Major challenges in substance use research in Canada in 2019

Aims: To synthesize knowledge on substance use and substance-attributable burden in Canada to determine research priorities for the next 3 to 5 years. Methods: We searched for and analyzed the latest epidemiological estimates of substance use prevalence and attributable burden and for economic data on the costs of substance use. Results: Based on trends over 2014-2019, opioid, alcohol, and cannabis use were identified as research priorities due to their current or anticipated future impact on health burden in Canada. Specifically, future research efforts should be directed towards: (a) reducing the number of opioid prescriptions, investing in interventions for those already addicted to opioids,  preventing both the development of opioid use disorders and deaths due to overdose; (b) identifying ways to reduce hazardous and harmful drinking, particularly among those with low socioeconomic status; and (c) monitoring and evaluating the impacts of the recent policy implementations for the legalization of cannabis on various outcomes. While tobacco attributable burden has been decreasing, it is important to continue to monitor vaping use over time. Conclusions:  Substance use is a significant and increasing risk factor for burden of disease, and research efforts are necessary to reduce this burden in Canada.