This research describes the work of one Tasmanian organisation, Anglicare Tasmania, with people who have substance use issues but who are using services outside the specialist Alcohol and Other Drug (AOD) sector. Workers reported struggling to provide an effective response, did not necessarily have appropriate training, and lacked access to specialist service and accommodation options. Many of the service users did not regard their substance use as a problem or were not ‘ready’ to make a change. These findings raise questions about the most effective mix of specialist AOD and other community support services.