Scotland has published its most ambitious alcohol and drugs strategy to date. It sets out a ten-year roadmap to reduce deaths and harms from substance use. Health experts and frontline organisations have broadly welcomed it, but calls are already growing for firm funding commitments and real accountability.

The Scottish Government and COSLA jointly launched Preventing Harm, Promoting Recovery: Scotland’s Alcohol and Drugs Strategic Plan 2026 to 2035. This marks the first time national and local government have come together to produce a unified framework of this kind. The plan carries more than £160 million in funding for 2026 to 27. It builds on the outgoing five-year National Mission on Drugs, which concludes this April.

Scotland’s Alcohol and Drugs Strategy Combines Both Issues for the First Time

One of the most significant shifts is bringing alcohol and drug harms under a single, integrated strategy. Previous frameworks like Rights, Respect and Recovery (2018) and the National Mission on Drug Deaths (2021) tended to treat these issues separately. This time, the Scottish Government has deliberately chosen to recognise the shared causes, overlapping harms, and similar treatment needs that connect problem alcohol and drug use.

Scotland’s record on both fronts remains deeply concerning. The country holds the highest rate of drug and alcohol deaths in the UK. In 2024, opioids featured in approximately 80% of drug deaths. Almost one in five Scottish adults show signs of hazardous or harmful drinking. Around 30,000 hospital admissions every year link directly to alcohol. That works out at roughly 82 every single day.

The strategy openly admits that despite record investment, Scotland still experiences some of the highest drug death rates in Europe. Ministers acknowledge a persistent gap between policy intentions and what actually happens on the ground.

What Scotland’s Alcohol and Drugs Strategy Commits To

The plan structures delivery around four areas: prevention and early intervention, harm reduction, treatment and care, and the wider circle of support. A human rights-based approach underpins everything, drawing on the Charter of Rights for People Affected by Substance Use. The United Nations recognised this charter as the first of its kind in the world.

On harm reduction, the plan supports expanding safer drug consumption facilities beyond Glasgow. The Thistle opened in January 2025 as the UK’s first official safer drug consumption facility. In its first year, staff recorded over 8,300 injecting episodes and stepped in during 97 medical emergencies. The plan also commits to exploring drug checking through mobile units and postal services.

Treatment commitments include maintaining at least 1,000 publicly funded residential rehabilitation placements each year. New overarching standards for all alcohol and drug treatment are due by 2027 to 28. The government will also commission a national needs assessment for alcohol treatment services. There is a strong emphasis on detox, crisis care, and stabilisation. These have long served as bottlenecks. Fixing them should release capacity and get more people into residential rehabilitation.

On prevention, an alcohol harm action plan will follow later in 2026. It will target the affordability, attractiveness, and availability of alcohol. Scotland’s Minimum Unit Pricing policy has already cut deaths directly attributable to alcohol by an estimated 13% and reduced hospital admissions by an estimated 4%. The biggest gains came in the most deprived communities.

Sector Voices: Welcome, With Conditions

Responses from the sector share a familiar pattern. Genuine praise sits alongside sharp questions about whether commitments will turn into sustained action and real resources.

Louise Stewart, Director of Scotland at WithYou, called it “the long-term framework we’ve been calling for.” She pointed to the stronger focus on alcohol and the expanded harm reduction commitments as reflecting what frontline teams and the people they support actually need.

Dr Alastair MacGilchrist OBE, Chair of SHAAP, was more direct. He noted that Audit Scotland called out the Scottish Government in 2024 for stepping back from alcohol harm. The watchdog recommended urgent action by mid-2025. More than three people die an avoidable alcohol death every day in Scotland. MacGilchrist said the scale demands action that matches the rhetoric.

SHAAP also flagged the plan’s cautious language around Alcohol Care Teams in hospitals. The plan only commits to “considering” an expansion of this model. SHAAP wants a firm commitment. Those 30,000 annual alcohol-attributable admissions represent thousands of missed opportunities to intervene.

COSLA’s Councillor Paul Kelly welcomed the significance of bringing local and national government together for the first time. He said no single service can tackle alcohol and drug harms alone. Only sustained, coordinated investment across the whole system will prevent problems before they take hold.

Closing the Scotland Alcohol Drugs Gap Between Policy and Practice

A persistent theme in responses to the alcohol drugs strategy is the implementation gap. This is the distance between what policy promises and what communities actually experience. The plan itself admits this. Engagement during its development found broad support for existing policies, but real frustration that action has not moved fast enough.

The Scottish Parliament elections in May 2026 add a layer of uncertainty. Will the commitments survive a potential change of administration? Questions remain about whether incoming parties will honour what is set out here or shift priorities once in office.

The plan builds in some flexibility. Rather than a fixed ten-year action list, it sets out shorter commitments for review every three years. This allows it to adapt as evidence grows and the drug supply changes. New synthetic opioids, rising cocaine use, and growing ketamine harms among young people all need responses that can flex quickly.

What Happens Next

The immediate steps include publishing an alcohol harm prevention action plan later in 2026, developing new overarching treatment standards, and launching a refreshed Alcohol and Drugs fund with multi-year support for local and community organisations.

For families, individuals, and professionals whose lives alcohol and drug harms touch, the question is not whether this strategy means well. It clearly does. The real question is whether Scotland’s political institutions have the resolve to see it through.

Source: dbrecoveryresources