Youth Voices on Treatment in the Shadow of the Overdose Crisis

Key recommendations and findings for care providers


The overdose crisis in British Columbia is having devastating effects on youth and their loved ones. Since an official public health emergency was declared in B.C. in April 2016, over 9,000 people, including over 1,600 young people under 30 years of age, have lost their lives to overdose in the province. Youth experiencing street involvement (i.e., those experiencing street-based homelessness or unstable housing) are particularly vulnerable to overdose in
this setting.

Who this is for

This report provides guidance and recommendations for those caring for young people experiencing street involvement, to help care providers foster more constructive relationships built on mutual trust and respect.

It draws from a series of qualitative research studies conducted with youth experiencing street involvement on the unceded, ancestral and occupied territories of the Lheidli T’enneh, Syilx Okanagan, Musqueam, Squamish, and Tsleil-Waututh Peoples. These places are also known as Prince George, Kelowna, and Vancouver.

Key Recommendations & Findings

Who We Are

We are a group of academic and community researchers and activists working in Vancouver, Canada. Many of us identify as youth with lived and living experience of substance use and mental health concerns in the context of unstable housing and homelessness.

The members of our team’s Youth Advisory Council (YAC), and the youth who participated in the qualitative interviews, focus groups, and summit event that inform this report, represent a diverse group of men, women, and trans and non-binary individuals between the ages of 14 and 28. Those who chose to disclose their ethnicity self-identified as white, Indigenous, African Canadian, Middle Eastern, Asian, and mixed.

All participants self-identified as having past or current experience with substance use in the context of street involvement. The vast majority had also experienced concurrent mental health concerns. They were recruited from drop-in centres, shelters, and other services dedicated to youth experiencing street involvement, and from the At-Risk-Youth Study (ARYS), a prospective cohort of more than 1,000 street involved young people who use drugs in Greater Vancouver. Interviews with youth-focused care providers have also informed this report. These providers include family physicians, nurse practitioners, nurses, drug and alcohol counselors, and social workers.

While youth participants were diverse, many expressed similar desires for their futures. They told us they longed to move into stable housing that was safe, comfortable, and clean. They spoke about securing a reliable and adequate source of income, preferably via employment. They wanted meaningful ways to fill their days, such as spending time with friends, family and romantic partners, pursuing hobbies and leisure activities, working on school, and advancing a career.

Though some youth critiqued the phrase, many spoke about these goals and aspirations as longing for aspects of a “normal life,” and recalled hopes that substance use and mental health treatment might be a way to achieve this. However, 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.”

Copyright © 2021, BC Centre on Substance Use

400-1045 Howe St, Vancouver, BC V6Z 2A9

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].