There are three broad steps we should consider in trying to implement alcohol and cannabis screening and brief intervention (SBI) in Canada.

The major barrier in my view is the intense emphasis on reactive care in our health systems. While we need reactive care to be fully resourced, an exclusively reactive approach keeps us from addressing substance use issues upstream through proactive screening and brief intervention.

It's going to take a lot of time to change our health systems to better balance reactive and proactive care. So that's a long term step that many are already working toward.

As a medium term step we can start expanding our view of health systems to contexts that are already quite proactive and wellness focused. Included here as potential settings for screening and brief intervention are those places where people now go to enhance healthy living: community-based programs like the YW- and YMCA as well as postsecondary and municipal fitness programs.

In the short term, we can provide tools to help individual alcohol and cannabis users reduce their use to lower risk levels partly or wholely on their own. We know that moderate risk users can often cut back without counseling. We can further empower them with well designed resources.