Intervening early to prevent and treat substance use disorders among vulnerable Canadian youth ages 14-18 (a critical period of neurodevelopment) is essential to reducing harms, including the long-term consequences of substance use disorders for development and social functioning. Evidence-informed substance use services are the cornerstone of the response to substance use among youth. Research suggests that the sooner substance use treatment is initiated, the shorter the duration and impact of substance use disorders. However, numerous distinct gaps and barriers exist in the provision of addiction services for youth, which for vulnerable, street-involved youth are often compounded by complex institutional trajectories that include pediatric care, mental health care, foster care, criminal justice and frontline service (e.g., shelter) systems.

The Care Pathways Study focuses on the experiences of younger youth (ages 14-18) as they simultaneously navigate multiple systems of care and supervision, including the substance use service, criminal justice, government care, and mental health care systems. Through interviews and ethnographic fieldwork, we are documenting the evolving experiences of these young people and their service providers over time. As with the Treatment Trajectories Study, our goal is to create new knowledge that can directly inform ongoing efforts to deliver innovative substance use services to youth across Greater Vancouver.


The objectives of the study are to:

  1. Characterize the individual, social, structural and environmental contexts that shape youth’s engagement with various addiction services, including harm reduction services, residential detoxification and treatment, outpatient psychosocial programs, and opioid agonist treatment (OAT);
  2. Describe how youth’s engagement with addiction services are shaped by responses from the other systems in which they are immersed, including the primary pediatric care, mental health care, foster care, criminal justice and frontline service systems; and
  3. Identify critical gaps and opportunities for improvement in the delivery of addiction services for vulnerable youth, and their onward impact on key health outcomes (e.g., overdose, remission of substance use disorders).


This study is co-led by Family Services of Greater Vancouver-Directions Youth Services.
Throughout all stages of the research, are working closely with the At-Risk Youth Study (ARYS) Peer Research Team and Youth Advisory Council.

Our other partners include:

  • Vancouver Coastal Health Authority
  • Urban Native Youth Association (UNYA)
  • YouthCO HIV and Hepatitis C Society


  • Canadian Institutes of Health Research
  • SickKids Foundation
  • Vancouver Foundation

Interested in finding out more about the Care Pathways Study?

Please contact Danya Fast at [email protected].

BC Centre on Substance Use

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E: [email protected] | T: (778) 945-7616 | F: (604) 428-5183

24/7 Addiction Clinician Support Line: (778) 945-7619

Online Addiction Medicine Diploma: [email protected].

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