Scotland reports >1,100 drug-related deaths annually—twice the UK rate and 10-times the EU average. The Scottish Government launched a National Mission and introduced Medication Assisted Treatment (MAT) Standards, emphasising trauma-informed care. Most people with substance dependency (PwSD) have complex trauma, complicating recovery. Pharmacy staff are central to harm reduction, offering opioid substitution therapy, injecting equipment, and naloxone. However, stigma persists among pharmacy staff and other health care professionals, often linked to limited training, and is rooted in psychological mechanisms (e.g. attribution theory, identity theory and cognitive biases). It undermines recovery, increases inequalities, and elevates death risk.

These challenges can be further complicated by the co-occurrence of mental ill health conditions in people with substance dependency. Mental ill health also has an increasing prevalence in Scotland, with higher rates identified for people who use drugs. In total, one-in-five adults are prescribed an antidepressant, and 2023/34 there were >11.5 million prescriptions for antidepressants, antipsychotics, and anxiolytics. The Scottish Mental Health Stigma survey identified that people with mental health conditions are commonly stigmatised within health care.

The ultimate aim of this PhD is to develop interventions to improve the care to this patient population. The PhD project will be mixed methods and will involve people with the lived experience of mental ill health and substance use, using co-production methods. This project will involve

• Qualitative exploration with people with lived experience of mental ill health and substance use
• The design of intervention(s) to improve practice, involving multi-stakeholder engagement
• Testing of the intervention(s) and analysis of impact on beliefs, attitudes, and behaviour change using mixed methods.

The exact methodology will be co-designed with any potential PhD applicant, who will be able to select their focus of interest whether it is on both mental health conditions or substance use, or if they wish to focus on a subset of the population (e.g. people with schizophrenia).

Previous research which informs this PhD project includes:

1. Weir, N., Dunlop, E., MacKenzie, A., Byrne, T., Johnston, K., O'Hagan, A., Rehman, Z., Richardson, H., Shah, A., Gemma, W., & Radley, A. (2025). Professionalism, professional identity, and community pharmacy culture: the context of substance dependency through the lens of student and early career pharmacists. Addiction. 
2. Weir, N., Dunlop, E., MacKenzie, A., & Radley, A. (2025). Development and testing of a training intervention delivered to undergraduate pharmacy students to address stigma towards people with substance dependency.  Research in Social and Administrative Pharmacy, 21(11), e47.