‘Strategic approaches to reducing the substance use-related burden of disease in Canada’ — authors' reply

We acknowledge Cénat et al.‘s response to our Commentary “Strategic approaches to reducing the substance use-related burden of disease in Canada” which focused on substance use-related burden of disease for main substance categories and related intervention priorities.^1,2 While we generally agree on the importance of racial-ethnic inequities, early prevention and stigma in considering substance use and related harms, our brief Commentary did not include the focus nor the space for in-depth analyses of the issues raised, or others of similar significance. We note, however, that it did make explicit reference to the need for a comprehensive public health approach that takes into account the “socio-cultural determinants of substance-related harms” and addresses the need to scale-up of “equity-based” interventions, and recommended “targeted prevention for youth and other vulnerable populations”. We appreciate the additional insights provided by Cénat et al. on these and related matters.

Contributors

BF and PC jointly developed the concept for the article; all authors collected and interpreted related data for the study. BF led the manuscript writing; WH, BLF and PC edited and revised the manuscript for substantive intellectual content. All authors approved the final manuscript submitted for publication.

Data sharing statement

All data presented in this manuscript are accessible in the public domain (e.g., in the form of journal articles, reports, websites).

Disclaimer

The views expressed in this paper are solely those of the authors and do not necessarily reflect those of the CIHR.

Declaration of interests

Dr. Fischer has held research and policy support grants and contracts in the areas of substance use, health, crime from public funding and/or government organizations (i.e., public-only sources) in the last five years, including: Correctional Service Canada; the Canadian Centre on Substance Use & Addiction; the Max-Planck-Society (Germany). He was temporarily employed by Health Canada/the government of Canada (2021–22). Dr. Fischer acknowledges present research and policy support from the Waypoint Centre for Mental Health Care/Waypoint Research Institute and contract funding from the Institute of Neurosciences, Mental Health and Addiction, Canadian Institutes of Health Research (INMHA/CIHR).

Dr. Hall does not have any conflicts to declare.

Dr. Le Foll declares research (e.g., research funding/in-kind) supports received from Indivior, Indiva, Canopy Growth Corporation, research consultancies from and/or science advisory roles with ThirdBridge, Shinogi, Changemark, NFL Biosciences, and travel support from Bioprojet. Dr. Le Foll acknowledges employment-based research support from the Centre for Addiction & Mental Health (CAMH), the Waypoint Centre for Mental Health Care, in addition to a clinician-scientist award from the Department of Family and Community Medicine, and the Chair in Addiction Psychiatry from the Department of Psychiatry, University of Toronto.

Dr. Conrod declares research support from a Tier-1 Canada Research Chair (CRC) in Preventive Mental Health and Addiction from the federal CRC program, Canada, and her role as Scientific Director of the INMHA/CIHR and related part-time employment by CIHR. She holds (non-financial) licensing rights for the Preventure Program, a prevention program for substance use disorders, has received honoraria for plenary lectures from public university (e.g., Yale U, U of British Columbia, U of Manitoba, McGill U) institutions, and has received travel support from CIHR. She was a member of the Legislative Review of the Cannabis Act expert panel appointed by the federal government of Canada.