Baseline Implementation of Medication Assisted Treatment (MAT) standards in Scottish Prison
Justice supplementary report 2025-26

About this release

This release presents the first national baseline assessment of Medication Assisted Treatment (MAT) standards implementation across all 17 Scotland’s prison establishments in 2025-26. The MAT standards aim to improve access to, and quality of, treatment and support for people who use drugs.

Evidence was assessed using two benchmarked streams:

• process evidence, covering pathways, policies, procedures and service arrangements
• numerical evidence, covering available data on service delivery and access

Experiential evidence, which captures the views of people with lived and living experience, was not benchmarked in 2025–26. Development work took place to support future experiential reporting in prison settings.

This publication is classed as Official Statistics in Development, meaning the statistics are still being developed and user feedback will help improve future reporting.

Main points

This is the first national baseline assessment of MAT standards implementation across all 17 Scottish prison establishments.

Most ratings were amber or green, indicating that many elements of the standards are in place, while further development is required.

The strongest implementation was seen for:

• MAT standard 2: Choice, with 71% of prisons assessed as green, indicating that prescribing options and related service arrangements were largely in place
• MAT standard 4: Harm reduction, with 59% assessed as green, indicating that harm reduction approaches were being implemented across most prison establishments

MAT standards 5, 6 and 10 were mainly assessed as amber, indicating progress but also areas for further development.

Red ratings were concentrated in:

• MAT standard 1: Same day access
• MAT standard 9: Mental health

MAT standard 7: Primary care provision was not assessed under RAGB in the first reporting year because primary care models vary across prisons and a consistent prison specific benchmark could not yet be applied.

Stacked bar chart showing the proportional distribution of RAGB status ratings for Medication Assisted Treatment (MAT) standards across Scottish prison establishments in 2025-26. Each bar represents a MAT standard, with segments indicating the proportion of establishments rated Red, Amber or Green under the MAT standards assessment framework. In this first year of reporting, no Blue ratings are present, reflecting early implementation stages as these can only be awarded after sustaining Green rating for two or more years. The figure highlights variation in implementation status across MAT standards.

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Chart 1: Proportion of Medication Assisted Treatment (MAT) standards implementation rating across prisons, by MAT Standard (2025-26)

Blue ratings were not available in 2025–26 because this was the first year of prison reporting. Blue reflects sustained implementation over time.

A total of 1,848 opioid agonist therapy prescriptions were recorded across Scottish prisons, with methadone and long-acting injectable buprenorphine accounted for similar proportions, totalling over 80% of prescriptions.

Most establishments demonstrated access to harm reduction services, including blood-borne virus testing, wound care and naloxone provision.

The first year of reporting highlighted challenges with data collection, information systems and analytical capacity.  In the years before the first national benchmarking exercise, MIST worked with Scottish prisons, NHS Boards, SPS and wider partners to build relationships, raise awareness of the MAT standards and support local implementation planning during a period of substantial operational challenge. This preparatory work took place during a period of substantial operational challenge. This helped identify good practice, strengthen collaboration and prepare prisons for national reporting and improvement.

The report provides a baseline for future improvement, benchmarking and national learning.

Background

People in prison experience high levels of substance use, co-occurring health needs and drug-related harm making prisons an important setting for MAT delivery and reducing drug-related harm.

The MAT standards were originally developed for community settings and have been adapted for prisons to reflect differences in prison healthcare, prescribing, governance, data systems and links to community services.

The 2025–26 reporting cycle was developmental. It established a national baseline, supported shared understanding of evidence requirements and identified priorities for future improvement.

Future reporting will continue to develop the prison benchmarking approach, including work on MAT standard 7, independent advocacy and social support, information systems and experiential evidence.

Additional resources

For wider background context more information on Medication Assisted Treatment (MAT) standards can be found here including previous MAT Standards Benchmarking Reports relating to community implementation across Alcohol and Drug Partnerships.

Further information

This report has been developed iteratively over the course of the MIST programme, with measures reviewed and refined across reporting years. Following the conclusion of the National Mission and the publication of the new Scottish Government Alcohol and Drugs Strategy 2026-2035, the reporting format will be reviewed to ensure future outputs remain aligned with strategic and analytical priorities.