Despair, not drugs, causing youth overdoses
Stemming a rising tide of overdose deaths and substance-related critical injuries among children and youth isn’t as simple as providing a supervised injection site, clean needles, teaching kids about safer drug use or even early interventions and better access to treatment and recovery services.
Among the kids using drugs, a small but significant number are self-medicating for trauma they’ve suffered when adults haven’t done enough to keep them safe.
In 2017, there were 24 children among the 1,452 British Columbians who died of illicit drug overdoses. The youngest was 10.
Another 154 kids suffered critical, substance-related injuries, nearly double the total from 2016. Of those 154, six died this year.
The direct cause of death may be drugs, but what’s killing these children is hopelessness and despair.
The file review by Jennifer Charlesworth, B.C. representative for children and youth, found that 86 per cent of the dead and critically injured had previously experienced sexual violence, domestic violence, physical assault and neglect.
That jumped to 99 per cent of the children in government care. One in five of those had been in care since before their first birthdays. Three-quarters had lived in multiple different placements.
Corey’s file is among the cases highlighted in the report. He was removed from parental care in early childhood, following multiple concerns of domestic violence, neglect and sexual abuse. He’s been through 10 different placements.
In those placements, he was sexually abused. Corey reported to police, but the prosecutor did not proceed with any charges, saying that Corey looked older than16andwasnotacredible victim.
When Corey walked away from a group home in 2017, he told staff, “If I had the chance to be hit by a car, I would take it.” He went on to say, “If I happen to overdose, I wouldn’t fight it.”
Two days later, Corey was found unresponsive in a public place. He had overdosed on crystal meth and heroin.
It remains a mystery when governments will address the root causes of the trauma and abuse that are fuelling youth substance use — and, potentially, the epidemic among adults as well.
More than two years and only weeks into a public health emergency triggered by fentanylrelated overdose deaths, Charlesworth’s predecessor released a comprehensive review of publicly funded substance-abuse services for youth.
Some changes have been made to address that report’s long list of missing or inadequate services, including the reopening of a residential treatment centre and establishing seven Foundry Centres where children and youth can access primary care, mental health and addictions services plus social services as well as peer support.
Anecdotally, it seems there are pressing needs for more and better services. Of the youth who died or were critically injured, six were on detox waiting lists and 18 were waiting for placement in residential treatment programs. One youth overdosed only five days after leaving detox. She needed longer-term residential care to address the underlying issues she faced, but it wasn’t available.
How long the waiting times are, Charlesworth couldn’t find out. The health authorities don’t have that data. How wide the gap between the demand and available services is is also an open question. There is no comprehensive list of services available inB.C.,whichmakesitdifficult for anyone to find help, let alone a traumatized, addicted youth with no parental supports.
Are children and youth dying because the services aren’t available or because they just can’t find them?
Compiling such a list is among Charlesworth’s recommendations. She wants it included in the ministry of mental health and addictions’ promised youth strategy, due in the spring along with a commitment that the list be updated at least once a year.
Theproblemisthatthedial has yet to move off crisis mode. Despite millions of dollars being spent on naloxone kits, supervised sites and other harmreduction measures, the overall numbers keep climbing. In September, 128 British Columbians died of illicit-drug overdoses, up eight per cent from the previous month, bringing the 2018 total to 1,143.
Thereisnoargumentthat everything possible must be done to keep children and youth alive long enough so that they can get the best possible treatment.
Still, these are Band-Aids. It’s time to move beyond mitigating harm of addictions, patching people up and hoping they can move on with their lives. As a society, it is past time that we addressed the underlying causes of substance abuse: trauma.
Blake was 13 when a support person asked how many homes he had lived in. “Too many to count,” he replied. Blake’s file also records there were no functioning adults in his life, other than the professionals paid to look after him.
In our wealthy, caring society, surely we can do better.