The connection between substance use and homelessness is complicated. While substance use is high among people who are homeless, it doesn’t fully explain homelessness. Just using substances doesn’t mean someone is addicted or living a harmful lifestyle. Many people who are addicted never become homeless. However, someone with housing troubles, often due to low income, has a higher risk of losing their home if they use substances. Once on the streets, it’s hard for someone with substance issues to get housing because they face huge barriers to getting healthcare, including substance treatment and recovery support.

“Substance use” includes all types of drug and alcohol use. This term replaces “drug abuse,” which carries social stigma and can push people away from the help they need. “Use” aims to reduce harm for all users—from occasional users to those with serious addictions. “Substance” covers a wide range of items, including alcohol, cigarettes, illegal drugs, prescription drugs, solvents, and inhalants that are habit-forming.

Substance use can cause much harm. This includes the effects of the substance that might make it hard for a person to make safe decisions and do tasks well. Problematic substance use can lead to poor health, accidental death, and risky sexual behavior. Other harms include losing the ability to work or stay in school, broken relationships with family and friends, and legal issues.

Responses to substance use vary. They include prevention (focusing on not using substances), treatment (for those with problematic use), harm reduction (programs to lower substance use risks), and enforcement. This is key. In Canada, as in other places, substance use is highly political. Some harmful substances are legal (cigarettes, alcohol, prescription drugs), while others are not. This means a potential harm of substance use is getting arrested.

People living on the streets and using substances face many risks, including trouble finding and keeping jobs and housing. These issues suggest the need for harm reduction programs that provide a safe space for clients who can’t stay abstinent. Also, stable supportive housing helps people deal with their substance use problems better.

Highlights of Recent Federal Actions

Shared the latest national data on deaths, hospital stays, ER visits, and ambulance calls related to opioids and stimulants with provinces and territories.
Updated predictions on opioid-related deaths up to December 2024 to plan for different situations.
Published a report on drug combinations found in opioid and stimulant deaths from 2018 to 2022.
Released a report on repeated ER visits for opioid issues in Alberta, Ontario, and Yukon from 2018 to 2022, showing differences between single and repeat visits.

For the new Youth Substance Use Prevention Program:

Funded seven new projects in four provinces to use and adapt the Icelandic Prevention Model in Canada.
Supported the creation of a new Knowledge Development and Exchange Hub for Youth Substance Use Prevention in Canada.
Co-hosted the National Pain Congress with the Canadian Pain Society and Pain Canada, bringing together experts, researchers, people living with pain, and policymakers to discuss pain issues and share knowledge.
Worked with the Centre for Addiction and Mental Health (CAMH) to create and share a toolkit for pharmacy workers to reduce opioid stigma.
Started the renewed Canadian Drugs and Substances Strategy (CDSS) to guide the government’s approach to tackling substance use harms and the overdose crisis.

Government Funding

Budget 2024 committed $150 million over three years for an Emergency Treatment Fund to help municipalities and Indigenous communities respond quickly to the overdose crisis. Additionally:

Proposed $500 million over five years for a new Youth Mental Health Fund to help young Canadians get mental health care.
Proposed $1.0 billion over four years for Reaching Home: Canada’s Homelessness Strategy, with $50 million to speed up community-level homelessness reductions.
Proposed $250 million over two years starting in 2024-2025 to address urgent issues of encampments and unsheltered homelessness.

The Government of Canada’s Working Together to Improve Health Care for Canadians includes $25 billion for four shared priorities, including better access to quality mental health and substance use services. Also, $2 billion over 10 years was announced to support Indigenous health initiatives.

The Government has committed over $1 billion since 2017 to directly tackle the overdose crisis, including funding community organizations through the Substance Use and Addictions Program (SUAP) to support people who use drugs, such as:

Supporting treatment projects, including expanding Opioid Agonist Therapy (OAT).
Supporting pilot projects providing prescription drugs as safer alternatives to toxic illegal drugs for those at high risk of overdose.
Helping reduce stigma and support families affected by the crisis.
Improving harm reduction initiatives to reach key groups like Indigenous peoples, youth, people in the correctional system, and healthcare workers.
Improving access to peer support and capacity-building projects.
Supporting projects addressing priority actions identified by the Canadian Pain Task Force.