Both the direct effects of substance use and poor general health are driven by socioeconomic 3 https://www.nhstayside.scot.nhs.uk/OurServicesA-Z/PublicHealth/PROD_213564/index.htm 19 CJ/S6/24/16/1 HSCS/S6/24/14/1 SJSS/S6/24/13/1 inequalities, poor living conditions, smoking and multi-factorial challenges in optimising management of chronic conditions.