Substance use services in the 2030s – What must be done to keep Finland on track?

The landscape of substance use and addiction is changing. The liberalisation of alcohol policy, the digital distribution of drugs, and the shift of gambling to online platforms have altered everyday life faster than the service system can respond.

Leaders of Finland’s wellbeing services counties estimate that the need for substance use services will continue to grow throughout the 2030s.

Minna Kesänen, Development Manager at the Finnish Institute for Health and Welfare (THL), describes the phenomenon as complex and cumulative:

“When we look at people’s living conditions, the availability of substances, and the state of communities, all three are shifting slightly in the wrong direction at the same time. This is not a single trend, but the development of multiple negative cycles. If inequality and feelings of exclusion increase while substances are easier to obtain than ever, it is not realistic to expect substance-related harms to decrease,” she reflects.

Access to services is crucial – The first 24 hours can define the entire path

When factors that increase substance-related harm accumulate simultaneously, the need for help also becomes more acute. What is decisive is how quickly a person can connect with services at the very moment they are ready to seek help.

“Access to detoxification services should be available within the first 24 hours of seeking help. That can determine whether a person engages with services or whether the path breaks before it even begins. Motivation for change does not wait when it comes to substance use – which is why the first 24 hours are the most critical moment for the entire system,” Kesänen states.

"Substance use services are work done by people for people – and that is precisely why success is possible.”

Wellbeing services counties have improved service accessibility, for example by increasing walk-in services and bringing substance use and addiction expertise closer to primary care.

Nevertheless, regional differences remain significant. In some areas, access is quick; in others, people may need to travel long distances with limited opening hours.

This highlights the challenge of equality: access to services still depends too much on where a person lives.

The service experience is often better than its reputation

When people do gain access to specialized substance use and addiction services, their experience is generally positive. THL’s feedback surveys show that the quality of care is strong in many areas.

“The quality of substance use services – and people’s experience of them – is often better than their reputation suggests. When people reach competent services and are able to engage with them, they often receive excellent care. The challenges more often arise before that point – in general services, where encounters with those needing substance use services, or their loved ones, can be inconsistent. The ability to meet people respectfully is not a soft added value, but the very core of service quality,” Kesänen notes.

Quality recommendations provide shared direction – and open development

Harms related to substances, nicotine products, and gambling affect nearly every Finn in one way or another. For this reason, THL and the Ministry of Social Affairs and Health (STM) are preparing new quality recommendations for 2025–2026 to support wellbeing services counties and municipalities in developing preventive substance use work as well as substance use and addiction services. The goal is to build a system that provides timely and effective support regardless of place of residence.

Kesänen describes the preparation of the recommendations as exceptionally open:

“If any field needs shared direction, it is substance use work. We have deliberately broken away from the model of closed working groups, shared ideas while still in progress, and invited professionals, experts by experience, and citizens to participate. This is not a matter of one perspective – the entire field is needed to define what good substance use work means.”

Where is the focus now? Four critical priorities

According to Kesänen, development in the coming years will be built around four fundamental elements:

1. Rapid access to services 
2. Smooth transitions and service pathways 
3. Supporting wellbeing, safety, and health alongside treatment 
4. Placing the client’s experience and rights at the center of the work

How well these are implemented will determine whether the system can respond to growing needs. At the same time, better data on service performance is required. Current data collection does not yet provide a comprehensive picture of where services are succeeding and where they are not – nor of what kind of support different regions most need.

“If substance use problems could have been solved with a single solution, they would already have been solved. We need shared commitment and movement in the same direction. Substance use services are work done by people for people – and that is precisely why success is possible,” Kesänen emphasises.