Seen or Judged? How Healthcare Systems Shape Care for People Who Use Substances 

This presentation examines barriers to healthcare access for people who use substances in Canada, with a specific focus on Newfoundland and Labrador, through a trauma-informed and systems-based lens. Drawing on current overdose and hospitalization data, it highlights how stigma, bias, and healthcare workers’ attitudes shape patient experiences, influence care-seeking behaviors, and contribute to avoidable health harms. The presentation explores how systemic factors—including rurality, service fragmentation, and criminalization—intersect with provider perceptions to limit equitable access to care. Emphasis is placed on the critical role of trauma-informed, non-judgmental healthcare practices in improving trust, engagement, and health outcomes for this highly stigmatized population. 

Jane Henderson, B.A., B.Ed., M.A, (she/her) is the Provincial Harm Reduction Consultant at the Newfoundland and Labrador Centre on Substance Use within Newfoundland and Labrador Health Services (NLHS). Jane began her career working in front-line community mental health and addictions for several years and then spent six years in senior leadership positions. She manages the Provincial Naloxone Program and is responsible for assisting the five NLHS Geographic Health Zones and their surrounding communities with adopting a harm reduction approach in addictions treatment.  She has a Master's degree in Counseling Psychology and finished course work towards a Ph.D in Community Health Medicine with a focus on harm reduction, duty of care, and people with substance use disorder. Jane started a National Naloxone group, co-chairs the Provincial Harm Reduction Collective, and contributes to many committees and working groups. She has a special interest in social justice and vulnerable populations and is a strong advocate for human rights, informed decision makingand consent.