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Homeless and vulnerably housed populations experience disproportionately high rates of substance use [1-3]. While individuals may use substances as a way to cope with adverse living conditions, stress, and the trauma of homelessness [4-6] it is also the case that without stable housing individuals often experience barriers to accessing and following treatment recommendations for substance use disorders [7]. Childhood traumatic experiences, posttraumatic stress disorder and adult exposure to other traumatic experiences can also influence substance use [8]. Despite the substantial unmet care needs of this population, people struggling with both substance use and homelessness experience overlapping barriers to accessing care, including stigma related to care itself [9], and abstinence-based treatment first housing services [10,11]. Together, these barriers increase perceived loss of control over one’s life, contribute to mistrust of the health system, and perpetuate lower access and adherence to care and treatment [12-14]. There is substantial literature demonstrating that people who are homeless benefit from receiving tailored, patient-centred care within interprofessional primary care teams with an integrated approach to community and social services [15-17]. Specifically, harm reduction and pharmacological interventions represent important approaches to facilitate care and treatment of individuals experiencing homelessness and concomitant substance use disorders. At its core,
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