Why We Use “Substance Use Health”

Putting substance use on a spectrum creates a space for more open conversations about safer, healthier, more manageable consumption.

Part of the Mental Health Commission of Canada’s work involves education on the distinction between mental health and mental illness. Mental health — an aspect of overall health — exists on a spectrum we all share. One end of the spectrum reflects optimal mental health, while the other shows where mental illness or mental health problems occur. A spectrum model is also helpful when we talk about substance use.

What it means
Toward one end of the substance use health spectrum, a person might abstain entirely or engage in sporadic use without any adverse consequences. At the other end are substance use disorders with far-reaching effects on overall health and well-being. Depending on the circumstances and a multitude of factors, anyone can move along the spectrum at any time.

Why it matters
Due in part to a long history of criminalization and secrecy around drugs and alcohol, a negative undertone persists. This way of thinking may lead people to see all substance use as problematic. On the other hand, putting substance use on a sliding scale helps create a space for more open conversations about safer, healthier, more manageable consumption — whatever that looks like for each individual.

Reducing stigma around substance use is also an important part of fostering recovery. The less negatively we judge substance use, the more comfortable a person might be about disclosing a concern about their own or someone else’s situation. For someone struggling with substance use, understanding that they can achieve safer, healthier consumption without (or before) complete abstention can help instil hope when they need it most.

How you can use it
Adopting the term substance use health can challenge personal biases and binary thinking. Substance use isn’t black and white. It’s not about being addicted or abstaining entirely. There’s a wide, grey area of movement, nuance, and individual circumstances in between. As with all mental health, the way we think and talk about substance use matters. The better we understand the substance use health spectrum, the better we can support people through every stage of recovery.