More young people are dying of overdoses in Canada

Harm reduction advocates in Canada say supervised drug consumption facilities tailored to youth are needed to address the growing number of young people who are overdosing as the country deals with a tainted illicit drug supply.

And they’re urging healthcare initiatives to focus less on abstinence-based treatments, which have been shown to be ineffective in many cases, or even harmful.

According to a new report from British Columbia’s children’s watchdog, 24 youth in the province between the ages of 10 and 18 died of illicit drug overdoses in 2017 — twice the number of youth who died of an overdose the previous year. The children’s watchdog also received 154 substance-related critical injury reports in 2017, nearly twice the amount received by the office in 2016.

B.C. has been grappling with the highest rate of opioid overdoses in the country, and in 2016 the provincial government declared a public health emergency over the situation. There were 1,452 overdose deaths in B.C. in 2017, and around 4,000 opioid-related overdose deaths in all of Canada that same year.

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The youth data shows that new solutions must be pursued, according to Jennifer Charlesworth, the B.C. children’s advocate. Among other measures, she is calling for youth-specific supervised drug consumption facilities — a proposal she acknowledged would receive pushback.

“But the reality is that these young people are using substances, and it’s our responsibility to do everything in our power to make sure that they are safe,” Charlesworth told The Globe and Mail. She also pointed out the need for youth to have better access to clean harm reduction supplies such as pipes and clean syringes.

Charlesworth’s calls are being echoed by addictions and drug policy experts in other provinces, who say perspectives from youth who use drugs are typically ignored in conversations around the implementation of services for them.

Services are typically not youth-friendly or youth-centred, and they really push things like mandatory treatment, which is based on this idea of abstinence and forced treatment, "which we know doesn’t work for adults,” Rebecca Haines-Saah, a public health researcher at the University of Calgary who specializes in harm reduction, told VICE News.

“We think of minors as vulnerable and in need of protection.” And while this is true, she added, “we need spectrum of services to keep them alive.”

There has also been a steady increase in the number of young people who have died of opioid overdoses in Haines-Saah's home province of Alberta.

Numbers from the Alberta health ministry show that 10 teens between the ages of 15 and 19 and 57 youth from 20 to 24 years old died of an opioid overdose in 2016. The number of teens from 15 to 19 who died doubled in 2017, and the number of deaths among 20 to 24-year-olds increased from 57 to 64.

The ministry provided VICE News with youth opioid overdose death numbers up until June of this year that show such deaths are roughly on par with last year at nine deaths among youth from 15 to 19 years old, and 32 deaths among 20 to 24-year-olds.

Earlier this year, the Alberta children’s advocate released its own report into the deaths of 12 young people who died from opioid poisoning. Each of these youth, ranging in age from 15 to 19 years old, were involved with the child services system in some way around the time of their death.

The rising rates of youth overdose is not a Canadian specific problem — the U.S. has seen drug overdose death rates among youth between the ages of 15 and 24 years old rise by 36 percent over the last decade, according to data from the Centers for Disease Control. A recent report out of the U.K. also found a sharp rise in overdoses among youth particularly involving antidepressants and painkillers, something it linked to feelings of distress and anxiety among youth in England between the ages of 10 and 25.

Both the B.C. and Alberta children’s advocate reports found an overarching theme of trauma and mental health issues among young people it studied. And both urge government healthcare services to prioritize a harm reduction approach, rather than an abstinence-based approach.

“There are young people who may not be ready or willing to stop using substances,” the Alberta report states. “They may connect better with outreach teams and benefit from harm reduction approaches, which are practical ideas aimed at reducing negative consequences associated with high risk lifestyles and open doors to help people become as safe as possible."

Haines-Saah and the B.C. children’s advocate urge services for youth to move beyond the typical mandatory abstinence-based options, as evidence shows them to be ineffective, or even detrimental, for people with addictions.

“Many people believe that all youth who use substances in ways that put them at serious risk should be in treatment to address their substance use issues and be in drug-free environments,” the B.C. report continues. “Yet it is a reality that many youth are not ready for treatment or abstinence programs, and until such time as they are ready, they need to be safe. The evidence gathered for this report points to the vital importance of positive relationships with caring adults who can help youth to become more open to change.”

A spokesperson for Ontario’s child advocate told VICE News in an email that it is “currently not tracking overdose deaths.” The Ontario government announced last week that it was shuttering the child advocate’s office and folding the responsibilities another department.

Data for Ontario shows that opioid-related overdose death rates among youth up to the age of 24 has been increasing over the last few years, so too have opioid-related emergency room visits and hospitalizations. Last year saw the highest opioid overdose rates yet in the province with more than 1,200 deaths, up from 867 in 2016.

Last year also saw a striking increase in opioid-related deaths among youth in two age brackets: 6 cases in youth up to 14 years old, and 117 among youth from 15 to 24 years old, up from 70 in 2016. And opioid-related emergency room visits saw the biggest jump over the last year for youth between 15 and 24 years old: from 702 in 2016 to 1,185 last year. Emergency room visits for youth up to 14 years old declined from 88 in 2016 to 78 last year.

Cover image of supervised injection site in Vancouver, BC. Jackie/VICE News.