Care providers have new tools to address challenges of treating youth with opioid addiction
published on June 13, 2018
Treatment guidelines released today will give care providers new evidence-based tools for supporting youth with opioid addiction.
The guidelines, developed by the BC Centre on Substance Use (BCCSU) with a provincial committee of health systems partners and representatives of community and family groups, provide recommendations and care principles for youth. Treating youth with opioid addiction has been challenging due to the absence of evidence-based guidelines and scarcity of youth-focused treatment resources. Those challenges can have severe consequences, as youth and young adults aged 10-24 have accounted for one-fifth of all illicit opioid overdose deaths in British Columbia.
“We are working to ensure that all British Columbians, especially youth, have the ability to access the treatment and care they urgently need when they need it,” said Judy Darcy, Minister of Mental Health and Addictions. “These guidelines will support young British Columbians by making sure that treatment is appropriate and consistent, and help them start on a pathway to hope and healing.”
The new guidelines are a supplement to the provincial guidelines for treating opioid addiction developed by the BCCSU and Ministry of Health, released in June 2017. The new youth-focused recommendations emphasize that treatment approaches for youth should be developmentally appropriate, youth-centred, trauma-informed, culturally appropriate, confidential, and encourage the youth to consent to involve their personally identified support systems when appropriate.
“Preventing opioid-related deaths is critical,” said Minister of Children and Family Development Katrine Conroy. “Front-line workers will be able to use these new guidelines to better support youth to overcome their substance-use challenges.”
Psychosocial treatment interventions such as counseling and other supports should be routinely offered to all, as should the full-range of available medical treatments (known as opioid agonist treatment, or OAT), with buprenorphine/naloxone recommended as the first-line treatment for both youth and adults.
“Primary care providers have long grappled with how to make evidence-based decisions when treating youth with opioid use disorder,” says Dr. Sharon Vipler, a general practitioner, with a specialization in addiction medicine, with Providence Health Care and Fraser Health Authority, and the guideline development committee co-chair. “My hope is that these new guidelines will help build confidence so health care providers can assist their patients and intervene with appropriate treatment and care.”
Youth with opioid addiction face multiple challenges, and patient engagement for health care providers can be challenging as well. Treatment for youth should be flexible, low-barrier, developmentally appropriate, youth-centered, and include family involvement when appropriate. The guidelines recommend that youth be offered services that offer a combination of pharmacological treatments and psychosocial treatment interventions, supports, and long-term recovery planning.
Additionally, the new guidelines also recommend that young adults continue to receive youth-oriented care and transition into adult-oriented care rather than aging out at age 19 (or younger) to ensure continuity of care. The guideline emphasizes that special attention and care planning is required for older youth when transitioning between services and into adult-oriented care.
“Youth often feel labeled, misdiagnosed, or disrespected, leading to further traumatization and disengagement from care,” said Cheyenne Johnson, Director of Clinical Activities and Development at BCCSU. “Taking a non-judgmental, culturally safe and youth-focused approach is especially important during a first encounter with a young person. This can help establish the trust that is critical to keeping them engaged in harm reduction, treatment and recovery supports to access care across the full continuum.”
The guidelines also highlight opportunities for further research, including the impact of substance use on brain development in adolescence, effective early intervention strategies; factors that increase treatment retention in youth, and recovery-oriented systems of care for youth.
For the new guideline, Treating Opioid Use Disorder During Pregnancy: Guideline Supplement, visit: http://www.bccsu.ca/oud-youth
To learn more about the BC Centre on Substance Use (BCCSU), visit: http://www.bccsu.ca
For more about preventing overdoses, visit: https://www.health.gov.bc.ca/stopoverdosebc/
Ministry of Mental Health and Addictions
BC Centre on Substance Use
Kevin Hollett, Communications Lead