Lessons Learned From “A Day for Youth Voices on the Opioid Overdose Crisis” and Future Directions for Research on the Youth Polysubstance Use Emergency in Canada

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Objective: Youth experiencing street-involvement are particularly vulnerable to substance use-related harms. Since an overdose public health emergency was declared in British Columbia (BC) in 2016, there have been concerted efforts to expand youth's access to integrated mental health and substance use treatment across the province. The present study sought to explore how youth were navigating this rapidly evolving treatment landscape.Methods: Focus groups were conducted with youth experiencing street-involvement in three BC cities, followed by a summit event in Vancouver. Audio recordings were transcribed verbatim and coded thematically alongside observational field notes. All activities were undertaken in collaboration with a Youth Advisory Council.Results: Across BC, youth expressed desires to achieve aspects of what some called a "normal life" following treatment, which required having "somewhere to go next." In the absence of desirable housing and adequate income, youth were often left with the crushing sense that, despite their efforts, treatment would not ultimately help them to "get somewhere better." Negative experiences in treatment settings were also shaped by the files that "followed" youth across care settings, inappropriate information sharing between providers, and an overemphasis on pharmacotherapies (namely, opioid agonist therapies and psychotropic medications). Conclusion:Our findings point to the inability of existing services and systems to address entrenched marginalization and chronic instability. Our findings also underscore the importance of relationship-, trust-, and future-building to providing treatment and care to youth. Young people must be empowered with control over their treatment trajectories, including decisionmaking surrounding pharmacotherapies and information sharing.

Section: Methodsmentioning

confidence: 99%

Navigating Treatment in the Shadow of the Overdose Crisis: Perspectives of Youth Experiencing Street-Involvement Across British Columbia

Thulien

Charlesworth

Anderson

et al. 2022

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Youth Perceptions of and Experiences With Opioids for Pain Management: Intersecting Stigmas and Ambivalence

Nairn,

Audet,

Anzarouth

et al. 2022

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Objective: There is very little in-depth qualitative research regarding youth experiences with medical use of prescription opioids and this is concerning as some youth are shown to be at risk for future nonmedical opioid use, addiction, and overdose as a result of medical use of opioids in adolescence. We sought to understand and characterize youth experiences with prescription opioids, such that researchers and healthcare professionals can improve both opioid and pain-related treatment and intervention programs for young people.Methods: We recruited participants through postering and television advertisements from the Emergency, Orthopedics, Dental, and Oncology/Hematology departments at a local children's hospital. We performed 3 focus groups, 5 in-depth interviews and one youth summit (n = 11 youth) for a total of 25 youth who had experience with prescription opioids. The results were analyzed using a thematic analysis approach.Results: The participants were heterogeneous and were youth who had been prescribed opioids due to surgery for scoliosis, cancer, brain surgery, dialysis, and other acute injuries. Youth simultaneously emphasized the positive (eg, to improve physiological functioning and to cope with mental (emotional) struggles related to their conditions in some instances) and negative effects of opioids (eg, adverse side effects and concerns about whether opioid use was related to other psychological struggles). The experience of ambivalence coincided with youth experience of intersecting stigma(s) related to their physiological conditions and their use of opioids. Youth discussed several solutions for how to improve youth-provider interactions in the context of these experiences and perceptions. Conclusion:Youth encounter a dearth of nuanced information about opioids during illness experiences and recovery and the experience of opioid-related ambivalence may be compounded by the everyday struggles associated with their conditions including intersecting prejudicial attitudes and stigmatization. Consistent with an interdisciplinary approach to prescription opioid use and pain rehabilitation, service providers could consider engaging in nuanced, empathetic, and empowering discussions with youth and provide alternatives or adjuncts to opioids for pain management.

“There's No Supports for People in Addiction, But There's No Supports for Everyone Else Around Them as Well”: A Qualitative Study With Parents and Other Family Members Supporting Youth and Young Adults

Khan

Lynn

Porter

et al. 2022

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Objectives: Harms from opioid use and opioid-related overdose death have continued to rise in Western Canada, constituting a public health emergency. While the presence of family support is essential to improving health outcomes for people who use drugs, affected family members continue to face considerable challenges in accessing timely and appropriate supports and services, both for their loved ones, and for themselves when needed. The overarching aim of our qualitative project was to employ qualitative methodology to understand family experiences with healthcare and treatment services when supporting a young person seeking treatment for use of opioids and/or other substance use.Methods: To understand the family experience of providing support for a youth or young adult who has experienced harms from opioids and other co-occurring substance use interviews (n = 17) were carried out in Alberta, Manitoba, and Saskatchewan, with adult family members (mostly mothers; 12/17) of youth and young adults who had experienced harms due to opioids and other substance use, including overdose death. Qualitative interview data was analyzed using Reflexive Thematic Analysis to distill themes.Results: We identified the following key themes from our analysis: (1) The challenges and stigma encountered when seeking care for a loved one using substances, and (2) The lack of support to address family member mental health needs. In addition to access and system navigation