³ÉÈË¿ìÊÖ

At present, we have no plans to establish and evaluate tests of change for alcohol treatment in the justice system.

The Scottish Prison Service is currently refreshing its Alcohol and Drug Recovery Strategy, this will ensure alcohol intervention and support are included in any recovery pathway planning across our establishments. It is anticipated that the strategy will be published later this year.

We are also supporting the UK Government on reviewing and updating clinical guidelines for alcohol treatment. The guidance will look to introduce new approaches to treatment and will apply to a broad range of settings including justice settings. The guidelines are expected to be published for consultation this year.

Following finalisation of the alcohol treatment guidelines, Scottish Government will review and use these to ensure that our justice systems are providing consistent and good care to those with problematic alcohol use.

Alcohol remains a priority for Scottish Government and we are treating our policies to reduce alcohol and drug deaths as twin public health emergencies in Scotland.

This is why we established a National Mission to improve and save lives, at the core of which is ensuring that every individual has access to, and choice in the type of recovery and treatment they need.

We are working to ensure people with alcohol use disorder receive the care and support in the same way that people can access for problematic use of drugs. The forthcoming Alcohol Treatment Guidelines will help ensure support for alcohol treatment, in a similar way to how the Medication-Assisted Treatment Standards ensure this for people impacted by opiates.

Following publication of the UK-wide guidelines it is our intention to draft a paper on specific alcohol treatment standards for Scotland.

Through our National Mission we are investing in residential rehabilitation that will benefit people experiencing alcohol and/or drug addiction.

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

Quality improvement methodology is being embedded across Scotland through the implementation of the Medication Assisted Treatment (MAT) standards.

The MAT Standards Implementation Support Team (MIST), based within Public Health Scotland, was set up to support local areas to build improvement-based capacity and capability so that they will be able to implement and sustain the MAT standards locally.

MIST helps local areas with quality improvement work which has focused on establishing that local areas have written procedures in place, have numerical information and data available and have a means in place to gather experiential data. All of which are required to help drive improvement.

Healthcare Improvement Scotland (HIS) is also supporting local areas and works closely with MIST in providing practical quality improvement assistance and advice to local areas.

HIS will shortly begin delivery of its full quality improvement assistance to local areas to build on the first phase of quality improvement work MIST has undertaken. HIS also provides close links between its other relevant workstreams on residential rehabilitation, prison healthcare and mental health and addictions services.

No One Left Behind is the Scottish Government’s approach to transforming employment support in Scotland. This strategy is tailored and responsive to the needs of people of all ages and backgrounds who want help and support on their journey towards and into work - particularly people with health conditions, people with disabilities and others who are disadvantaged in the labour market, including those with lived and living experience of alcohol and drug use.

In January of this year, the Scottish Government published our to the Drug Deaths Taskforce, ‘Changing Lives’ final report. This response set out our commitment to progress Cross Government work to provide employment support through the No One Left Behind strategy.

Scottish Government’s forthcoming Drugs and Alcohol Workforce Action Plan will provide further information on work underway to support people with lived and living experience of drugs and alcohol use towards, and into work, including roles within the drugs and alcohol sector.

The launch of our National Mission in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the action plan milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

We recognise the damaging impact alcohol misuse can have and we are working to ensure that people with problematic alcohol use can access treatment that is suitable for them at the time they need it.

On 7 September 2023 the Minister for Drugs and Alcohol supported a Member’s Debate Motion calling for investment in alcohol services - outlining the Government’s plan to reduce harm from alcohol misuse. The plan includes measures to improve access to treatment and support, including through stabilisation and crisis management, expansion in local assertive outreach services and increasing the availability of residential rehabilitation placements. The plan also includes working with partners and stakeholders to implement alcohol treatment standards – building on the forthcoming UK-wide Clinical Alcohol Treatment Guidelines.

Rights, Respect and Recovery sets a clear expectation that all people accessing services with a substance use condition should receive holistic, person-centred care. MAT standard 9 builds upon this, stating that ‘all people with co-occurring drug use and mental health difficulties can receive mental health care at the point of MAT delivery.’ The government is taking forward a number of measures to ensure that people with co-occurring mental health and substance use conditions receive this joined-up care.

We have funded Healthcare Improvement Scotland to test new models of care in five health boards – Tayside, Grampian, Lanarkshire, Greater Glasgow & Clyde, and Lothian.

The government also published a rapid review into mental health and substance use services in November 2022. This included a literature review, a survey of practitioners in substance use services, and a set of recommendations.

Finally, the government has recently commissioned Healthcare Improvement Scotland to produce an exemplar protocol which will set out how mental health and substance use services should work together. This will build on existing best practice and support local areas to implement the recommendations from the rapid review and the criteria of the MAT standards.

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

Assertive outreach is being delivered though the guidance for Medication Assisted Treatment (MAT) standard 3. The aim of MAT standard 3 is to proactively identify people, including through assertive outreach, who are at high risk, and to prevent harms by rapidly providing that individual with appropriate support.

In practice, implementation of MAT standard 3 extends to all substance misuse problems. A significant proportion of support offered to people identified through outreach is for problem alcohol use. Alcohol-specific outreach guidance will feature in wider standards for alcohol and drug treatment following the publication of UK-wide alcohol treatment guidelines.

The launch of our National Mission on Drugs in January 2021 has meant that some of the commitments set out in the Rights, Respect, Recovery Strategy and the action plan for it, refreshed in December 2020, are being delivered in a different way. Many of the milestones are being delivered through the National Mission and others are being picked up as part of more recent Government commitments.

The Medication Assisted Treatment standards published on 31 May 2021 and are a set of standards aimed at providing a framework to ensure that MAT is sufficiently safe, effective, acceptable, accessible and person-centred to enable people to benefit from treatment for as long as they need it.

The standards are evidence based and were developed through extensive consultation with multiagency partners that deliver care, and, with the individuals, families and communities with experience of problematic drug use.

The Scottish Government has committed to full and sustained implementation of MAT standards 1-10 in community and justice settings by April 2026. To help local areas achieve this, the MAT Implementation Support Team (MIST), based within Public Health Scotland (PHS) is supporting the roll out of the standards ensuring local areas have systems, protocols and procedures in place to be able to continuously improve services based on evidence.

In order to demonstrate implementation of the MAT standards, local areas provide process, numerical and experiential evidence to MIST which helps to inform an annual National Benchmarking Report, published by PHS. Process evidence includes formularies, clinical guidelines, care pathways, standard operating procedures, policies and other supporting documentation.

The National Benchmarking Report for 2022/2023, published in July 2023 reported that the 29 ADP areas assessed against each of the 10 MAT standards, 66% (96/145) of MAT standards 1–5 were fully implemented and 88% (127/145) of MAT standard 6–10 were partially implemented.

Yes, on 8 November 2021 the Scottish Government published A Review of the Existing Literature and Evidence on Young People Experiencing Harms from Alcohol and Drugs in Scotland.

The review can be found here:

In 2021, the Scottish Government formed a working group to develop Action 4 from the Rights, Respect and Recovery Action Plan. The aim of the working group is to ensure that good quality early intervention support services are available across Scotland for young people with emerging problematic drug and alcohol use.

The first phase of this work involved the working group gathering data from a range of sources to understand the size of the problem of younger people using drugs and alcohol as well as risk factors.

In 2022, we commissioned We Are With You to engage with young people in order to learn from their experiences of drug and alcohol use. This engagement has helped the working group to understand young people’s preferences for seeking help and the perceived barriers they face and this insight will aid the development of support for young people at risk from drugs/alcohol harms.

In Spring 2023, the working group began engaging with young people, using a co-design approach, to gather their views of good support. These findings, along with existing international evidence of good practice will be used by the working group to develop standards of support for children and young people.

The working group will outline the minimum principles of support that is required to meet the needs of children and young people and provide early intervention support in a way they want.