Alcohol and drugs services: national specification

Summary

The aim of the new long-term Alcohol & Drugs Strategic Plan, ‘Preventing Harm, Promoting Recovery’, is to prevent harm from alcohol and drugs, promote recovery and save lives. The alcohol and drug treatment and recovery system is a critical part of the support available to people. The National Specification for Alcohol and Drugs Services describes the minimum service components that must be available within local systems in Scotland for individuals and families affected by alcohol and drug use.

The services described in this specification:

• Give practical effect to the Charter of Rights for People Affected by Substance Use
• Support delivery of Scotland’s Alcohol and Drugs Strategic Plan
• Contribute to Scotland’s wider population health ambitions
• Form part of the provision that will be assessed under national treatment and recovery standards,

The specification proposes that, regardless of where someone lives in Scotland, the core components of an alcohol and drug treatment and recovery system are in place and accessible. It is designed to provide strategic guidance on what services must exist. It does not prescribe detailed service standards, operational requirements, regulatory expectations, or performance measures. These elements will be developed in collaboration with stakeholders through forthcoming national standards, guidance, and review of regulatory frameworks. The specification will support the development of these wider elements of service improvement and will be kept under review.

Core Service Components

Local systems must ensure provision across the following areas:

1. Prevention and Early Intervention

• Information and advice
• Screening and assessment
• Brief interventions
• Early detection of alcohol-related harm
• Clear signposting and referral pathways

2. Harm Reduction

• Risk assessment and triage
• Advice and equipment to reduce harm (including naloxone)
• Drug checking and safer consumption services where available
• Assertive outreach
• Clear pathways from harm reduction into treatment

3. Treatment and Care

• Comprehensive assessment and care planning
• Psychological and psychosocial interventions
• Pharmacological interventions, including Medication Assisted Treatment
• Detoxification options (inpatient, community, and home where appropriate)
• Residential rehabilitation and structured day programmes
• Crisis care and inpatient provision
• Support for co-occurring mental health conditions
• Aftercare and relapse prevention

4. Wider Communities of Care

• Family support pathways
• Peer support and recovery communities
• Independent advocacy
• Community and social support

5. Working in Partnership

• Housing and homelessness support
• Criminal justice pathways
• Employment and skills support
• Benefits and income maximisation
• Primary care and wider health services
• Delivery of Mental Health and Substance Use Protocol
• Support for other dependencies

What is the National Specification for Alcohol and Drugs

This service specification defines the minimum service components that local systems are expected to make available to individuals and families affected by alcohol and drug use in Scotland.

This specification defines what services and pathways must exist within local systems. It does not set out performance thresholds, governance structures, delivery mechanisms, or quality requirements. Those matters are addressed through the Partnership Delivery Framework, National Standards, Quality Principles, and associated guidance.

The services listed are evidence-based components of the alcohol and drug treatment and recovery system that must be accessible in order to keep people safe, improve their physical and mental health and wellbeing and support recovery. These service components give practical effect to the rights set out in the Charter of Rights for People Affected by Substance Use and contribute to Scotland’s wider population health ambitions.

Some of the earliest stages in a treatment journey are provided by practitioners in non-specialist settings where the main focus is not alcohol and drug treatment. Local systems must ensure clear pathways between non-specialist and specialist provision.

More advanced stages on a treatment journey are typically delivered in specialised alcohol and drug treatment services with their own premises in the community or in hospital settings. Other delivery may be undertaken by outreach (including work in generic services or other agencies or domiciliary or home visits.) Some of this work takes place in primary care settings, as well as in pharmacies, but alcohol and drug-specialist-led services are required within local systems for the provision of care for severe or complex needs and to support primary care.

Alcohol and drug-treatment interventions may also be delivered in prison settings, and community criminal-justice programmes can be delivered in contracted community drug-treatment services. Continuity of care between custodial and community settings must be supported through defined pathways.

In-patient services are typically provided within specialist dedicated inpatient or residential units or wards. Services may be delivered in general psychiatric wards for patients with co-morbid severe and enduring mental illness, but many such patients will benefit from a dedicated substance use specialist inpatient unit. Those with complex alcohol and drug, and other needs requiring inpatient interventions may require hospitalisation for their other needs (for pregnancy, liver problems, and HIV-related problems, for example).

Continuity of care is essential for preserving gains achieved in residential treatments.

Local systems must ensure that inpatient detoxification, residential rehabilitation, and community aftercare are connected through seamless transition arrangements.

This specification does not outline who is responsible for delivering any of the services outlined. Accountability, governance, and assurance arrangements are set out in the Partnership Delivery Framework.

The National Specification is to be used within the current health and social care framework for the planning, commissioning, and delivery of services for people affected by alcohol and drugs. Local systems must be able to demonstrate, through planning and commissioning arrangements, that the service components outlined in this specification are provided for their population.

National Standards, monitoring, and evaluation

The provision of the services in this specification will be subject to treatment and recovery standards, As part of our commitments laid out in Preventing Harm, Promoting Recovery: Scotland’s Alcohol & Drugs Strategic Plan 2026 – 2035, Scottish Government will develop standards of support for all drugs and alcohol treatment, with publication scheduled for 2027/28.

The following elements describe how future standards may assess implementation; they do not alter the service components defined below:

• Inclusion of these treatment and initiatives in ADP and HSCP strategic plans, delivery plans and local commissioning plans which ensure people are assessed within agreed waiting times and have quick access to the type of treatment that would be of most benefit to them.
• Coordinated packages of treatment and care identify support needs to improve personal safety, health, and wellbeing. This includes support for people who have co-occurring conditions and those receiving criminal justice or safeguarding interventions, for example case management of people subject to alcohol and drug support court orders.
• Treatment services offer high quality information and advice and appropriate support to people directly affected by another person’s problem drug or alcohol use. Relatives are actively engaged in the treatment of a family member if appropriate.

While not established in statute, the services outlined in this specification represent the minimum service components that local systems are expected to make available and will form part of the provision assessed under the national standards.