Joint position statement on the role of substance use social work in public service reform
November 2026
About us
Social Work Scotland is a national membership organisation supporting the professional leadership and management of social work in Scotland.
The Scottish Association of Social Work (SASW), part of the British Association of Social Workers (BASW) UK, is the largest professional association for social workers in Scotland and the UK.
Substance Use Social Work: An Essential Component of Public Service Reform
As Scotland progresses its programme of Public Service Reform, it is essential that the distinctive contribution of substance use social work is recognised and reflected within policy development, service redesign and workforce planning. Social Work Scotland and SASW members highlight a strong concern that current reform conversations are often framed around social care delivery, with insufficient attention given to the broader contribution of social work and the particular role of substance use services.
Substance use social work operates at the intersection of health, social care, justice, housing, child and family support, public protection and community wellbeing. It supports people experiencing some of the most complex and severe forms of disadvantage, including trauma, poverty, homelessness, mental ill-health, family breakdown and social exclusion. Effective responses therefore require more than healthcare interventions alone; they require skilled, relationship-based social work interventions that address the wider social determinants of recovery and wellbeing.
The contribution of substance use social work extends beyond individual support. Practitioners play a critical role in prevention, early intervention, public protection and the promotion of recovery. Through sustained engagement with individuals, families and communities, social workers help prevent escalation of need, reduce the likelihood of crisis and support long-term positive outcomes across multiple policy areas. This contribution is particularly significant in relation to child and family wellbeing, community safety, reducing inequality and tackling health harms.
Scotland’s continuing challenge with drug-related deaths reinforces the importance of this wider social work contribution. Despite significant national investment in treatment services and improvements in access to evidence-based interventions, Scotland continues to experience an unacceptably high level of drug-related mortality. While treatment remains a vital component of Scotland’s response, the persistence of these deaths demonstrates that substance-related harm cannot be addressed through healthcare interventions alone. Drug-related deaths are closely associated with poverty, trauma, homelessness, mental ill-health, social isolation, family adversity and inequality. These are issues that sit at the heart of social work practice. As Public Service Reform seeks to improve outcomes and reduce demand on public services, it must recognise that addressing substance-related harm requires action on the social conditions that place people at risk, alongside access to effective clinical treatment.
Social Work Scotland and SASW members emphasise that recovery is fundamentally relational. Trusting relationships, community connections, peer support and recovery communities are often the foundations upon which change occurs. Substance use social work is uniquely placed to support these processes through persistent engagement, advocacy and coordination across services. However, the value of this work is not always visible within systems that prioritise activity measures, waiting times and service throughput over complexity, prevention and long-term outcomes.
Members further highlight the importance of family support, prevention and community-based responses. Substance use affects families and communities as well as individuals, contributing to a range of social harms including child protection concerns, family breakdown, involvement in the justice system and poorer life outcomes for children and young people. Effective social work intervention can help prevent these harms from escalating and can contribute to improved outcomes across generations.
The increasing prominence of social care within reform discussions has brought renewed attention to the need for greater clarity regarding the relationship between social care and social work. While recognising the essential contribution of social care, there is concern that the terms are sometimes used interchangeably, obscuring the distinctive role of professional social work. Substance use social work demonstrates the importance of this distinction. It is a discipline grounded in evidence, theory, ethics, human rights and professional judgement, often operating in situations of significant complexity, uncertainty and risk. Reform must therefore ensure that social work is recognised not simply as a gateway to services, but as a direct intervention in its own right that supports recovery, reduces harm, protects individuals and families, and addresses the wider social determinants of wellbeing.
Public Service Reform presents an opportunity to strengthen integrated, person-centred support and to build services around people’s lives rather than organisational boundaries. To achieve this ambition, reform must explicitly recognise substance use social work as a critical component of Scotland’s response to substance-related harm and create an enabling context within which social workers can fully deploy their skills. Future reform should support whole-family approaches, investment in prevention, stronger partnerships with recovery communities and lived experience organisations, and outcome frameworks that capture the importance of relationships, recovery and social inclusion alongside traditional performance measures.
Key Position
Substance use social work is not an adjunct to treatment or social care services. It is a distinctive, skilled and essential area of practice that contributes directly to prevention, recovery, public protection and community wellbeing. Scotland’s continuing challenge with drug-related deaths demonstrates that no single service or professional group can address substance-related harm in isolation. Sustainable improvement requires a whole-system response that combines effective treatment with prevention, family support, community recovery, public protection and action on poverty and inequality. Substance use social work is uniquely positioned at the intersection of these priorities and should be explicitly recognised, supported and invested in as a core component of Scotland’s Public Service Reform agenda.
