Residential rehabilitation: literature review

1. Background

The level of harms from alcohol and drugs in Scotland are high in comparison to the rest of the UK and Europe, and cause avoidable damage to people's lives, families and communities. Tackling the high level of drug related deaths in Scotland is a priority for the Scottish Government. On 20th January 2021, the First Minister made a statement to Parliament which set out a National Mission to reduce drug deaths through improvements to treatment, recovery and other support services. One of the five priorities was increasing capacity and improving access to residential rehabilitation. This accompanied a commitment of £250 million investment in drug treatment services over the next five years, including £100 million for residential rehabilitation.

This paper forms part of a wider suite of research exploring residential rehabilitation across Scotland, and reviews the existing evidence from the Scottish, wider UK and international literatures pertaining to various aspects of residential rehabilitation. In doing so, it responds to the recommendation by the Residential Rehabilitation Working Group to better understand "the variety of treatment models available and…their components (medical, psychological and social approaches) and…the evidence base underpinning these" (Recommendation 7a). This paper will also feed into addressing the recommendations around "best value" (Recommendation 3b) and "standardisation" (Recommendation 4a) (Scottish Government 2020).

The literature review also identifies areas where there is a need for future research to inform our understanding of, and the ongoing development of, residential rehabilitation in Scotland. The need for a more strategic, systematic approach to developing the residential rehabilitation evidence base in Scotland has been noted previously (Best et al. 2010). The review seeks to identify overarching themes based on identified gaps in the existing literature, specifically those pertaining directly to the Scottish context, but likely with wider international relevance.