National Mission on Drugs: annual report 2025 to 2026

4. Outcome 2: Risk is reduced for people who take harmful drugs

4.1 Overview

People have a right to support that reduces the harms associated with drug use regardless of where they are on their recovery journey. This includes promoting safer drug consumption practices, preventing overdoses, and reducing the risks and harms associated with drug use.

4.2 Progress in 2025-26

4.2.1 National Naloxone Programme

Progress continued in 2025/26, aimed at expanding both the scale and accessibility of naloxone across Scotland. At the end of 2025/26, the ‘reach’ of the National Naloxone programme (percentage of people at risk of opioid overdose who have been supplied with take home naloxone) was estimated to be 89.9%.

Amendments to the Human Medicines Regulations 2012 established new distinct routes of supply, strengthening the legal and delivery framework:

We have continued to work throughout 2025/26 with partners to establish a new registration service, to replace the current one held by Scottish Government, for any service or professional wishing to distribute naloxone not currently included within the legislation.

We also helped inform the UK Government consultation on expanding access to naloxone, which ran from December 2025 to March 2026. This included questions on the introduction of public naloxone boxes (naloxboxes) in community settings, similar to defibrillators, to support rapid bystander response in emergencies.

We provided £251,548 in funding to support the continued operation of the naloxone click and deliver service, made possible following the 2020 amendment to prosecution guidelines, allowing a wider range of organisations to distribute kits. An additional £37,000 was invested to enhance naloxone storage capacity and capability, supporting wider distribution and access across Scotland.

We have also expanded community access routes for naloxone, including sustained delivery through community pharmacies, alongside continuing to seek new ways of distributing and supplying naloxone.

Operationally, naloxone carriage is now fully embedded across frontline policing through Police Scotland. Following national roll-out completion, officers continue to administer naloxone as part of routine emergency responses, reinforcing its role as a standard first aid intervention in overdose situations.

The ongoing provision of naloxone remains a priority for Scottish Government, as set out in the new Strategic Plan and we will continue working to deliver the new commitments set out in that plan in the coming year, with a particular focus on the importance of naloxone carriage by those who have kits.

4.2.2 Safer Drug Consumption Facilities

Since the opening of the Thistle Safer Drug Consumption Facility in January 2025, the available evidence shows that the service continues to reach and encourage interactions with the people it was designed to support.

Data up to the end of March 2026 (The Thistle data) showed that the Thistle had been accessed 15,158 times, supported 10,498 supervised injecting episodes, and safely managed 137 medical emergencies, most of which were resolved on site without escalation. Service use has increased throughout 2025/26, demonstrating growing awareness, trust and uptake among people at highest risk of drug-related harm.

The Thistle has also attracted significant national and international interest from people seeking to understand Scotland’s approach to harm reduction and the practical implementation of safer consumption facilities within a wider treatment system.

A comprehensive, independent evaluation programme is now underway to assess the health, social, community and system level impacts of the pilot. Findings from this work will inform decisions on the future operation of the Glasgow facility, including considerations of sustainability, potential service enhancement and the applicability of the model in other settings.

While outside of the reporting period, progress has also been made elsewhere in Scotland. City of Edinburgh Council and partners began a public consultation on a potential Safer Drug Consumption Facility in the capital (April – July 2026), with potential locations identified. Engagement work is underway to assess feasibility, service design and potential community impact.

These developments build on work undertaken throughout the course of the National Mission to consider how, in line with the commitments set out in the new Strategic Plan, we can work with partners who would be interested in establishing further SDCFs, to develop a proposal which could be considered by the Lord Advocate.

4.2.3 Drug Checking

Progress was made in 2025/26, with three local drug checking sites - Glasgow, Aberdeen and Dundee – having been issued the appropriate licenses from the Home Office to allow them to proceed. We have provided support to partners to progress these services throughout the reporting period and expect further progress in 2026/27.

Complementing these local sites, an agreement was also put in place with the University of Dundee for them to host the National Testing and Research Laboratory. This will provide more complete analysis of samples from the local sites and supply vital information on drugs in circulation to the national early warning system. Looking ahead, we will continue working with the University to get the laboratory established as soon as possible, with drug checking recognised as a commitment in the new Strategic Plan

4.2.4 Other Harm Reduction Work

While 2025/26 has seen progress in the areas outlined above, challenges remain in other areas of harm reduction due to the legal framework set out in the Misuse of Drugs Act 1971 (MDA). Over the course of the National Mission, we have been in receipt of evidence that the provision of safer inhalation pipes (SIPs) meaningfully reduces harm and encourages engagement. We have continued to share the latest evidence on the benefit of SIPs with the UK Government and have highlighted concerns regarding the current legislative constraints of the MDA which restricts their provision. This has included a presentation on the need for such equipment and the evidence of the harm reducing benefits they can bring, at a Four Nations ministerial meeting in September 2025. This was followed by written agreement from Scottish Government, Welsh Government and Northern Ireland Executive ministers that they would all be supportive of a change to the Misuse of Drugs Act to allow for SIP provision.

The Advisory Council on the Misuse of Drugs (ACMD), an independent expert advisory body to the UK Government, also established a working group to undertake a review of the evidence on this matter and will make recommendations to the UK government in due course. Some of these recommendations may have relevance to devolved administrations as well, where matters fall within devolved competence. Scottish Government officials will support the ACMD in this work and continue to explore possible options available to make provision possible in Scotland.