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 Improving Treatment Together (ITT) Project is designed to improve the experiences and outcomes of substance use services in the local community for young people who use opioids.
Between 2018 and 2023, the Canadian Centre on Substance Use and Addiction (CCSA) partnered with eight community organizations in British Columbia and Alberta to work with youth, families and service providers affected by youth opioid use to understand their needs and co-design resources to improve treatment services. Our community partners in British Columbia included the Foundry centres in Victoria, Prince George, Vancouver-Granville and Kelowna. Our partners in Alberta Health Services included 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 ITT project followed a community-based participatory and co-design process with 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 the 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.
- During phase 2, we worked with our community partners to develop prototype ideas that came directly from the community workshops.
- Phase 3 included implementing and evaluating each prototype at the community level.
The initiatives described in the tabs below highlight the final products of the ITT project.
Parent Handbook
Parents Like Us. The Unofficial Survival Guide to Parenting a Young Person with a Substance Use Disorder is a support resource for parents. A group of 12 parents in Victoria, B. C., created the handbook in partnership with CCSA, Foundry Central Office and Foundry Victoria. The handbook is intended to help families deal with the complexities of parenting a young person with a substance use disorder and improve access to community-based services.
The handbook is a collection of shared experiences and stories to help other parents and caregivers find 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.
Adaption Toolkit
We wanted to spread the reach of the Parents Like Us handbook after seeing the affect it had in Victoria.
As a pilot project, CCSA partnered with the Sault Ste. Marie Hospital to adapt this handbook for the needs of parents and caregivers in their Ontario region.
Using the Victoria and Sault Ste Marie experiences as a guide, we developed the adaption toolkit. The toolkit offers communities the processes, considerations and resources they need to create their own adapted version of the handbook.
Youth Stories
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 the workshops also wanted to show their involvement in projects like Improving Treatment Together as a way for young people to positively influence service delivery.
The youth worked for six weeks with the assistance of a professional storyteller 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.
Simulation
NOTE: For a seamless experience, the simulation should be viewed using the latest versions of the Chrome, Firefox, Edge or Safari web browsers.
Crossroads to Compassion is an interactive simulation story based on the experiences of young people who use opioids. It was created in partnership between CCSA and Alberta Health Services. It is accompanied by a facilitator’s guide to help organizations and educators engage participants in meaningful conversations using the Crossroads to Compassion resource as a learning tool. There is also a podcast segment, which includes interview audio from youth with living experience of opioid use, a family member and a front-line paramedic as they describe their perspectives on the opioid crisis in their communities.
The intention of the simulation is to encourage participants to reflect on and discuss what the characters in the story may be experiencing by walking in their shoes. This is done through the participant making choices for the characters based on what they feel they would do if they were in the same situation.
The goal is to normalize conversations about substance use health and ultimately reduce the stigma faced by people who use substances.
Although the stories and characters are fictional, they were created by youth, family and service providers to reflect their real-life experiences in dealing with opioid use disorder.
Disclaimer: The simulation shows an overdose event and may evoke a strong reaction. Please seek support as needed. Free and confidential mental health and substance use support is available 24 hours a day, 7 days a week from Wellness Together Canada.
Call 1-866-585-0445 or text WELLNESS to 686868 for youth or 741741 for adults.
OAT Guide
In collaboration with community partners Foundry Kelowna and Foundry Vancouver-Granville ,“Step-by-Step: A Youth-Informed Guide to Opioid Agonist Treatment” is a short, lived-experience video series. It focuses on a young person’s everyday experience with opioid agonist treatment (OAT) as part of a treatment program. The videos hope to demystify and destigmatize OAT by providing authentic and relatable information for those seeking treatment for opioid use and to increase confidence for youth considering or starting OAT.
The series features four episodes:
- You’re Worth It: Defines what OAT is and its potential life-saving benefits within the context of the drug toxicity emergency.
- The Daily Routine: Provides descriptions of the different types of medications available for youth in British Columbia. Youth describe what being on OAT looks like in day-to-day life.
- Side Effects: Explains common side effects youth experienced while on OAT.
- The Big Picture: Explores the idea that OAT is only one tool that supports one’s wellness journey, and everyone’s treatment pathway is different. Youth share what other elements helped them while on OAT, including staying connected through support groups, friends and peers.
Assessment Tool
In collaboration with Foundry Prince George, the ITT team developed a youth service assessment tool for health and social organizations to serve young people. The tool supports 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: What is the 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: How is continuity of care ensured, 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
Resources
- Marchand, K., Tallon, C., Katan, C., Fairbank, J., Fogarty, O., Pellatt, K. M., … Barbic, S. (2021). Improving Treatment Together: A protocol for a multi-phase, community-based participatory, and co-design project to improve youth opioid treatment service experiences in British Columbia. Addiction Science and Clinical Practice, 16(1), Article 53.
- Marchand, K., Fogarty, O., Pellatt, K.M., Vig, K., Melnychuk, J., Katan, C., … Barbic, S. (2022). “We need to build a better bridge”: Findings from a multi-site qualitative analysis of opportunities for improving opioid treatment services for youth. Harm Reduction Journal, 19, Article 37.
- Marchand, K., Turuba, R., Katan, C., Brasset, C., Fogarty, O., Tallon, C., … Barbic, S. (2022). Becoming our young people’s case managers: Caregivers’ experiences, needs, and ideas for improving opioid use treatments for young people using opioids. Substance Abuse Treatment, Prevention, and Policy, 17(1), Article 34.
- Youth Research Academy. (2019). Meaningful youth engagement practices that target low-resourced youth who use substances: Knowledge summary. Vancouver, BC: McCreary Centre Society.
- Youth Research Academy. (2020). Prescribing pain: Misuse of prescription medication, heroin and other substances among youth in BC. Vancouver, BC: McCreary Centre Society.
