Providing compassionate care to young people who use substances

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SHOW NOTES
 

Summary

Young people are the fastest-growing age demographic for hospitalizations due to opioid poisoning in Canada. In British Columbia, more than 1000 youth between the ages of 10 and 29 have died of overdose since a public health emergency was declared in 2016.

This episode of Addiction Practice Pod focuses on caring for youth who use substances. Addiction physician Dr. Christy Sutherland, journalist David Ball and their guests discuss the unique needs of this population and best practice for providing compassionate, evidence-based care for opioid use in young people.
 

Lineup

In this episode, you’ll hear:

• 3:22 – Leslie Mcbain – Founder of Moms Stop the Harm, and Family Engagement Lead at the BC Centre on Substance Use
• 8:20 – Haileigh Anderson – Peer Research Associate with the At-Risk Youth Study (ARYS), BC Centre on Substance Use
• 16:00 – Gwen Lister – Social worker with AIDS Vancouver

 
Pearls 

Here’s what listeners can take away from this episode:

1. Social support is so often an important part of people’s journey through substance use disorder. When it’s appropriate, and with the permission of the youth, you can involve family. Think about safety –  is this person safer from overdose or harm with their family involved? Confidentiality is part of our duty as clinicians. If you can’t discuss specific clinical issues with a patient’s family, you can still provide them with resources, support, and education without breaking patient confidentiality.
2. When making up a clinical plan for young patients, understand the context of their life. Do they have a strong social network? What is the context of their drug use — why do they use? If they are street-involved, find ways to help reduce harm by recommending and helping them to access resources in the community.  Address and optimize mental health, housing, supports, money, and goals alongside treating substance use.
3. Treating opioid use disorder in youth has many similarities to the adult population, but there are some subtleties to consider. These are discussed in the youth supplement to the Clinical Guideline on Opioid Use Disorder Management. Read it here: https://www.bccsu.ca/wp-content/uploads/2018/06/OUD-Youth.pdf
4. When working with young people, be candid, sincere, and caring with your approach. Be transparent with your thinking: “Here is what I’m thinking for your options and why”. Listen to what these patients have to say, and let them take an active role in decision-making for their health. Youth can really tell when you fake it; and when you’re faced with a lot of judgement, it’s harder to seek help, let alone return for follow-up treatment.

 
Resources

Organizations

• Moms Stop The Harm
• AIDS Vancouver
• At-Risk Youth Study

Online Learning

• BC ECHO on Substance Use (Online, interactive sessions delivered via Zoom with didactic and case-based portions; currently offering an Opioid Use Disorder series and Alcohol Use Disorder series)
• BCCSU’s Provincial Opioid Addiction Treatment Support Program (Online, self-paced, free) — See Unit 20, Youth with Opioid Use Disorder
• BCCSU’s Addiction Care and Treatment Online Certificate (Online, self-paced, free)

Guidance

• BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder [Internet]. 2017.
• BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder — Youth Supplement [Internet]. 2018.
• BC Centre on Substance Use. A Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder [Internet]. 2020.

Articles

• Chang, DC, Rieb, L, Nosova, E, Liu, Y, Kerr, T, DeBeck, K. Hospitalization among street-involved youth who use illicit drugs in Vancouver, Canada: A longitudinal analysis. Harm Reduct J. 2018 Mar;15(14).
• Fast D, Kerr T, Wood E, Small W. The multiple truths about crystal meth among young people entrenched in an urban drug scene: a longitudinal ethnographic investigation. Soc Sci Med. 2014;110:41-48.
• Giang, V, Thulien, M, McNeil, R, Sedgemore, K, Anderson, H, Fast, D. Opioid agonist therapy trajectories among street entrenched youth in the context of a public health crisis. SSM Popul Health. 2020 Jun;11.

Other

• BC Centre on Substance Use. Opioids: A survivor’s guide [Internet].  Vancouver: BCCSU; 2019.
• The BCCSU has an online repository of resources for families, caregivers and loved ones of people who use drugs.

Episode cover photo by Ted McGrath on Flickr, used under a Creative Commons license