Adequate support needed to address Canada's rising youth opioid use

Youth opioid use is increasing in Canada, as are related emergency department visits and deaths, yet governments are not providing adequate support to address this public health crisis, argue the authors of a CMAJ (Canadian Medical Association Journal) editorial https://www.cmaj.ca/lookup/doi/10.1503/cmaj.251682.

"If this crisis is not properly addressed now, Canada's health systems will play a part in perpetuating the opioid crisis for decades to come," write Dr. Shannon Charlebois, medical editor, CMAJ, and Dr. Shawn Kelly, a pediatrician and addictions medicine specialist, CHEO and the University of Ottawa, Ottawa, Ontario.

In Ontario, students' use of prescription opioid pain relievers for nonmedical reasons increased significantly from 12.7% in 2021 to 21.8% in 2023. Students in younger grades (7 to 9) were more likely to report use than older high school students (grades 10 to 12). Youth aged 15 to 24 made up 9% of emergency department visits in Ontario for opioid use, and opioid-related deaths increased 369.2% from 2.6 to 12.2 per 100 000 population from 2013 to 2021.

Paradoxically, youth struggle to access opioid agonist therapy, with evidence showing that fewer prescriptions are written even as the need increases. Other effective treatments, such psychological therapy and substance use disorder programs, are sparse, have long wait-lists, and are often privately funded, making them inaccessible to those most at risk.

"Health systems' inaction and lack of investment to provide evidence-based addictions services for youth is inexcusable, as the opioid crisis involves this population. Physicians who treat youth need support to be able to care for their patients with OUD [opioid use disorder]. Anything less represents complicity in the next decade of preventable deaths," they conclude.