This page is your hub for educational training, clinical tools, and other resources related to substance use and trauma informed care in Primary Health Care.
Substance Use Health
The Substance Use Health portion of the Practice Support will include common substances, expanding upon the pre-existing opioid use practice support program.
Substance use can be interpreted as a synonym for addiction and, historically, viewed as a specialty service. We use the term “substance use health” to highlight that substance use occurs on a spectrum (see Figure 1).
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Figure 1
Substance Use Spectrum
This spectrum of use reflects, in part, that even people without a Substance Use Disorder (SUD) diagnosis can consume substances harmfully and benefit from an intervention (e.g., education, conversation). Evidence suggests that the cost to the health care system is greater from those who use substances harmfully than from those with a SUD.
Primary Health Care has an essential role in promoting substance use health. Integration of SUD services into primary care have been shown to improve physical and mental health, as well as accruing health care cost savings. Health care providers like you can incorporate evidence-based approaches in your practice and feel more confident in providing care and support for patients with a SUD.
We have included a toolkit of basic information for primary health care providers working with people who use substances. The toolkit contains information on the following topics:
- Substance Use Screening
- Alcohol
- Tobacco
- Cannabis
- Opioids
- Substance Use and Suicide Prevention
- Stigma
Open: Substance Use - Toolkit
Trauma Informed Care
Substance use is a risk factor for repeated exposure to traumatic events and individuals with a Substance Use Disorder have a high prevalence of childhood trauma. For these reasons, among others, a trauma informed approach can improve patient health.
Trauma informed care is a process of becoming aware of how trauma impacts individuals and how to respond appropriately. Its tenets include:
- Recognizing the signs and symptoms of trauma in patients, families, and staff
- Integrating trauma awareness into policies, procedures, and practices
- Actively working to prevent re-traumatization
Trauma informed practices are embedded in existing approaches, such as quality improvement, change management, and motivational interviewing.
By recognizing the prevalence of trauma early in a patient’s health care journey, health care providers can improve the quality of their patient’s care. For example, using a trauma informed approach and recognizing a patient’s unique identities will destigmatize the dominant “addict” social identity that has taken over for people who use opioids, while promoting a therapeutic patient-provider relationship.
This example illustrates how stigma reduction, trauma informed care, and substance use health are interrelated, and the value of ensuring that patients with lived experience of trauma are supported within primary health care settings.
Recognizing the expression of trauma can be difficult, which can limit the ability of the health care provider to initiate trauma informed care. This Practice Support provides education and training to enhance the ability of health care providers to deliver trauma informed care.
