Agree on a long-term plan beyond the National Mission
Scotland needs a national drug and alcohol outcomes framework that’s built around what matters to people, with consistent measurement, transparent reporting, and accountability. 1 2 3 4 5 6
Drug and alcohol harm won't be solved in a single parliament. A multi-decade, cross-party strategy must tackle health inequalities and invest in prevention, early intervention, and workforce development, with career pathways for people with lived experience embedded at every level.
Put people first by embedding rights & tackling stigma
The next government must introduce the Scottish Human Rights Bill, meaningfully involve people with lived experience in shaping policy and services, and fund a national programme that tackles stigma.
Expand harm reduction to save more lives
Scotland must use all available legal powers to expand naloxone access, extend safer consumption facilities, enable drug checking and safer inhalation kits, and widen access to heroin-assisted treatment.
Ensure services are accessible and consistently available
Everyone should get support when they need it, wherever they live. That means genuine choice between face-to-face and virtual services, rapid response for people in crisis, and clear pathways to residential rehabilitation, all properly funded
Deliver a dedicated alcohol strategy for Scotland
Alcohol needs the same strategic focus as drugs. That means a dedicated strategy covering pricing and availability, alcohol care teams in major hospitals, improved access to in-patient and community detoxification, and sustainable funding.
Establish clear outcomes and accountability across all services
Foreword
Every
day across Scotland, we work alongside people dealing with the impact
of drugs and alcohol.
We see their courage. We see what's possible when the right support is there And we see what happens when it isn't.
There is real progress to build on. Drugrelated deaths fell in 2024 to their lowest level in several years MAT Standards are changing how services respond.
Glasgow's Thistle facility has shown that safer drug consumption can work here. Lives are being saved But progress is fragile. Scotland continues to have one of the highest drug death rates in Europe.
Alcohol deaths still outnumber drug deaths. And where you live still has too much bearing on the support you can access.
Investment in treatment makes both human and economic sense. Evidence from across the UK shows that for every £1 invested in drug treatment, there's a £4 return.
For alcohol treatment, there’s a £3 return, and those figures rise significantly over time. But the real return is in lives saved, families kept together, and communities made stronger.
The National Mission ends weeks before this election What comes next matters enormously.
These are our priorities for the next Scottish Government, shaped by evidence, by the people we support, and by what we see working in our services every day.
Their voices and experiences are central to everything in this document.
Louise Stewart Director for Scotland
About in Scotland
We’re a charity providing free, confidential support for people experiencing challenges with drugs, alcohol and mental health. We’re one of Scotland’s largest third sector providers in this area.
Last year, we worked with 14,000 people in Scotland. People attended more than 63,000 appointments across our services. Our webchat, funded by the Scottish Government, is available seven days a week. WithYou Anywhere, launched in Highland in 2025, is the UK’s first fully commissioned virtual drug and alcohol service.
Our approach is person-centred, trauma-informed and grounded in harm reduction. Lived experience is central to our workforce, governance and service design. We use research and frontline insight to understand what works best for the people we support. Our 2025–30 strategy commits us to innovation, tackling stigma, and ensuring no one is turned away.
Priority 1: Agree on a long-term plan beyond the National Mission
Scotland has some of the most significant health inequalities in Europe Drug deaths are up to 12 times higher in our most deprived communities Alcohol deaths are 4 5 times higher. These aren't random tragedies. They're driven by poverty, trauma, housing and exclusion, root causes no five-year funding cycle can fix
Addressing these inequalities requires generational commitment, not a single parliamentary term. The next government needs a long-term, whole-society approach connecting health, housing, justice, education and employment that lasts beyond any administration.
This can't be done by drug and alcohol services alone. It requires cross-government, cross-sector and cross-party support. Getting this right will save lives and significantly reduce long-term costs to public services.
A gap in strategy or funding after March 2026 would put lives at risk The structures driving improvement, such as MAT Standards and the Charter of Rights, must be embedded, not abandoned.
Prevention and early intervention must be central. So too must investment in a sustainable workforce with genuine career pathways for people with lived experience, ensuring their expertise is valued and embedded at every level.
What we’re asking for:
Publish and fund a long-term successor strategy to the National Mission with protected multi-year funding that rises with inflation, shaped by evidence and lived experience. This must be a multidecade plan with cross-party support
Take a cross-government approach connecting drug and alcohol policy with housing, employment, mental health, justice, education and welfare Invest in prevention and early intervention, including communityled recovery and outreach to people not yet engaged with services. Fund workforce development that ensures services can build sustainable, trauma-informed teams with clear career pathways for people with lived experience, from frontline delivery to strategic leadership.
Priority 2: Put people first by embedding rights and tackling stigma
Rights and lived experience must guide everything the next government does on drugs and alcohol. Around 80% of people experiencing alcohol dependency don't access treatment. That means designing services around people, not systems. It means listening to lived experience and acting on it. And it means confronting stigma that stops people from seeking help.
The Charter of Rights, launched in December 2024, was a landmark step But a charter only has value if it changes what people experience.
Government must ensure rights and accountability are woven into how services are designed, commissioned and delivered, with real influence for people with lived experience.
The proposed Scottish Human Rights Bill would provide the accountability framework needed to put these protections into practice. It must be introduced in the first term.
Stigma isn't just about public attitudes. It exists within systems and organisations, sometimes in ways people don't recognise. Tackling it requires everyone, including service providers, to examine their own culture and practice
What we’re asking for:
Introduce the Scottish Human Rights Bill in the first term, providing the accountability framework the Charter of Rights needs Ensure people with lived and living experience are meaningfully involved from concept to evaluation. Fund a national stigma reduction programme that addresses structural stigma in health, housing, employment and justice, and challenges organisations to examine their practice.
Provide stigma and drug/alcohol awareness training for frontline public sector staff.
Priority 3: Expand harm reduction to save more lives
Keeping people alive must always come first. Scotland's investment in harm reduction likely contributed to 2024's fall in drug deaths. But the drug supply is becoming more dangerous. By September 2025, nitazenes were detected in 14% of drug deaths, the highest level recorded and a sharp increase from 6% at the start of the year. Cocaine is now implicated in 47% of drug deaths. The response needs to be faster and more agile
The Thistle safer consumption facility shows what's possible when the Scottish Government uses available legal powers The Lord Advocate's prosecution policy created space for evidence-based intervention. That same boldness is needed now. We need to use every Scottish legal and policy lever available, without waiting for Westminster to act.
Some barriers do require UK Government action. But the Scottish Government can and must do more with the powers it has, including using legal mechanisms to immediately enable drug checking and the provision of safer inhalation kits
Expand naloxone distribution and training, including in non-traditional settings.
Extend safer consumption facilities beyond Glasgow, based on the Thistle pilot, by establishing a permanent, sustainable legal framework using all available Scottish legal and policy levers.
Use all available Scottish legal mechanisms to immediately enable the provision of drug checking and safer inhalation kits through harm reduction services, rather than waiting for changes to the Misuse of Drugs Act 1971 Widen access to heroin-assisted treatment for people who haven't benefited from other medicationassisted treatment.
Build a faster, more agile system for responding to emerging drug threats, including strengthened near-fatal overdose response.
Work with the UK Government where needed to address legislative barriers that limit harm reduction interventions, while using all available Scottish powers immediately.
Priority
4: Ensure services are accessible and consistently available
Where you live in Scotland shouldn't determine what support you can access. Scotland needs a national framework ensuring consistent standards and quality, with services designed around people, not systems.
That means genuine choice. Virtual services reach people in rural areas or balancing work and caring responsibilities, but only when properly funded with skilled staff and the right technology, not as a cheaper alternative. Residential rehabilitation offers intensive, structured support, but access remains inconsistent and too often lacks proper preparation or aftercare.
It also means help when you need it most. When someone ' s life is at risk, often through escalating substance use, mental health crisis, or loss of housing, they need rapid support. Assertive outreach teams can reach people in crisis, build trust, and connect them to longer-term support.
None of this works without a stable workforce Short-term funding undermines services and makes it harder to recruit and retain skilled people.
What we’re asking for:
Deliver a no “wrong door” approach offering genuine choice between face-to-face and virtual support, recognising that both models require proper investment in staff, technology and quality. Ensure rapid access to assertive outreach for people in crisis, with intensive support available immediately when lives are at risk. Ensure consistent access to residential rehabilitation across Scotland with national pathways that make preparation, placement and aftercare standard practice. Make multi-year funding standard, with transparent commissioning that gives the third sector equal standing.
Priority 5: Deliver a dedicated alcohol strategy for Scotland
Alcohol-specific deaths in Scotland outnumber drug deaths. In 2024, 1185 people died Yet alcohol has consistently received less policy focus, less funding and less urgency. The National Mission was drug-focused. While it addressed an acute crisis, alcohol harms have continued at devastating levels.
What we’re asking for:
Develop a dedicated alcohol strategy with specific actions and ring-fenced resources
Review and update Scotland’s alcohol policy framework, including strengthened regulation of pricing, advertising and availability
Establish alcohol care teams in major hospitals, with clear pathways into community support. Improve access to in-patient and community alcohol detoxification across all areas.
Introduce a sustainable funding mechanism for alcohol services, such as an alcohol retailer levy, so that the industry that profits from alcohol sales contributes to reducing the harm it causes
services
Progress can't be measured by funding or strategy documents alone. It must be measured by what changes in people's lives. Scotland needs a national approach to outcomes, improvement and accountability that applies consistently across services.
Too often, services are measured against process targets rather than outcomes that matter to people.
When things go wrong, there's no consistent route for feedback to lead to change People must be able to see what's working, what isn't, and what's being done about it.
everyone works towards the same goals.
Define outcomes that matter to people, such as stability, safety, housing, relationships, mental health and harm reduction, not just treatment completion statistics. Measure outcomes consistently with transparent reporting so communities, services and government can see what's working and what needs to change. Use feedback and complaints as core improvement tools, ensuring people with lived experience shape services and concerns lead to visible change.
Build continuous improvement into commissioning and funding so services are supported to improve. Ensure accountability at every level to close inequalities in access, quality and outcomes.
