Canada’s opioid crisis: The challenge with youth

Tucked away on a quiet road just outside of Carleton Place, Ont., is one of two Dave Smith Youth Treatment Centre (DSYTC) residential facilities.

The facility, an old red brick home, houses young men aged 13-21 living with drug and alcohol addictions. Here, they can receive anything from family counseling to academic programming while on their road to recovery.

Just a half hour drive away, in a slightly newer home, is the DSTYC’s young women’s facility. The centre helps young women, also aged 13-21, with their own struggles with addiction.

While the DSYTC’s services are extensive, the number of young clients that can benefit from their help is extremely limited. Between the two facilities, only 24 beds are available to youth, with admission waitlists that can last weeks, even months.

The demand for their services is “always higher than what our capacity is and that was always true from day one. It continues to be true and I suspect it will only grow,” says Mike Beauchesne, DSYTC’s executive director.

Youth play a significant, if overlooked, role in Canada’s ballooning opioid crisis. In the 2015 Ontario Student Drug Use and Health Survey (OSDUHS), an estimated 10 per cent of students in grades seven to 12 used opioid pain relievers without a prescription—almost 95,000 youth in Ontario alone.

Oxycodone, Codeine and Fentanyl are some of the most commonly misused opioids in Canada. Young people typically get access to these dangerous drugs by taking them from their own homes.

Opioids are dangerous—overdoses can happen after just one use, making treatment services like those offered by DSYTC essential for youth struggling with addiction. But with thousands of youth potentially in need of help, and limited services available, what does this bode for the future of opioid addicted youth?

Gaps in the system

The demand for youth addiction treatment is not an uncommon problem across Canada and sheds light on where the addiction treatment system falls short.

Extensive waitlists for residential treatment, limited community based treatment capacities and the need for more detox beds are just a few of the resources available to youth that are seriously underfunded, explains Beauchesne.

As part of Ontario’s 2016 budget, the province invested $51.8 billion in health care—nearly 42 per cent of the province’s expected total spending for that year.

Of that $51.8 billion, less than seven per cent of the province’s resources went towards mental health and addiction services.

“We know that for every dollar spent on addiction treatment results in at least four to seven dollars in savings in healthcare costs alone.”

“It’s a tremendous investment that provides great return for the community and we just need to allocate and invest more in where it’s needed,” says Beauchesne.

In the OSDUH survey, approximately 114, 600 students in grades nine to 12 reported having symptoms of a drug use problem, but only 0.6 per cent of those surveyed, an estimated 4, 200 students, had been in treatment for their substance use problems.

In the race to fill the gaps and properly allocate funding in the youth addiction treatment system, the number of youth in need but not seeking help constantly looms overhead.

“I think in the larger scale, we need to consider estimates are in the range of 10 per cent of individuals who actually require addiction treatment, reach out to receive it so even with our challenging ability to meet current demand, we’re also only dealing with the tip of the iceberg.”

Youth: Not your typical patients

Once youth have successfully been admitted into a treatment program, they present a unique set of challenges to healthcare providers.

Often, a youth’s mental health plays a large role in the development and treatment of their opioid addiction, says Benedicte Carriere, a social worker in The Royal Ottawa hospital’s regional opioid intervention service.

Typically, youth are going through challenging stages of development, both physically and mentally, which can be detrimentally impacted by substance use.

“We see a lot of young people with very complex mental health problems that require stabilization and treatment along with their substance use disorder,” explains Carriere.

According to a 2013 study, approximately three per cent of Canadian youth aged 15-24 fit the diagnostic criteria for a concurrent disorder.

“Concurrent disorders become kind of a chicken and the egg situation because the mental health symptoms aggravate the substance use problems, and the substance use problem aggravates the mental health problem,” adds Carriere.

In addition to mental health problems and their stage in development, a major challenge health practitioners face when treating youth is the nature of opioids themselves.

“Opioid use is a very high risk behaviour and so supporting youth in managing some of those risks and avoiding a lot of negative consequences as they go through treatment is challenging,” says Carriere.

“Young people tend to think, ‘Take risks and experiment,’ but these young people are just experimenting with something that’s particularly high risk.”

Not a new problem, but a changing problem

Although there’s been a growing awareness of youth drug use, it’s not a new issue in Canada.

What’s changed is the substance itself.

“Opioid use specifically has been a growing problem in youth and we’re seeing it grow exponentially over the past few years,” says Carriere. “I don’t think that we necessarily saw this level of experimentation with this high risk of a substance in the past… Certainly the risk involved has increased.”

Unlike alcohol or marijuana, the most commonly used substances among youth, one opioid use could have fatal consequences.

These consequences have shaken the Ottawa community in recent months, seeing the deaths of two youth to opioid overdoses.

As a result of these highly publicized overdoses, waitlists at the DSYTC skyrocketed, “because of increased attention to the issue,” says Beauchesne.

In their own efforts to cutback on waitlists and the shortage of spaces for youth with addictions, the DSYTC is now advocating for a new facility.

“With the new build, we’d be able to increase our capacity by six beds, so that would be a 25 per cent increase to what we provide now,” explains Beauchesne.

Six beds might not seem like a lot, but it could make all the difference for youth struggling with addiction and who manage to overcome the psychological barriers to seeking treatment.

“As we continue to work towards reducing stigma and fighting the shame, creating awareness around addiction and hopefully encouraging more and more people who need help to reach out for it, demand is only going to increase,” says Beauchesne.