADPs in improving the way people affected by substance use can take part in decision-making in their local area. We want to improve the quality of this participation, focusing on meaningful opportunities to influence outcomes and to improve services.

In addition, the Scottish Drugs Forum, with support from the Scottish Government, is delivering a Living Experience Engagement Project, the purpose of which is to maintain the progress of the established living experience groups and support their expansion into new areas and to support and develop the independence of the National Living Experience groups in order to empower their constituents to articulate the real time experiences and needs of people who use drugs.

2.2.2 Equalities and human rights

The National Collaborative

The National Collaborative was established to address two cross-cutting priorities of the National Mission on Drugs - putting people with lived and living experience of substance use and their families at the heart, and Equalities and Human Rights.

It is led by an independent Chair, Human Rights expert, Professor Alan Miller, driven by a Change Team of people with life experience of substance use, and supported by a wider network of organisations, groups and individuals.

The Charter of Rights for People Affected by Substance Use was launched in December 2024 by the National Collaborative, and supported by the First Minister, Cabinet Secretary for Health and Social Care and the UN Office of the High Commissioner for Human Rights.

The launch of this Charter of Rights emphasises Scotland’s commitment to ensuring a person centred and rights-based approach to the design and delivery of drug and alcohol services, drawing on internationally recognised standards to address stigma. An animation summary was produced to explain key aspects of the Charter.

The Charter, recognised as the first of its kind in the world by the UN Office of the High Commissioner for Human Rights, will help ensure people know their rights and the support they can expect to receive, and that people who use drugs and alcohol, and their families, are treated with dignity. The Charter also sets out the requirements on duty bearers in developing and delivering services for those affected by substances, to ensure a rights-based approach.

In order to develop the Charter, during 2024/25 InterAction meetings were convened with the Change Team and Duty Bearers to encourage engagement with the process of developing the Charter of Rights and to help duty bearers to understand their responsibilities in delivering on the rights included in the Charter.

In early 2025 a new phase of InterActions with a focus on implementation were co-convened by the Scottish Government and Change Team to explore how local plans for implementation can be developed by duty bearer organisations, and what is needed to support that.

Emerging practice is being captured to share ideas and learning as a human rights-based approach is developed and delivered by duty bearers. The Scottish Government has made a clear commitment to bring forward the Human Rights Bill in the next parliament. Using a human-rights-based lens now will help in preparation for any new legislation.

The focus now for the National Collaborative and Scottish Government is to ensure broad awareness and understanding of the Charter amongst rights holders and duty bearers, and to support and embed implementation of a human-rights based approach.

2.2.3 Tackling Stigma

During 2024/25 we further developed our work to tackle stigma experienced by people who use drugs and alcohol, their families and communities. Deciding Matters were commissioned to deliver a series of workshops, identifying where changes to services and public perceptions in Scotland can tackle stigma experienced by people with substance use. The resultant report will inform the next phase which will work closely with other parts of Scottish Government such as mental health, criminal justice and beyond to ensure that momentum is built to achieve concrete and meaningful shifts in culture change.

2.2.4 Surveillance and data informed

Data is vital to understanding our challenge and monitoring our progress and significant progress has been made to improve the quality and management and communication of our data.

Rapid Action Drug Alerts and Response (RADAR)

The ability to know what is in the drug supply and when substances of concern, such as synthetic opioids, appear is vital. Recognising the need to understand changes in the substances people are taking, alongside being able to identify potential threats, has meant that through the National Mission we have invested in developing our surveillance abilities.

Throughout 2024-25, PHS continued to develop RADAR, Scotland’s drugs early warning system. The system collates and analyses a range of information relating to drug harms made available through organisations such as Police Scotland, NHS Health Boards, Scottish Prison Service, third sector, and people with lived and living experience. This enables each local area to identify trends in drug harms, share key information across Scotland and ensure evidence-based approaches are in place to reduce drug harms.

To date, RADAR has identified several changes in the drug supply through its reports. The findings also informed public health alerts, such as a new alert issued in 2024-25 in relation to xylazine.

We have continued to fund A Surveillance Study of Illicit Substance Toxicity (ASSIST), which aims to establish a robust toxicology surveillance system in the emergency department of Queen Elizabeth University Hospital, Glasgow. The information this study provides has been vital for informing services, staff, drug organisations and those who use drugs about changes in the drug supply through PHS quarterly RADAR reports.

The information provided through ASSIST, and through PHS and RADAR, has been vital when addressing the recent clusters of near-fatal overdoses (NFOs) which have occurred across Scotland. That information also allowed for the release of a further alert from PHS supported by additional harm reduction guidance from partners.

Prevalence of opioid dependence

An updated estimated prevalence of opioid dependence in Scotland was published in March 2025. The report presents estimates of the number of people aged 15 to 64 years old with opioid dependence, along with estimates of the prevalence of this group among Scotland’s general population.

It found that in 2022/23:

• The estimated number of people with opioid dependence in Scotland was 43,400. This represents an estimated prevalence of 1.23% of 15- to 64-year-olds.
• Prevalence of opioid dependence was highest among males (1.74% and 0.75% among females).
• Prevalence of opioid dependence was highest (2.39%) among people aged 35 to 49 years, 0.67% among people aged 15 to 34 years, and 0.88% among people aged 50 to 64 years.

DAISy

The Drug and Alcohol Information System (DAISy) is a national database that holds demographic and treatment data about people who engage with specialist drug and alcohol treatment services in Scotland. The most recent DAISy treatment report was published in November 2024, providing an overview of initial assessments for specialist drug and alcohol treatment. The DAISy dataset aims to enable a better understanding of the impact of drug and alcohol treatment services at both a local and national level and supports analysis and reporting on treatment (including Official Statistics on waiting times) to inform national policy and practice.

PHS have moved into the implementation phase of the DAISy review as they continue to ensure it remains fit for purpose and tracks relevant contemporary treatment modalities in the face of dynamic trends in drug use. PHS publish reports on drug and alcohol treatment services across Scotland using data captured by this system. PHS publish National drug and alcohol treatment waiting times statistics quarterly (the most recent publication was in June 2025) including monitoring of performance in relation to the Scottish Government Standard that 90% of people referred for help with problematic drug or alcohol use will wait no longer than three weeks for specialist treatment

Alcohol and Drug Partnership Annual Reporting Survey

The main aim of the Alcohol and Drug Partnership Annual Reporting Survey is to evidence progress of the National Mission by providing information on the activity undertaken by ADPs, as well as understanding some of the barriers experienced at local level. This is part of the provision made in the 2019 Partnership Delivery Framework for local accountable entities to report to the Scottish Government on their monitoring and prudent application of public funds and progress made towards national outcomes.

The 2023/24 survey was published in November 2024, and compiled responses from all 30 ADP areas. To facilitate data collection and reporting, the survey adapted the National Mission’s outcomes and cross-cutting priorities, with the survey reviewed annually to reflect evolving priorities while enabling year-on-year comparison. This allows the report to be read alongside the National Mission Annual Report and National Mission Annual Monitoring Report, which set out the progress made towards the National Mission Outcomes Framework.

Digital Lifelines Scotland (DLS)

This programme has supported significant expansion in access to digital technology for people accessing support for drug and alcohol harms. The 2025 DLS Evaluation highlighted that a total of 5,502 individuals supported to date (3,048 experiencing homelessness, 2,037 in custody, and 417 hospital-based). Across its projects, DLS distributed thousands of devices and connectivity packages to those in need. Importantly, DLS didn’t just hand out devices; it also invested in training and support so people could use them.

Service users reported that with personalised support from staff or volunteers, they felt able to do things online that they couldn’t before. This includes being able to access drug and alcohol support services remotely and also apply for housing, benefits, and employment opportunities, contributing to greater stability and independence.

DLS has opened up opportunities by giving people the tools and confidence to participate in the digital world. This work will continue into 2026, continuing to demonstrate the value and impact of digital inclusion for those most in need.

2.2.5 Resilient and skilled workforce

Attracting, retaining, and supporting the drugs and alcohol workforce is a vital part of the National Mission.

Work has been undertaken in 24/25 to deliver to deliver the Scottish Government’s Drugs and alcohol workforce action plan. The Drug and alcohol workforce learning directory was published in January 2025 which provides learning opportunities for those working with people affected by substance use. This work was developed in collaboration with a Workforce Expert Delivery Group (WEDG) subgroup who provided oversight and advice at all stages of development and implementation. This was developed in response to the Drug Deaths Taskforce’s recommendation that those working in the sector should receive training on:

• Taking a human rights-based approach
• Practising trauma-informed care
• Tackling stigma
• Delivering family-inclusive practice
• Providing harm-reduction advice

The Drugs and Alcohol Workforce Knowledge and Skills Framework was developed which sets out to practitioners, commissioners, managers and service providers the knowledge and skills required by the drugs and alcohol workforce to support consistent delivery of high-quality services.

To support employers, ‘Guiding Principles’ were developed which set out best practice on how employees with lived and living experience should be supported within the workplace. Employability toolkits were developed to support people with lived and living experience of substance use into employment within the substance use sector or elsewhere. The ‘Pathways to Employment: Your Guide to a Career in Substance Use Services’ and the ‘Pathways to Employment: Supporting people with lived and living experience of substance use in to work’ were developed to support both employers and employees at every step of the employment journey.

In 24/25, we also continued to provide funding to the Scottish Drugs Forum deliver the National Traineeship and for the Royal College of General Practitioners to deliver the Certificate in Management of Problem Drug Use. We have also provided funding for the Humanising Healthcare Café project which provides medical students with insight into addiction and recovery from the perspective of people with lived and living experience of substance use.

The next steps will be for the formal launch and implementation of the Knowledge and Skills Framework , Guiding Principles and the two Employability Toolkits to in 2025.

These resources provide the workforce with support to current challenges, without any additional reporting requirements.

Humanising Healthcare Conversation Café Project

2024 also saw an expansion of the Humanising Healthcare Conversation Café Project which fosters conversations between medical students and individuals with lived and living experience of problematic substance use.

Launched in 2021 as a student-led initiative, the project provides a platform for students to engage with individuals who have experienced problematic substance use. The conversation café model was adapted to fit into medical school curriculum, with the intention of enhancing experiential learning. In the academic year 2024/25, 578 students completed feedback surveys, and 98.8% reported that the conversation cafes were beneficial to their medical training.

2.2.6 Psychologically informed

In 2024-25 there has been continued focus on implementation of the Medication Assisted Treatment (MAT) Standards. This includes MAT Standard 6 which aims to ensure that the system providing MAT is psychologically informed and can provide psychosocial interventions, and MAT Standard 10 which aims to ensure that trauma-informed principles underpin all care and support provided by specialist services. Progress towards full implementation of the MAT Standards is published annually by Public Health Scotland in a Benchmarking Report and the 2024-25 Report was published on 17 June 2025.