Preventing Harm, Promoting Recovery: Scotland's Alcohol & Drugs Strategic Plan 2026 – 2035

Prevention & Early Intervention

Outcome: Fewer people develop problem alcohol and drug use.

Prevention is one of the most effective approaches to improve population health, reduce inequalities and ease pressure on acute services.^[56]

Many health harms - and particularly those caused by alcohol and drugs - fall disproportionately on more deprived communities.^[57] Significant work is underway across national and local governments to address the structural drivers of poor health through tackling poverty, optimising early child development and reducing inequality (related policies can be found in Annex C). The Population Health Framework sets out how we, along with key partners, will tackle the overarching environmental factors and fundamental drivers of poor health in Scotland, through a long-term preventative approach.

Our approach to prevention and early intervention in relation to alcohol and drugs broadly falls into the models used by the Advisory Council on the Misuse of Drugs Act^[58] and the WHO.^[59] These include universal measures which are designed to reach whole populations, targeted (or selective) interventions which focus on at risk communities and measures aimed at intervening early for those at risk (indicative).

Our key priorities for prevention and early intervention include:

• Targeting the affordability, attractiveness and availability of alcohol
• Supporting the healthy development of children and young people
• Targeted support for at risk communities
• Early intervention for at risk individuals

Targeting the affordability, attractiveness and availability of alcohol

The WHO identifies three key levers for national governments in reducing alcohol-related harm – targeting the attractiveness, affordability and availability of alcohol.^[60] Scotland remains committed to this evidence-based approach, building on the success of our world-leading Minimum Unit Pricing (MUP) for alcohol policy. Research commended by experts has estimated that MUP policy has saved hundreds of lives and is likely to have averted hundreds of alcohol-attributable hospital admissions.^[61] Alcohol consumption remains a significant cause of preventable ill health, including the long-term effects on people who drink at hazardous and harmful levels.^[62] Building on work to date, we will take forward whole population preventative action on alcohol harm, drawing on the WHO’s framework. This includes next steps on alcohol marketing restrictions, working as part of the four nations to consider calorie and health warnings on alcohol product labels, and increasing awareness of the links between alcohol consumption and cancer.

Commitment: We will continue to reduce population level alcohol harms through:

• Implementing an alcohol harm prevention action plan to be published later in 2026, which will target the attractiveness, affordability and availability of alcohol – with appropriate engagement undertaken with stakeholders, including in clinical and public health sectors and in business and industry, on the impact and effect of potential actions.

Supporting healthy development of children and young people

Universal measures that support children, young people and families to live well are crucial to building strong foundations for healthy development and reducing the prevalence of substance use.

Children’s services planning is key to ensuring effective implementation of Getting it Right for Every Child (GIRFEC). GIRFEC is Scotland’s national approach to ensure all children, young people and their families receive the right support at the right time so every child can reach their full potential.

Efforts must begin in pregnancy and continue through the years of child development as early experiences play a major role in shaping later outcomes.^[63] Health visitors, midwives, family nurses, early learning practitioners and school staff play key roles in ensuring harms related to alcohol and drugs in care givers are spotted as early as possible (including before conception and before birth) and support is provided to protect children from harm.^[64]

Alongside these wider primary prevention efforts, to prevent harms before they start, children and young people must be supported to make safe and informed decisions about alcohol and drugs – spanning formal education, wider youth work settings, as well as online environments.

PHS’s 2025 Consensus Approach on Prevention of Substance Use Harm Among Children will be used to inform national and local planning in line with the Population Health Framework, utilising a whole system approach to prevention.

Scotland has piloted the Planet Youth model in several areas, which aims to reduce youth substance use and improve wellbeing. There are early signs that the pilot has improved community coordination, increased parental engagement, and created more prevention activities for young people.^[65] Originating in Iceland, the model demonstrates the importance of a community-driven approach.^[66] It involves regular youth surveys, locally tailored action plans developed and implemented by coalitions of community stakeholders, and investment in protective factors like family engagement, structured leisure, and school connectedness.

A Public Health Approach to Learning is crucial and we are working with partners across Education Scotland, PHS and Police Scotland to improve health, education and social outcomes for Scotland’s children and young people. Education Scotland is leading on the development and delivery of the new Curriculum Improvement Cycle. We will ensure that learning around alcohol and drugs is age and stage appropriate, and that local authorities are supported to embed prevention across learning materials. It is important that materials are evidence informed and regularly updated to reflect emerging trends. As part of the wider approach to relationships and behaviour policy in schools, national guidance will support education authorities in updating local policies for responding to substance use in school settings.

Commitment: We will continue to support the healthy development of children and young people through:

• Embedding appropriate support and advice on the risks of alcohol and drug use during pregnancy across preconception care, maternity services and early childhood services such as health visiting and the Family Nurse Partnership.
• Supporting community-based prevention activities through effective collaboration between ADPs, Community Planning Partnerships and local partners.
• Supporting the development of age and stage appropriate alcohol and drug education and prevention resources – as part of the wider curriculum review.
• Supporting the implementation of national guidance to aid education authorities to update local policies for responding to substance use in school settings.

Targeted support for at risk communities

Some communities face heightened risks of developing substance use issues.^[67] These risks may be driven by factors such as poverty, trauma, intergenerational substance use, unstable housing, disrupted education, and violence including gender-based violence. Individuals with four or more adverse childhood experiences are significantly more likely to engage in harmful alcohol and drug use.^[68]

We are committed to addressing root causes through a range of targeted policies as outlined in Annex C. Our Whole Family Support approach aims to drive system change so that families in Scotland’s highest need communities can access timely and consistent support, helping to support early child development, reduce child poverty and improve wellbeing. Providing early support and preventing harms is central to achieving the Scottish Government’s commitment to Keep the Promise.

Our targeted prevention approach includes supporting programmes that work with young people affected by substance use in their families, using codesigned and trauma-informed methods to help break intergenerational cycles of harm. We have also supported initiatives that equip families with evidence-based tools to support loved ones experiencing substance use challenges, while strengthening their own wellbeing and resilience. Our Families Affected by Alcohol and Drug Use Framework sets out the national model for family inclusive practice and a whole family approach for families affected by alcohol and drugs. It provides a framework for consistent, sustained support for families and is designed to guide ongoing improvements in the way family support is delivered across Scotland.

Commitment: We will continue to pursue targeted prevention measures through:

• Supporting targeted initiatives for communities at higher risk of developing substance use issues.
• Supporting local areas to embed a whole family approach and family-inclusive practice, in line with the ‘Families Affected by Drug and Alcohol Use in Scotland Framework’.

Early intervention for at risk individuals

Evidence shows that substance use can become problematic at various stages across the life course.^[69] While pregnancy, early years and adolescence offer critical windows of opportunity, initiatives need to be available for all age groups.

Certain life transitions and experiences can heighten vulnerability to substance use. Entering adulthood, unemployment, relationship breakdown, bereavement, retirement, and declining health are all associated with increased risk of developing substance use issues.^{[70] [71]} Targeting early intervention activity around these critical life stages and ensuring awareness of these risks across wider services will help to ensure support remains effective.

The Standards for Young People Accessing Treatment or Support for Alcohol or Drugs published in 2025 recognise the need for tailored, age-appropriate interventions and aim to give every young person access to reliable, high-quality treatment and support as soon as they begin to face challenges, and before they reach a point of crisis.

Alcohol Brief Interventions (ABIs) are widely used by health professionals, including maternity services, to raise awareness of risk as part of short, structured conversations with individuals that can screen for early intervention or referral for specialist assessment.^[72] In many cases, these conversations are the first step toward accessing specialist support. The 2024 review of ABIs by PHS and the publication of the UK-wide will help to inform improvements to the ABI programme.

Commitment: We will continue to support early intervention measures through:

• Supporting services to implement the Standards for Young People Accessing Treatment or Support for Alcohol or Drugs.
• Raising awareness of and targeting support around high risk life-course events.
• Learning from the recommendations of the 2024 ABI review by PHS and implementing these where appropriate, including by expanding ABIs into a wider range of settings and developing tools to support conversations.

Case Study: Supporting Families - Grow Your Own Routes

The Scottish Government’s Whole Family Wellbeing Funding Programme has supported Scottish Families Affected by Alcohol and Drugs to develop and pilot the ‘Grow Your Own Routes’ initiative. Through this work, Scottish Families Affected by Alcohol and Drugs has partnered with organisations across six areas* to deliver their evidence-based youth work programme, ‘Routes’, which supports young people aged 12–26 affected by familial substance use. The programme aims to break intergenerational cycles of substance use issues.

Through the programme, young people have been supported to achieve practical goals such as applying for jobs and further education, while also being encouraged to express emotions, explore creativity, and take on new challenges. Young people play an active role in shaping the programme - co-producing activities, designing services, and contributing to staff training by sharing their lived experiences and insights into the impact of substance use.

This work contributes to our commitment to Keep the Promise, ensuring that young people affected by familial substance use have access to one-to-one and group support, and meaningful activities and events.

*Delivery partners and supported areas include: Aberlour (Falkirk); Action for Children (Renfrewshire); Alcohol and Drugs Action (North Aberdeenshire); Barnardo’s (North Lanarkshire); Circle (East Lothian) and Right There (Orkney).