“…Access to health services is often difficult due to a lack of health literacy (citizens’ access to health information and their capacity to use it ( Sørensen et al, 2013 )), and it is often very difficult to establish and maintain contact with substance-using citizens in treatment and in care services. Many health professionals lack the knowledge and expertise on how to help this group, and the group is considered “difficult” to help, e.g., due to instability, intoxication, unwanted behaviour or lack of “willingness to cooperate” ( Bach & Bjerge, 2021 ; Bach et al, in press ; Bjerge et al, 2023 ; Jønsson, 2021 ; Kappel & Johansen, 2022 ; Sundhedsstyrelsen, 2021 , 2022 ). However, the life expectancy of citizens who use substances has risen within the past two decades, e.g., due to harm reduction measures, prevention services, and street and social nurses.…”