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Increase in youth opioid deaths during pandemic alarming, says report

We need to meet young people where they are at, says the Office of the Child and Youth Advocate.
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Associate Minister of Mental Health and Addictions, Jason Luan, discusses opioid use data at a press conference on Dec. 18, 2020.

There has been an alarming increase in opioid deaths among young people over the course of the pandemic, according to a recent report released by the Office of the Child and Youth Advocate.

“If we don't do something specific to young people who are going to be the adults tomorrow, we're going to continue to see young lives lost,” said Terri Pelton, executive director.

On June 16 the advocate's office released Renewed Focus: A Follow-Up Report on Youth Opioid Use in Alberta and is calling on the province to create a public body that will move forward a youth opioid and substance use strategy in Alberta.

Pelton said a youth-specific strategy is important because young people are different from adults.

“The brain is still developing until 25 and some of the research even says later. And so, a developing brain requires a different (approach). They don't have the same sense of consequences that adults do,” Pelton explained.

The new recommendation follows the 2018, Into Focus: Calling Attention to Youth Opioid Use report that came after a steady increase in accidental opioid deaths among people under the age of 24. Into Focus made five recommendations the province has been working toward but has not yet completed.

Pelton said the number of young people who died decreased after Into Focus, but those numbers spiked in 2020, with 95 youth deaths from overdoses.

The numbers for this year are potentially worse. In the first quarter of 2021, 29 young people who died from opioid use across the province. At this rate, the province could see a record number of opioid deaths among its youth.

Tracy Palmquist, director of children, youth, and families for addiction and mental health in the Edmonton zone for Alberta Health Services (AHS) said she has noticed in the clinical teams, the pandemic has seen an acceleration in opioid use.

In her work with the opioid response committee with AHS, she has seen an increased number of accidental and intentional overdoses in youth.

She hasn’t seen a noticeable increase in opioid use issues at the St. Albert clinic, something she said makes sense.

“You wouldn't present to a community clinic – you wouldn't just show up there. You're going to go to the emergency room, you're going to go into a youth detox bed, you're going to access (Protection of Children Using Drugs) PChAD. Those would be the places where we're seeing a significant increase in opioid use and methamphetamine,” she said.

Although Palmquist does not have opioid or substance use numbers specific for St. Albert, she said there has been a noticeable trend in opioid use in kids from such feeder communities as St. Albert, Sherwood Park, and Spruce Grove.

She has also noticed a trend in repeat presentations from the same youth.

“I think sometimes the complexities of treating (substance abuse) in youth are a bit challenging,” she said.

If a child is using opioids, they are not typically in school, they may have family breakdown, they might be homeless or bouncing around from place to place, and they might also have legal troubles.

However, Palmquist said, substance abuse can happen everywhere.

“I think society likes to think they're the broken kids; they're the impoverished kids; they're the rabble-rousers. It's all of that. Every kind of kid is impacted. It's two-parent homes with huge amounts of income. It’s single-parent homes. It’s grandfather's home. It's all of it,” she said.

Palmquist said the pandemic has forced AHS to evaluate and implement several changes to reduce barriers to kids.

In August 2020 they created a team that does home visits and follows youth for six months to be assertive on the therapeutic side.

“Not like demanding or, ‘We're going to lock you out,’ but more of that really assertive approach to providing support and counselling and treating-in-place, wherever that is, and where their family is,” she said.

In January, they created a program to add transportation to their services and shortened the hours of their programs.

AHS is continuing to look at making programs more seamless for youth.

"I think it's really important in (the) adolescent population that there's no disruption or fractured care planning,” she said, adding she does see hope with opioid treatment.

“If we can intervene when kids are struggling, and when they feel like they don't have hope, and we become agents of hope for them, I think what we see (is) people can get through it, struggle, and still have a really positive outcome for their life,” said Palmquist.

In an emailed response, Justin Marshall, press secretary for the associate minister of mental health and addictions, said the province made significant progress on the five recommendations from the 2018 Into Focus report.

As for the newly recommended youth panel, Marshall said as Alberta transitions to a recovery-oriented system of care, the province will include voices of youth and their families.

“Details are still being worked out, and we will have more to say about the Mental Health and Addictions Advisory Council’s work in the coming months,” Marshall said.

Lori Sigurdson, NDP Critic for Mental Health and Addictions, said she doesn’t understand how the province can say they’ve made significant progress when we are in the middle of an emergency.

“People are addicted to the substances and they need support. And certainly, I would not be saying we've had all this progress. It's just not true. People are dying. The situation is the worst than it's ever been in Alberta,” she said.

Sigurdson said Alberta needs to have an emergency plan in place and expand services across the province, including regulated and safe pharmaceutical and drug testing for street-drug toxicity.

Pelton from the advocate's office said they saw movement from the province after the initial report was released, but not enough to gain traction.

The latest report is suggesting the province consider the initial five recommendations, and that the public body be made up of people with lived experience.

They also want Alberta to address the full continuum of services, from prevention and intervention in schools, to harm reduction with intervention and post-intervention.

Pelton said there are serious issues that still need to be addressed in Alberta.

“When a young person is ready for treatment, there isn't always a bed available … They'll finish their detox and then there won't be a treatment bed for three months. And then, in that three months, they slide backwards," said Pelton. 

"There is a real need to meet young people where they're at, and when they're asking for help. Because if we can do that, we will see more success.”

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