National Mission on Drugs: annual report 2025 to 2026

2. Cross-Cutting Priorities

2.1 Overview

The National Mission had six cross-cutting priorities. This chapter outlines the progress made in 2025/26 on each priority and reflects on how this work has informed future delivery under the Strategic Plan.

2.2 Progress in 2025/26

2.2.1 Lived and Living Experience (LLE), Equalities and Human Rights, and Tackling Stigma

The National Collaborative Charter of Rights for People Affected by Substance Use was co-designed with a Change Team of people with lived and living experience of alcohol and drug harms. The Charter’s development was informed by an extensive engagement process involving people affected by substance use and their family members as rights-holders, alongside duty bearers, including Alcohol and Drug Partnerships, health, social care, housing and justice services, and third sector providers.

The Charter and accompanying Toolkit support the adoption of a human rights-based approach, promoting dignity, respect and meaningful participation in decision-making, while helping services to be designed and delivered in ways that uphold the rights of people and families affected by substance use.

In collaboration with the Change Team and wider partners, a substantial programme of awareness-raising, engagement and training was initiated throughout 2025-26 to embed the Charter and a Human Rights-Based Approach across the sector. This included targeted learning to support individuals and organisations to better understand rights, alongside key frameworks and tools such as the PANEL Principles, FAIR model, AAAQ framework, and Equality Act 2010. Rights-based training has engaged people with lived and living experience and staff across recovery communities, independent advocacy services, and statutory and third sector organisations.

Examples of how the Charter is being put into practice are set out in the Emerging Practice section of the Toolkit.

The National Collaborative and Change Team concluded in March 2026 in line with the National Mission.

Throughout 2025-26, the voices of people with lived and living experience and their families have been shaping policy and service delivery so that they better reflect people’s real-world experiences. This progress has been supported by the Charter of Rights, which prioritises meaningful involvement of lived and living experience across the design, delivery and monitoring of support services.

For example, the MAT Standards experiential assessment is aligned with the Charter of Rights in order to evaluate the experiences of people accessing MAT support services and to support continuous quality improvement based on real-life feedback.

All ADPs reported having formal mechanisms in place to gather feedback from people with lived and/or living experience who use ADP-funded services. All ADPs also reported at least one mechanism through which people with lived and living experience are able to participate in ADP decision making, with the most common mechanism being through an ADP group, panel or reference group. [24/25 ADP Survey] All ADPs reported at least one way in which family members can participate in ADP decision-making, most commonly through a group or network independent of the ADP. [24/25 ADP Survey]

We continued to support initiatives to facilitate engagement with people with lived and living experience through local and national structures. This includes the Scottish Drugs Forum’s (SDF’s) Living Experience project which has established 12 local engagement groups that provide safe spaces for people with living experience to share their views, build confidence, and influence service design and policy, utilising the Charter of Rights to apply human rights-based approaches such as the FAIR model.

Alongside this, Scottish Recovery Consortium (SRC) led on recovery-focused work across community and custodial settings combining grassroots engagement (including peer support and outreach) with strategic activity to influence policy, strengthen partnerships, and embed lived experience in decision-making. This work supported recovery communities, peer networks, and engagement with ADPs, as well as participation in national policy forums. National events such as the Recovery Walk Scotland played a key role in building connection, reducing stigma, and promoting recovery. Family-focused programmes such as SFAD’s ‘My Family My Rights’ course further supported rights awareness and advocacy, while service providers increasingly focussed on embedding human rights-based approaches to improve the availability, accessibility, acceptability and quality of support.

NHS Greater Glasgow and Clyde Stigma Action Group, in collaboration with SDF and SFAD, produced a guidance tool for talking about drugs and tackling stigma: Tackling Drug Stigma is Everyone’s Business. The document seeks to explain the impact drug stigma has on health and provide practical tools, suggestions and strategies to tackle stigma.

In addition, Digital Lifelines Scotland expanded access to digital technology for people affected by drug harms, supporting almost 5,900 individuals by February 2026. The programme has provided nearly 3,300 devices and 4,000 connectivity packages, alongside tailored support to help people access recovery services, housing, benefits, education and employment opportunities. By reducing digital exclusion, DLS supports a human rights-based approach by helping people access services, realise their rights and participate more fully in their communities.

The new Alcohol and Drugs Strategic Plan is underpinned by a human rights-based approach, as set out in the Charter. The Charter is also embedded within the Partnership Delivery Framework for ADPs and the National Specification and is being reflected in relevant grant processes and procurement frameworks for future funding programmes.

Case Study

West Lothian ADP held a Charter of Rights workshop in February 2026 in collaboration with SRC which brought together 52 participants, including staff, people with lived and living experience, and family members. The session aimed to build understanding of human rights and support participants to apply this knowledge in practice through interactive, group-based learning.

Participants took part in structured tabletop exercises, culminating in applying the FAIR (Facts, Analysis, Identify, Review) model to real-life priorities. Six groups focused on key issues from an advocacy case study: stigma (three groups), access to general practice (two groups), and mental health and pathway access (one group). Outputs from this work will inform future planning through integration into partnership FAIR templates.

At the outset, most participants reported limited awareness of human rights-based approaches, alongside a high level of experience of unmet rights. By the end of the day, the majority reported significantly improved knowledge of the Charter of Rights and greater confidence in applying human rights-based approaches in practice. Participants highlighted increased confidence to advocate for rights, use structured tools like FAIR, and better understand responsibilities in service delivery.

The ADP is also monitoring awareness of the Charter of Rights through their ADP survey for people accessing support.

2.2.2 Surveillance and data informed

Rapid Action Drug Alerts and Response (RADAR)

The PHS Rapid Action Drug Alerts and Response (RADAR) system remains the primary source of information on drug harms and substance use trends in Scotland. Through its quarterly reports, RADAR provides Scottish Government, third sector organisations, service providers and people who use services with information on substances in circulation, service activity and toxicology findings.

During the reporting period, RADAR identified and reported on changes in the drug supply, publishing two new alerts on novel benzodiazepines and medetomidine, alongside an update to its existing alert on nitazenes.

Funding has also been provided for the Surveillance Study of Illicit Substance Toxicity (ASSIST), which has established a robust toxicology surveillance system within the emergency department at Queen Elizabeth University Hospital, Glasgow. Findings from ASSIST contribute to RADAR reporting and have been important in informing services, frontline staff, drug support organisations and people who use drugs about emerging trends in the drug supply.

Information from ASSIST, PHS and RADAR plays an important role in efforts to reduce drug-related deaths and harms, while highlighting the increasing toxicity of the drug supply. It has also supported responses to clusters of fatal and near-fatal overdoses across Scotland, with RADAR providing intelligence that has assisted local areas in their response.

Prevalence of opioid dependence

Updated estimates of the prevalence of opioid dependence in Scotland were published in March 2026. In 2023/24, the estimated number of people with opioid dependence in Scotland was 43,400 (95% credible interval: 42,000 to 45,400). This represents an estimated prevalence of 1.13% of 15-to-69-year-olds (95% credible interval: 1.09% to 1.18%). Prevalence of opioid dependence was higher among males and among people aged 35-to-49 years. Between 2014/15 and 2023/24, there was evidence of a small reduction in the estimated number of people with opioid dependence. Plans to develop these statistics include exploring the potential for generating estimates for populations using other types of drugs.

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 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 to inform national policy and practice. PHS publish reports on drug and alcohol treatment services across Scotland using data captured by this system. This includes the quarterly national drug and alcohol treatment waiting times statistics and Overview of Initial Assessments for Specialist Drug and Alcohol Treatment. This has helped the monitoring of performance against 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 that supports their recovery.

PHS and the Scottish Government continued to implement the findings and recommendations of the DAISy review, with a particular focus on improving data quality and completeness, strengthening governance arrangements, enhancing the recording of treatment outcomes, and increasing the value of DAISy for service planning and performance improvement. Activities undertaken during the year included ongoing engagement with ADPs and service providers to improve the consistency and completeness of data submissions, the provision of guidance and support to local services, continued development of reporting products and analytical outputs, and the introduction of additional treatment outcome information within national reporting.

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 forms part of the expectations set out in the revised Partnership Delivery Framework for local accountable entities to report to the Scottish Government on their monitoring and prudent use of public funds, and on progress towards national outcomes.

The 2024/25 ADP survey was published in March 2026, 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.

2.2.3 Resilient and skilled workforce

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

In 2025/26, we continued our collaboration with a Workforce Expert Delivery Group (WEDG) subgroup to deliver remaining activity under the Scottish Government’s Drugs and alcohol workforce action plan. This included publication of a range of supporting documentation designed to provide the workforce with support to current challenges, without any additional reporting requirements:

• The Knowledge and Skills Framework (June 2025) to support consistent delivery of high-quality, compassionate and rights-based services across Scotland. It 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. This is supported by the Learning Directory, published in January 2025, which provides learning opportunities for those working with people affected by substance use. These learning opportunities are mapped against the five themes of the Knowledge and Skills Framework.
• ‘Guiding Principles’ (June 2025) for employers, which set out best practice on how employees with lived and living experience should be supported within the workplace.
• ‘Pathways to Employment: Your Guide to a Career in Substance Use Services’ and ‘Pathways to Employment: Supporting people with lived and living experience of substance use in to work’ (June 2025) which were developed to provide support to both employers and employees at every step of the employment journey.

To encourage wide use of these materials we put into action a targeted and multichannel communications plan. This included information sessions with various stakeholder groups, and materials such as videos and leaflets for dissemination throughout services and employment support providers, enabling individuals to engage in a way that best meets their needs.

In 2025/26, we provided funding to the Scottish Drugs Forum to deliver the National Traineeship and for the Royal College of General Practitioners to deliver the Certificate in Management of Problem Drug Use.

We also continued to provide funding for the Humanising Healthcare Conversation Café project which provides medical students with insights into substance dependence and recovery from the perspective of people with lived and living experience.

The Conversation Café model was adapted to fit into medical school curricula, with the intention of enhancing experiential learning. In the academic year 2025/26, more than 600 students completed feedback surveys, with the vast majority of these reporting that the conversation cafes were beneficial to their medical training.

2.2.4 Psychologically informed

The Drugs and Alcohol Workforce Knowledge and Skills Framework identifies tackling stigma as one of its five core themes, alongside family-inclusive care, harm reduction, human rights-based approaches, and trauma-informed care.

Addressing experiences of stigma and blame is recognised as a key opportunity to support emotional wellbeing, with staff highlighting the value of more affirming, trauma-informed workplace cultures.

Investment in training, tools and resources throughout 2025/26 supported workforce capability across the system, helping to ensure the delivery of high-quality, person-centred, trauma-informed and rights-based care. This included dedicated funding to Public Services Delivery Scotland (formerly NHS Education for Scotland) to deliver trauma-informed training for the substance use and mental health workforce as part of the implementation of Medication Assisted Treatment (MAT) Standard 10.

This funding enabled the delivery of specialist training, reflective practice, building frontline services to deliver compassionate, consistent, trauma-informed care.