Drug use: treatment for drug use

NHS Boards, councils and voluntary sector organisations provide a range of treatment options for people who experience problems related to drug misuse. In addition, 30 Alcohol & Drug Partnerships (ADPs) across Scotland form the focal point for local action on drug misuse, and receive strong support from the Scottish Government.

Drug and Alcohol Information System (DAISy)

The Drug and Alcohol Information System (DAISy) is a national database developed to collect drug and alcohol referral, waiting times and outcome information from staff delivering specialist drug and alcohol interventions. The objectives of developing a single system were to enhance the quality and completeness of the data available on treatment for problematic drug use and to start the collection of alcohol treatment data, while reducing the amount of data entry required by staff working in ADPs and specialist treatment services.

DAISy gathers key demographic and outcome data on people who engage with drug/alcohol treatment services. It enables a better understanding of the impact of drug/alcohol treatment services at both a local and national level and consequently will facilitate improvements in service planning and delivery. Recording of data on DAISy at the national level began on 1 April 2021. Initial assessments for people seeking treatment for drug use were recorded on the Scottish Drugs Misuse Database (SDMD) prior to this.

The second report providing an Overview of Initial Assessments for Specialist Drug and Alcohol Treatment 2023/24 was published in November 2024, with an accompanying Excel workbook.

Main Points

In 2023/24:

Initial assessments for 16,507 people accessing specialist alcohol and/or drug treatment were recorded on DAISy.

Demographics:

People starting alcohol treatment had a higher median age (47 years) than people starting drug (36) or co-dependency (problematic use of alcohol and drugs) treatment (33).
Almost one third (32%) of people starting treatment for problematic substance use were female (68% were male). The percentage of females was highest for people starting alcohol treatment (37%), followed by drugs (28%) and co-dependency (22%).
Higher percentages of people starting treatment for co-dependency (13%) and drugs (12%) than for alcohol (1%) were in a prison/young offender institution at the time of their assessment.

Alcohol:

The median age for when people deemed that their alcohol use became problematic was 30 years for males and 34 years for females.
89% of people starting alcohol treatment reported drinking in the month prior to their assessment. Spirits (36%) was the most commonly reported main drink type.
61% of people starting alcohol treatment who had consumed alcohol in the month prior to assessment reported drinking on a daily basis.

Drugs:

Cocaine (30%) was the most commonly reported main drug used by people starting specialist drug treatment in Scotland, overtaking heroin (28%) for the first time since drug treatment reporting began.
Of the people who reported using opioids in the previous month, 63% had a take-home naloxone kit (a medication to prevent fatal opioid overdoses) at the time of initial assessment.
10% of people reported injecting in the month prior to assessment, and 17% reported last injecting more than a month before.

Co-dependency:

Spirits was the most common main alcohol type (30%) and cocaine the most common main drug (50%) reported by people starting treatment for co-dependency.
Daily alcohol consumption was lower for the co-dependency cohort (29%) than the alcohol cohort (61%).
35% of people in the co-dependency cohort who reported cocaine as their main drug used it at least once a day. This was lower than for the drug cohort (48%).

Drug and Alcohol Treatment Waiting Times

Between 2011 and 2021, data on waiting times for specialist drug and alcohol treatment were collected in PHS’s Drug and Alcohol Treatment Waiting Times (DATWT) database. In December 2020, waiting times began to be recorded on the Drug and Alcohol Information System (DAISy) for four NHS Boards (NHS Ayrshire & Arran, NHS Dumfries and Galloway, NHS Grampian, and NHS Western Isles). The remaining NHS Boards transferred to DAISy in April 2021. Both DAISy and the DATWT systems measure the duration of the wait from referral to treatment for both drug and alcohol services, taking into account periods of unavailability and non-attendance for appointments. DAISy and DATWT supports delivery of the Scottish Government’s Local Delivery Plan Standard for drug and alcohol treatment which states that 90% of people who need help with their drug or alcohol problem will wait no longer than three weeks for treatment that supports their recovery.

All recent (quarterly) publications can be found in the Drug & Alcohol Publications and dashboard section on the PHS website. The percentage of waits longer than three weeks is also an indicator included in the ScotPHO Drugs Profile, where data is shown at Scotland, NHS Board and ADP level.

For the publication that covers the quarter between 1 July and 30 September 2024 (Quarter 2 2024/25), the main points were:

10,919 referrals were made to community-based specialist drug and alcohol treatment services: 5,493 (50.3%) were for problematic use of alcohol, 3,910 (35.8%) for problematic use of drugs, and 1,516 (13.9%) for co-dependency (use of both alcohol and drugs).
7,454 referrals to community-based services started treatment. Of these, 6,976 (93.6%) involved a wait of three weeks or less. Four NHS Boards did not meet the Standard (Lothian, 89.8%; Western Isles, 89.3%; Shetland, 78.9%; Highland, 72.3%).
Nationally, the Standard was met for referrals to community-based services across all substances: drugs (95.6%), alcohol (92.6%) and co-dependency (92.2%).
1,004 referrals were made to prison-based services. Of these, 816 (81.3%) were for people seeking help for problematic use of drugs.
357 referrals to prison-based services started treatment. Of these, 342 (95.8%) involved a wait of three weeks or less (alcohol, 100.0%; co-dependency, 97.7%; drugs, 94.7%).
2,239 community-based service referrals had not started treatment. Of these, 323 (14.4%) involved a wait of more than three weeks.
31 prison-based service referrals had not started treatment. Of these, 13 (41.9%) involved a wait of more than three weeks.

As of 30 September 2024:

2,239 community-based service referrals had not started treatment. Of these, 323 (14.4%) involved a wait of more than three weeks.
31 prison-based service referrals had not started treatment. Of these, 13 (41.9%) involved a wait of more than three weeks.

Naloxone

Accidental overdose is a common cause of death among users of heroin, morphine and similar drugs, which are referred to as opioids. Naloxone is a drug which reverses the effects of a potentially fatal overdose with these drugs. Available as an intramuscular injection, or intranasal product since April 2019, naloxone provides time for emergency services to arrive and for further treatment to be given. Following suitable training, ‘take home’ naloxone kits (hereafter referred to as ‘THN’ or ‘kits’) are issued to people at risk of opioid overdose in order to help prevent overdose deaths. The monitoring report for 2021/22 and 2022/23 was released in February 2024, which reports on annual numbers of ‘take home’ naloxone distributed via the national naloxone programme since 2011/12.

Key points:

In 2022/23:

28,689 THN kits were issued in Scotland, which was a 1% decrease compared to 2021/22 (29,075). The annual number of kits supplied in 2021/22 and 2022/23 was substantially higher than in any year up to and including 2020/21 (22,378).
22,184 THN kits were issued from community outlets, 1,929 kits were issued in prisons upon release, 3,249 kits were dispensed via community prescription, and 1,225 kits were distributed by the Scottish Ambulance Service (SAS).
The most common sources of community THN supply were drug treatment services (12,575, 57%); Scottish Families Affected by Alcohol and Drugs (SFAD) (5,042, 23%); and non-drug treatment services (such as homelessness services) (1,581, 7%).
Of the 28,689 THN kits issued in Scotland, 20,918 (73%) were intramuscular Prenoxad® kits and 7,759 (27%) were intranasal Nyxoid®
7,708 THN kits were distributed as repeat supplies. Of these, 2,013 (26%) were issued because the previous kit was reported as having been used to treat an opioid overdose.
Of the 2,257 THN kits issued via peer-to-peer supply, 1,453 (64%) were distributed from community outlets and 804 (36%) were distributed from prisons.

At the end of 2022/23:

A total of 151,944 THN kits had been supplied in Scotland.
The 'reach' of THN (based on the number of people at risk of an opioid overdose supplied with kits between 2011/12 and 2022/23) was estimated to be 705 kits per 1,000 people with problematic drug use.

Quarterly monitoring bulletins of the distribution of ‘take home’ naloxone kits are also available, the most recent of which covered 1 April 2024 to 30 June 2024.

Key points:

During 2024/25 Quarter 1 (1 April 2024 to 30 June 2024):

7,886 Take-Home Naloxone (THN) kits were issued.
6,285 THN kits were issued by services based in the community..
- Community THN supplies included 1,680 kits issued by non-drug treatment services. Of these, 64% (1,069) were supplied by Scottish Families Affected by Alcohol and Drugs (SFAD.
541 kits were issued by prisons in Scotland.
757 kits were dispensed by community pharmacies.
299 THN kits were provided by the Scottish Ambulance Service.
A total of 693 kits (354 in the community and 339 in prisons)were supplied by peers (a trained champion/mentor that provides training and a THN kit to others who may witness an overdose).

At the end of 2024/25 Quarter 1, the 'reach' of the NNP (percentage of people at risk of opioid overdose who have been supplied with THN) was estimated to be 77.7%, an increase of 1.5 percentage points compared to 2023/24 Quarter 4 (76.2%).

Residential Rehabilitation

Residential rehabilitation is a well-established intervention for the treatment of problematic drug and alcohol use and is recognised as an important option for some people requiring treatment.

As part of the National Mission on Drugs, the Scottish Government has committed to invest £100M for residential rehabilitation between 2021 and 2026. The latest quarterly Interim monitoring report on statutory funded residential rehabilitation placements was published in December 2023, covering the period from April 2021 to September 2023.

Key points:

Overall, between 1 April 2021 and 30 September 2023, 1,829 statutory funded placements (including ADP approved placements, National Mission funded placements and data from other sources) for residential rehabilitation were approved in Scotland. The total estimated cost over this time frame was £15,981,643.
Of the 1,829 statutory-funded placements, 1,533 were ADP-approved placements.

Between 1 April 2023 and 30 September 2023:

477 statutory funded placements were approved for residential rehabilitation in Scotland. This was an increase of 126 placements when compared to April 2022 to September 2022 (351), and a slight increase of 16 placements when compared to October 2022 to March 2023 (461).
Of the 477 placements approved, 386 placements were approved by ADPs, 39 placements were approved by Ward 5 Woodland View in NHS Ayrshire and Arran, and 52 placements were approved through the Scottish Government's National Mission Programme.
The total estimated cost for 477 placements was £5,196,784. This cost was made up of £3,912,944 from 386 ADP-approved placements, £585,468 for 39 placements to Ward 5 Woodland View, and £698,372 for 36 prison-to-rehab placements, which were included under the National Mission programme. Cost information was not available for Aberlour Mother and Child Recovery House; River Garden Auchincruive and Phoenix Future Harper House - Specialist Family Service Scotland.
Of the 386 ADP-approved placements, 62% (233) were for males and 38% (143) were for females. The remaining were unknown or individuals preferred not to say.
Of the 386 ADP-approved placements, 48% (187) were for people with problematic alcohol use, 31% (121) were for problematic drug use and 20% (78) were for people with co-dependency.

Please note: If you require the most up-to-date data available, please check the data sources directly as new data may have been published since these data pages were last updated. Although we endeavour to ensure that the data pages are kept up-to-date, there may be a time lag between new data being published and the relevant ScotPHO web pages being updated.