Wednesday, September 06, 2023

Pediatricians call youth overdoses a public health emergency. What will end it?

Story by Naomi Barghiel • GLOBAL NEWS

The Alberta government is taking steps to prevent and reduce tobacco use among underage youth and limit children’s exposure to second-hand smoke.© Spencer Platt/Getty Images

Most parents assume substance addiction and overdoseing isn’t an immediate threat to their children, says Drug Free Kids Canada (DFKC) executive director Chantal Vallerand, but studies pointing to a growing crisis say otherwise.

As students prepare to go back to school -- where peer influence is highly prevalent -- prevention organizations are urging parents, caregivers and schools to take action against the rising risk of substance abuse to youth.

“Parents don’t think their kids are at risk. It’s always somebody else’s kid. But it’s more important than ever to take preventative measures,” Vallerand told Global News.

A report by the 2022 Canadian Paediatric Surveillance Program (CPSP) surveying 1,000 pediatricians has called drug overdoses among children and teens a public health emergency.

The number of youth suffering from severe, life-threatening overdose is increasing and has become the leading cause of death in children 10 to 18 years of age in Western Canada, the report says.

Stimulant overdose was the most commonly reported, followed by sedatives, then opioid overdoses.

A survey by DFKC found that only 11 per cent of Ontario high-schoolers admitted to using opioids or prescription drugs for recreational use, but Vallerand warns there is still a high risk.

“It’s not the vast majority, it’s not the substance of choice for initiation… but things could still turn up bad like the stats we’re seeing on overdosing,” Vallerand said.

Vallerand says parents or any trusted adults that have a relationship with a child, play an essential role in limiting the risk of harm to youth when it comes to substance use.

DFKC’s annual tracking study surveys parents and children separately. Each year kids have listed their parents as their most reliable source of information, followed by school and then peers.
‘Just say no’ approach is outdated, say experts

Vallerand says the “just say no” lecture approach to educating youth on substance use is outdated, as it is anchored in the belief of abstinence as a solution.

Instead, DFKC aims to help educate and empower parents to normalize the conversation, she says.

“We’re proposing for parents to have early discussions, informed discussions, approaching it with curiosity as opposed to lecturing a kid,” Vallerand said.

Vallerand adds that while she is all for supporting youth who are already suffering from addiction, prevention is important.

“Let’s make sure we equip kids to make informed decisions about their health. When they go to a party and they’re being offered whatever drug, you want them to make the best decisions for themselves,” she said.

“It’s not easy, it can be intimidating, but we really encourage parents to start the conversation early.”

Video: Why early intervention in youth mental health is important, according to expert

This year’s tracking survey also found that 49 per cent of kids who admitted to using prescription drugs recreationally got them from home.

As part of National Drug Drop-Off month during August, DFKC encouraged parents to limit accessibility to prescription drugs at home, making sure they are safely stored or disposed of if no longer needed. Safe disposal means bringing drugs back to the pharmacy, for example, rather than throwing them in the toilet or garbage.

Another reliable source of information on substance use are schools. D.A.R.E. (Drug Abuse Resistance Education) originated in 1983 and offers schools around the world curriculums that aim to provide kids with the skills they need to live healthy and safe lives.

One ten-week program offered in Canada and internationally is keepin’ it REAL, taught by law enforcement officers rather than teachers. It covers problem solving, risk, peer pressure, bullying and stress.

“It’s very much about empowering young people to use their brain, to educate themselves, to become more confident… more resilient, so that when… there’s peer pressure for them to do something or try a drug, they have more confidence and more skills to resist,” Shawn Evans, retired Ontario Provincial Police (OPP) officer and member of D.A.R.E Canada, told Global News.

A three-year, multi-longitudinal study of D.A.R.E.’s keepin’ it REAL program by UNC Greensboro and Prevention Strategies found statistically significant reductions in the prevalence of alcohol consumption, cigarette smoking and vaping among students who received the program. It was entirely successful in preventing marijuana use, the report found.

ABC’s of Youth Substance Use is another project aiming to build up the capacity of adults around young people.

The initiative is funded by the government of British Columbia and promotes evidence-based approaches to youth substance use education in B.C. schools.

The ABCs refers to Autonomy, Belonging and Competencies. According to Ash Amlani who co-leads the program, the ABCs are essential stepping stones to promoting youth wellbeing, preventing, delaying and reducing harms related to substance use.

“A lot of our focus and attention on the ABCs is really on all of the adults in the school building, as well as the administrators that are surrounding and supporting youth as they grow older,” Amlani told Global News.

One way the project supports schools is by giving them the ability to refer parents with tools and resources on youth substance use.

“Sometimes the folks in the school building become the bridge between the two systems,” said Amlani, who is also the former harm reduction epidemiologist for the B.C. Centre for Disease Control.

“A lot of times teachers or principals are called on to support parents (by) talking to parents about what’s happening with their child,” she said.

Video: Program launched in Richmond to help at-risk youth receive support

Amlani echoed Vallerand’s sentiments on the “just say no” tactic for substance use discussions, saying it limits the conversation.

“When you just say no, well, what if I’m in an environment when someone else has said yes? What do I do in that situation? So we want to create that sense of safety. Being able to have those open, candid conversations (is part of that),” she said.
What is causing youth to seek substances?

Amlani says sometimes substance use is introduced as a coping mechanism for some young people. While substances aren’t often the first thing they go to, for some it becomes a critical part of coping.

“Post-COVID I would say this is a very common experience. Youth have really struggled with their mental health. Some experience social anxiety… sleep patterns have been very disrupted. So there’s lots of things that youth are dealing with,” Amlani said.

In a 2022 study by the Canadian Centre on Substance Use and Addiction (CCSUA), only one in four youth between the ages of 16 and 24 reported having excellent or very good mental health

Fifty-one per cent of participants reported problematic cannabis use. 37 per cent reported increased alcohol use.

Wellstream is another initiative investigating how to better support youth substance use through the school system.

Based in B.C., and part of the Canadian Centre for Innovation in Child and Youth Mental Health and Substance Use, the initiative launched as a response to the need for research and programming aimed at addressing the upstream issues that affect mental health and substance use for kids.

Dr. Emily Jenkins is the head of research for Wellstream. She says there have been a number of initiatives to address the crisis of overdosing as the leading cause of death among young people in B.C., but other interventions that “span the whole spectrum of substance use” are missing. That includes initiatives aimed at mitigating crimes and preventing the early onset of substance use.

Jenkins notes that a large portion of the youth who died in B.C. due to overdose in the last few years had involvement with the child welfare system.

“What that tells us is that this issue is particularly concentrated among youth who experience or have histories of trauma, of violence, poverty, of racism, the complex relationships between these issues,” Jenkins told Global News.

“In order to help address where the need is concentrated, we need to have approaches that are really responsive to the underlying issues that are influencing substance use,” she said.

Jenkins says treatment beds are important, but it’s also essential to pay attention to how governments provide safe and secure housing and opportunities for education and meaningful employment.

“Without doing that, we’re going to continue to be chasing this problem, which is not an okay solution,” she said.

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