Providing a comprehensive continuum of services and supports

• Developing coordinated, accessible systems

Services for the prevention and treatment of substance misuse and substance use
disorders have traditionally been delivered separately from other mental health and
general health care services.

In 2018, more than 20 million people ages 12 and older had an SUD involving illicit or
prescription drugs or alcohol—they are a significant public health concern.2 And from 1999 to
2017, more than 700,000 people died from drug overdoses. In 2017 alone, there were more than
70,000 deaths, the majority of which involved opioids.3

Today SUDs are recognized as chronic, relapsing medical conditions.4 Individuals with SUD
may struggle to manage other medical conditions, also known as comorbidities. When SUDs are
not addressed in the treatment of other conditions, patients may not properly take medications
and suffer additional consequences, such as poor control of hypertension and diabetes, and
increased risk for various cancers and other illnesses.5 In addition, individuals with SUD have
higher rates of emergency department visits and hospital readmissions,6 and when left untreated,
SUDs are associated with high rates of injury, disability, and death. 7

To improve outcomes, health professionals are developing care coordination approaches that
address SUDs and aim to increase patient engagement and retention in treatment, support better
management of comorbid medical conditions, and ensure successful connections to medical and
behavioral interventions.

Care coordination models for individuals with SUD share many core features but can differ in
their designation of the entity or individual primarily responsible for coordinating care, where the
coordination occurs, and how it is financed.

• Decreasing stigma and discrimination

• Focusing on “upstream” prevention
• Enhancing early identification and intervention

Stigma matters
People who use drugs, especially those struggling with addiction
face discrimination and barriers to getting help.
Stigma can:

 lead a person to avoid getting help because they are afraid

of judgement or getting in trouble with work, their loved
ones or even the law
 cause a person to hide their drug use or use drugs alone
 affect a person's ability to find housing and jobs, which
affects their health and quality of life
 contribute to people who use drugs receiving a lower quality
of care from the healthcare system when they access
services

Addiction is not a choice

There is a common misconception that addiction is a choice and
that people can stop using drugs when they want to. Addiction is
complex. People develop addictions because of many reasons,
including:

 events in life, especially trauma and chronic stress

 environmental factors
 mental well-being (emotions, thoughts, feelings, and mental
illness)
 genetics and biology

https://www.canada.ca/en/health-canada/services/opioids/stigma.html#a2

Overall, 308 participants (96%) perceived a need for care for mental health or substance use
problems in the year preceding data collection, and 303 (95%) indicated receiving one or more
services in the previous 12months.Nevertheless, 263 participants (82%) reported unmet need for
one or more services during the past year. Given the exceptionally high rate of unmet need
across services, we also examined unmet need for care for each service. Social interventions
(190; 59%) and counselling (152; 48%) were the two service categories with the highest levels of
perceived unmet need.