Background: In July 2021 1339 drug related deaths (DRDs) were recorded in Scotland for the year 2020, the highest number on record. To put this in context, National Records of Scotland estimate this figure to be three times that of the UK1. To reduce DRDs and other harms associated with drug use, Medication Assisted Treatment (MAT) Standards for Scotland were published in May 2021, with the aim to deliver and measure a no barrier, consistent access to treatment regardless of individual circumstances and ensure appropriate choice re medications prescribed, deliver assertive outreach to those not in services and ensure people are retained on MAT for as long as they need it. This project sought to provide a baseline of current MAT provision, prior to implementation, from the perspective of people currently in treatment. It is intended to be a reference point to inform and improve practice in relation to implementation of MAT.

Methods: A semi-structured questionnaire was used in which telephone interviews collected both quantitative and qualitative data from participants. Data collection was facilitated by 13 peer researchers, 6 of the core group of interviewers were still in treatment themselves. The study aimed to recruit a sample of 20 participants from each of the targeted areas: Ayrshire and Arran, Grampian, Greater Glasgow and Clyde, Lanarkshire, Lothian, and Tayside. The project was approved by NHS clinical governance teams in each of the health board areas. A multi-faceted recruitment process was used to ensure as representative a sample, as possible, under the constraints of Covid 19. Due to the challenges of recruitment, in a pandemic, 95 people in total took part in the study. Qualitative questions provided in depth insights into the experience of people accessing MAT across Scotland. A sample of 16 participants from Perth Prison were also included in this study. 

Conclusion: This baseline evaluation of people’s experiences of accessing MAT in Scotland indicates why the implementation of the MAT standards are crucial to how people access and experience MAT across Scotland. The experiential narrative gives insight into ways in which action can reduce both drug related harms and drug related deaths by increasing satisfaction with services with same day prescribing, choice of treatment and subsequent retention. This snapshot illustrates the issues faced by people who are not retained in services long enough to access support needed to address presenting issues. It highlights that retention is a major issue and reinforces other studies SDF have undertaken. This work was intended to shed light on the current living experience of people using services and in doing so provide an overall picture to inform quality improvement at local and national levels. The findings outline the challenge is in the how to move from where we are, to where the MAT standards require services to be. This report suggests further work on implementation should consider actions in the following areas as both specific challenges and opportunities for improvement.