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Canadian Centre on Substance Use and Addiction

Improving Treatment Together Project

In Canada, substance use treatment for youth has failed to keep pace with the evidence. Young people aged 15 to 24 living in Canada are the fastest-growing population requiring hospital care from opioid overdoses. 94% of opioid overdose deaths happen by accident — many because street drugs in Canada have become tainted with powerful opioids such as fentanyl.

There is a clear need for treatment services that are accessible, appropriate and responsive to the needs of youth suffering from opioid use disorders. The purpose of the Improving Treatment Together (ITT) program is to improve the experiences and outcomes of substance use services in the local community for young people who use opioids.

The ITT project follows a community-based participatory and co-design process. Since 2018, CCSA has partnered with eight community organizations in British Columbia and Alberta to work with youth, families and service providers impacted by youth opioid use to understand their needs and co-design resources to improve treatment services. Our community partners in British Columbia are the Foundry centres in Victoria, Prince George, Vancouver-Granville and Kelowna. Our four partners in Alberta Health Services are the Virtual Opioid Dependency Program, the Calgary Opioid Dependency Program, Child and Adolescent Addiction and Mental Health Services, North Zone, and Child, Youth and Families Addiction and Mental Health Services, Lethbridge.   

The process the project follows has three distinct phases.

In phase 1, we collaborated with our community partners to host stakeholder workshops to understand the experiences and needs of young people, parents and caregivers accessing treatment services and service providers delivering them. We then brainstormed solutions and designed prototypes that could address the root causes of opioid disorders as defined by these populations. 

We are currently in phase 2 of the project. During this phase we are working with our community partners to develop prototype ideas that came directly from the community workshops. 

Phase 3 includes implementing and evaluating each prototype at the community level. 

The following initiatives are part of the ITT project.

Parents Like Us. The Unofficial Survival Guide to Parenting a Young Person with A Substance Use Disorder is a support resource for parents dealing with a young person who has a substance use disorder. A group of twelve parents in Victoria, British Columbia, created the handbook in partnership with CCSA and Foundry Victoria. It is intended improve the experiences and outcomes of community-based services for young people who use substances, their families and service providers. 

The handbook is a collection of shared experiences and stories to help other parents and caregivers find refuge, support and courage to reach out for help. Whether your young person is experimenting with substances or has developed a substance use disorder, this handbook can help you feel connected with other parents and caregivers going through similar experiences. 

CCSA is developing a manual that provides step-by-step instructions on how an individual or group can create a similar handbook for their community. If you want a copy of the manual, please let us know at

Our Alberta youth workshops felt there were a lack of positive stories in the public domain that feature young people doing well dealing with an opioid use disorder. The youth we spoke with reflected that most stories in the media deal with fatal overdoses and systemic failures. They identified a need for stories of hope showcasing the real experiences of youth. The youth from our workshops also wanted to show their involvement in projects like ITT as a way for young people to positively influence service delivery.

The youth, with the assistance of a professional storyteller, worked for six weeks to develop their stories around their lived and living experience with opioid use. The youth then created their own videos to effectively tell their story of how they achieved wellness and what worked for them on their journey.

Alberta Health and Wellness has released the first set of Real stories from youth. These stories:

  • Cover opioid use and opioid use disorder treatment options;
  • Explain why young people might use opioids;
  • Fight stigma around opioid use;
  • Help encourage youth to get help for opioid use; and
  • Show there is hope for treatment and recovery.

One of the videos has been featured in Frayme’s Great Big Stories virtual gallery. CCSA was one of ten organizations chosen by Frayme to capture and tell stories of youth and caregiver equity, while including the creation, design and refinement of youth mental heath and substance use programs and services.

CCSA is developing an interactive simulation of what it is like for a youth to be engaged in opioid use or have an opioid use disorder. The simulation also looks at the impact of the youth’s disorder on their family, trying to access services and effects of stigma on youth with opioid use disorder.

The simulation will allow the user to experience it in both a rural and an urban setting. The characteristics of each setting will have an impact on the types of choices available. We expect to release the simulation in 2022.

The Youth Informed Guide to Opioid Agonist Treatment is an animated, short, lived-experience video series about a young person’s everyday experience with opioid agonist treatment (OAT) as part of a treatment program. The animated series will explore the OAT process to demystify and destigmatize it, and to increase confidence for youth considering or starting OAT.
The series will feature:

  • Descriptions of the different types of medications available to youth in British Columbia;
  • Lived experiences from young people on what it’s like to get access to OAT, what a typical day is like for someone receiving OAT, and its benefits and side effects; and
  • Authentic and relatable information about OAT.

The Youth Informed Guide to OAT video series will be released in the summer of 2022.

In collaboration with Foundry Prince George, CCSA is developing a youth inclusion tool for health and social organizations that serve young people. The tool will support organizations in an ongoing learning process to improve youth service experiences by providing insight on their strengths and helping identify feasible solutions to address their weaker areas. The tool will help organizations assess their status in four areas:

  • Accessibility: how accessible is the service for young people, including hours of operation, affordability and the ageing out process.
  • Service environment: how welcoming and comfortable is the service environment, including inclusivity and diversity and whether the organization meets young people’s basic needs.
  • Quality of service: including whether the organization applies a patient-centred approach, respects young people’s rights to privacy and confidentiality, and is responsive to youth feedback.
  • Continuity of care: including whether the organization is well connected to other services in the community that serve youth who use substances

The tool comes with a list of youth-informed recommendations to address each assessment question, a list of youth services to improve youth and service provider awareness of local services, and a question sheet that includes questions young people may want to ask their service providers when accessing substance use services. The tool will be of interest to:

  • Substance use service providers
  • Mental health service providers
  • Youth treatment service providers
  • Harm reduction service providers
  • Youth shelters
  • Community health centres
  • Social services
  • Hospitals
  • Emergency departments

The youth inclusion tool is scheduled for release in the spring of 2022.

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