Substance use and addiction services under transformation – service use is moving to basic services, where structures and competence must be strengthened
Substance use and addiction services are in a transitional phase, where service contacts increasingly take place in basic services. The change offers opportunities for earlier support and more efficient referral to treatment, but requires determined development of the service structures, collaboration and competence in basic services. Otherwise, there is a risk that the services do not meet people’s increasingly diverse needs,” states a recent report on the state of substance use and addiction services by the Finnish Institute for Health and Welfare (THL).
For example, in 2024 there were 56% more clients accessing substance use and addiction services in primary health care due to alcohol use than in 2019. Conversely, there has been a decrease in specialised medical care visits.
“Visits related to substance use and addiction seem to be increasingly shifting to primary health care and other basic services. This requires that service structures and professional competence support the change,” says Senior Researcher Kristiina Kuussaari from THL.
“The future of substance use and addiction services is shaped by the structures and resources of wellbeing service counties and wider societal changes, such as the ageing of the population and increasing cultural diversity. As a result of the changes, new solutions are also needed in preventing and reducing the harmful effects of substance use and addictions,” says Kuussaari.
For the first time, the report compiles an extensive situational picture of public sector substance use and addiction services and preventive substance use work.
Collaboration structures do not yet support access to comprehensive help
Problems related to substance abuse and addiction are often complex and simultaneously concern health, finances and social welfare. Despite this, collaboration between social welfare and health care is still often unstructured.
“The need for collaboration is widely recognised, but the practical structures for its implementation are sometimes missing,” says Maria Heiskanen, Senior Researcher at THL.
The wellbeing services counties must develop the structures of services and collaboration, so customers can get the help they need easily and all in one. This requires cross-sectoral management of social welfare and health care and the involvement of professionals and customers in the development of collaboration.
Employed people need functioning service packages
A significant proportion of harms associated with substance use and addiction affect people in employment. According to research, early identification and support are effective ways of preventing the exacerbation of the problems, but the service system does not always provide risk users with clear and easily accessible service packages.
“For some people, bringing up the substance use or other addiction is enough. On the other hand, others need more support,” says Kuussaari. When substance abuse and addiction harms are addressed in time, both employees and employers benefit.
The role of primary health care and occupational health care in addressing less severe harms should be strengthened.
In addition to the use of intoxicants, increasing service needs are arising especially from activities connected to the digital world, such as gambling.
Personal contact is at the heart of substance use and addiction services
Access to services is a key prerequisite for receiving help. Digital solutions can support services, but personal contact is still essential for many customers.
The everyday support services targeted at the most vulnerable substance abusers or people experiencing addictions are often insufficient. The poor availability of services, high thresholds and insufficient access may prevent seeking help in time and increase the experiences of being an outsider.
“In the development of substance use and addiction services, the key question is whether the services meet people’s everyday lives or not,” sums Kuussaari.
Further information:
Kristiina Kuussaari
Senior Researcher
tel. +358 29 524 7476
[email protected]
Maria Heiskanen
Senior Researcher
tel. +358 29 524 8112
[email protected]
Jenna Grundström
Senior Researcher
tel. +358 29 524 7696
[email protected]
Katariina Warpenius
Senior Researcher
tel. +358 29 524 7019
[email protected]