Understanding Mental Health and Substance Abuse in Canada
If you or someone you love has ever used substances to cope with stress, sadness, or anxiety, you are far from alone. In Canada, the relationship between mental health and substance use is not just common—it’s one of the most significant public health challenges we face. This isn't about a lack of willpower; it's about complex brain chemistry, trauma, and the human need to find relief from pain.
Understanding this link is the first step toward compassion, effective support, and recovery.
The Core Connection: What is Concurrent Disorder?
When a person experiences a mental health issue and a substance use disorder simultaneously, it is known as a concurrent disorder (or co-occurring disorder). The Canadian Centre on Substance Use and Addiction (CCSA) emphasizes that these conditions are deeply intertwined, each influencing and worsening the other.
Think of it this way:
Self-Medication: A person with untreated anxiety might use alcohol to quiet their racing thoughts before a social event. A person with depression might use stimulants to temporarily lift their energy and mood. In the short term, it works. But in the long term, it creates a destructive cycle.
Substance-Induced Issues: Conversely, the prolonged use of certain substances can alter brain chemistry and trigger the onset of mental illnesses like psychosis, severe anxiety, or depression, even in someone with no prior history.
This creates a chicken-or-egg scenario where it becomes difficult to untangle what came first. The critical point is that both conditions must be treated together, in an integrated way, for recovery to be successful.
The Canadian Landscape: By the Numbers
The statistics paint a clear picture of the scale of this issue in Canada:
High Co-Occurrence: It is estimated that among people seeking treatment for substance use disorders, 50-75% also have a concurrent mental health disorder (CCSA).
A Leading Cause of Death: The ongoing opioid crisis, deeply connected to mental health and pain, continues to claim lives. In 2023, there were an average of 22 opioid-toxicity deaths per day in Canada (Government of Canada).
Youth Vulnerability: Young people aged 15-24 are more likely to experience mental illness and substance use disorders than any other age group, with early intervention being critical (Canadian Mental Health Association).
Why Does This Cycle Persist? Key Contributing Factors
Several factors, often overlapping, contribute to the development of concurrent disorders:
Shared Risk Factors: Genetics, trauma, and chronic stress can make a person biologically and psychologically vulnerable to both mental illness and substance use disorders. A history of adverse childhood experiences (ACEs) is a major risk factor.
The Brain’s Reward System: Both mental health conditions and substance use directly impact the brain's delicate balance of neurotransmitters like dopamine and serotonin. Substances artificially manipulate this system, creating a powerful but unsustainable sense of relief or pleasure.
Stigma and Barriers to Care: The stigma surrounding both mental illness and addiction often prevents people from seeking help. They may feel shame or fear being judged. Furthermore, our healthcare systems have historically been siloed, making it difficult to find treatment that addresses both issues at once.
The Path to Healing: Evidence-Based Treatment and Support
The old model of treating the addiction first and the mental health issue later (or vice versa) is ineffective. The CCSA and other leading health bodies advocate for Integrated Concurrent Disorder (ICD) treatment.
This means:
A Single, Coordinated Team: A person works with a team of professionals who are trained to treat both conditions simultaneously.
Holistic Approaches: Treatment goes beyond medication and therapy to include housing support, employment counseling, and social integration—addressing the whole person, not just their diagnoses.
Trauma-Informed Care: Recognizing that many with concurrent disorders have a history of trauma, care is provided in a way that avoids re-traumatization and emphasizes safety and empowerment.
Effective treatments include:
Cognitive-Behavioural Therapy (CBT): Helps individuals identify and change the negative thought patterns and behaviours that fuel both their mental health and substance use challenges.
Motivational Interviewing: A collaborative, person-centred approach that strengthens a person’s own motivation and commitment to change.
Medication-Assisted Treatment (MAT): For opioid use disorder, medications like buprenorphine/naloxone can stabilize brain chemistry, reduce cravings, and allow the person to engage fully in therapy.
Peer Support: Connecting with others who have lived experience can break down isolation and provide immense hope and practical guidance.
How You Can Help: Breaking the Stigma
If someone in your life is struggling, your support can be a lifeline.
Educate Yourself: Understanding that concurrent disorders are a medical condition, not a moral failing, is the foundation of compassion.
Listen Without Judgment: Use person-first language (e.g., "a person with a substance use disorder," not "an addict"). Let them know you care about them, not just their behaviour.
Encourage Integrated Help: Gently suggest seeking support from a family doctor or a local agency that specializes in both mental health and addiction. You can search for resources through the CCSA’s resource hub or your provincial health authority.
Take Care of Yourself: Supporting a loved one through this is challenging. Seek your own support through groups like Al-Anon or a therapist.
A Message of Hope
Recovery from a concurrent disorder is not only possible—it happens every day. It is a journey of small steps, setbacks, and profound courage. By understanding the deep connection between mental health and substance use, advocating for integrated care, and replacing stigma with empathy, we can build a healthier, more supportive Canada for everyone.
If you or someone you know needs help, you are not alone. Reach out:
Talk to your family doctor.
Call 911 in a medical emergency.
Whatever it is, we’re here for you.
Life is uncertain. Jobs are stressful. Parenting is hard. Relationships take work. Families can be dysfunctional. And sometimes, love hurts. When you’re confronted by feelings, events, or issues that are making your life challenging, it’s okay to ask for some help.
References:
Canadian Centre on Substance Use and Addiction (CCSA). Guidance, Tools and Resources.
Government of Canada. (2023). Opioid- and Stimulant-related Harms in Canada.
Canadian Mental Health Association (CMHA). Mental Health and Substance Use.
Health Canada. About Substance Use.
