Substance use and addiction services in transition, contacts are moving to basic services, where structures and competence must be strengthened

06.05.2026 - Substance use and addiction services are in a transition phase, in which service contacts are increasingly focused on basic services. The change offers opportunities for earlier support and more effective referral to treatment, but it requires determined development of service structures, cooperation and professional competence in basic services. Otherwise, there is a risk that services will not meet people’s increasingly diverse needs, according to the Finnish Institute for Health and Welfare’s (THL) new report on the state of substance use and addiction services.

For example, in 2024, 56 percent more clients used primary health care substance use and addiction treatment services because of alcohol use than in 2019. At the same time, contacts with specialised medical care have decreased.

“Contacts related to substance use and addictions appear to be moving increasingly toward primary health care and other basic services. This requires service packages and professionals’ competence to support the change,” says Kristiina Kuussaari, specialist researcher at THL.

“The future of substance use and addiction services is shaped by the structures and resources of the wellbeing services counties, as well as broader societal changes, such as population ageing and increasing cultural diversity. These changes also require new solutions for preventing and reducing harm related to substance use and addictions,” Kuussaari says.

For the first time, the report brings together a broad overview of public sector substance use and addiction services and preventive substance use work.

Cooperation structures do not yet support access to comprehensive help

Problems related to substance use and addictions are often complex and affect health, finances and social wellbeing at the same time. Despite this, cooperation between social welfare and health care remains unstructured in many places.

“The need for cooperation is widely recognised, but in many places the practical structures for implementing it are missing,” says Maria Heiskanen, specialist researcher at THL.

Wellbeing services counties must develop service and cooperation structures so that clients can easily receive the help they need as a whole. This requires leadership that crosses the boundaries between social welfare and health care, as well as the involvement of professionals and clients in developing cooperation.

Functional service packages are needed for people in working life

A significant share of substance use and addiction-related harm affects people who are active in working life. Early identification and support are proven to be effective ways of preventing problems from worsening, but the service system does not always offer clear and easily accessible service packages for people with risky use.

“For some people, it is enough that substance use or another addiction is brought up. Others need more support,” Kuussaari says. “When substance use and addiction-related harm is addressed early, both employees and employers benefit.”

The role of primary health care and occupational health care in treating milder forms of harm should be strengthened.

In addition to substance use, increasing service needs are emerging especially from activities linked to the digital world, such as gambling.

Personal contact is at the heart of substance use and addiction services

Accessibility of services is a key condition for receiving help. Digital solutions can support services, but personal contact remains necessary for many clients.

Everyday support services for people in the most vulnerable situations who use substances or experience addictions are insufficient in many places. Poor service availability, high thresholds and inadequate accessibility can prevent people from seeking help in time and increase experiences of exclusion.

“A key question in developing substance use and addiction services is whether the services meet people’s everyday lives or not,” Kuussaari summarises.

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Source: THL