Underage drinking is a significant public health problem in Canada. Excessive drinking is responsible for more than 3,500 deaths and 210,000 years of potential life lost among people under age 21 each year. The harmful use of alcohol is a causal factor of more than 60 major types of diseases and injuries that include Alcohol Use Disorders (AUD), cancer, cardiovascular diseases, fetal alcohol syndrome, diabetes mellitus, suicide, and violence. The World Health Organization (WHO) reported in 2010 that heavy episodic drinking (defined as at least monthly consumption of 60 g or more of alcohol on a single occasion) is more prevalent, on average, among 15–19-year-olds world-wide (11.7%) than among the general adult population (7.5%). Early initiation of drinking is associated with the development of an alcohol use disorder later in life. 

Given the high prevalence of risky drinking and alcohol-related harm among young populations, delaying alcohol initiation and preventing heavy use by youth and young adults is a public health priority. Primary care activities related to alcohol abuse focus on early prevention and intervention, identification of alcohol consumption problems, and referral to specialty care. 

Substance-use disorders are a global public health crisis and carry with them significant morbidity and mortality. Stigma toward people who abuse addictive substances, as well as the internalization of that stigma by substance users, is widespread. 2% of Canadians over the age of 15 say they have suffered personal harm as a result of alcohol abuse and addiction. Access to residential treatment has not improved, with most public-access beds having wait lists of four months or more. The lack of addiction treatment in Canada has been a growing concern. The Canadian Centre for Substance Abuse, as well as grassroots treatment centers, say the demand far exceeds the ability to provide. The reality, however, is that treatment is available if one can actually afford it. More financial support is needed to help youth and young adults who are struggling with alcohol addiction in acquiring rehabilitation, detoxification, necessary medications, therapy programs, and any other health care services required to maintain optimal health.