The health of many people misusing drugs and alcohol has not improved in a decade despite the Scottish Government spending more than £740 million on the problem.
Publishing a review of drug and alcohol services, Audit Scotland said there was much work still to do, particularly in tackling drug misuse.
The report reviewed progress in the 10 years since the Scottish Government’s first national harm reduction strategies and made suggestions for actions that would help successful implementation of the government’s new strategy, launched last year.
Scotland has the highest rate of drug-related deaths in western Europe, with the number of people dying expected to reach 1,000 this year.
Audit Scotland said the outcomes for many people misusing drugs and alcohol in Scotland had not improved in a decade, despite some areas of progress.
And it said a long-term strategy was needed to tackle the stigma of drug misuse similar to the work underway on mental health.
Caroline Gardner, Auditor General for Scotland, said: “The last decade has seen several notable achievements in drug and alcohol treatment in Scotland, including more recovery communities, improved drug harm reduction strategies and minimum unit pricing for alcohol.
“But without clear performance data around what measures are working, the government will continue to find it hard to achieve its aim of reducing deaths and better supporting people to recover.”
Statistics published last year showed there were 934 drug-related deaths registered in 2017, the largest number since records began.
Campaigners have called for a range of radical interventions such as a drug consumption room in Glasgow and consideration of decriminalisation, a policy which has helped reduce deaths in Portugal since its introduction there in 2001.
Public health minister Joe FitzPatrick said: “We welcome the Audit Scotland report on drug and alcohol services in Scotland. It highlights a number of the positive steps we are taking to tackle drug and alcohol-related harms including the introduction of the take-home Naloxone programme, Minimum Unit Pricing and the fact we are meeting our targets in terms of drug and alcohol treatment waiting times.
“I believe that what Scotland faces in drug deaths is an emergency. To determine what more we can do I will soon be convening an expert group to advise on what further changes, in practice or in law, could help save lives and reduce harm.”