New guide­lines is­sued for deal­ing with youth ad­dicted to opi­oids

Times Colonist - - The Capital / B.c. - CAMILLE BAINS

VAN­COU­VER — New guide­lines aimed at im­prov­ing treat­ment for opi­oid-ad­dicted young peo­ple have been re­leased by the Bri­tish Columbia Cen­tre on Sub­stance Use, which says a lack of youth-fo­cused treat­ment pro­grams has cre­ated challenges in the prov­ince with the high­est num­ber of fa­tal over­doses.

Rachel Sta­ples of Oak Bay, whose 16-year-old son El­liot Eurchuk died in April from an ac­ci­den­tal over­dose, said that while the guide­lines are a good start, in­suf­fi­cient treat­ment beds and a law pro­hibit­ing parental in­volve­ment in care with­out a youth’s con­sent are big prob­lems that must be ad­dressed.

Dr. Sharon Vi­pler, who was on the com­mit­tee that de­vel­oped the guide­lines, said they call on doc­tors to pre­scribe treat­ment drugs such as sub­ox­one be­fore methadone is tried, as well as coun­selling to sup­port youth deal­ing with ad­dic­tion.

The guide­lines say short-term de­tox pro­grams alone are not rec­om­mended be­cause they tend to in­crease rates of re­lapse, HIV in­fec­tion and over­dose death, but that pa­tients should be re­ferred to on­go­ing treat­ment, in­clud­ing in res­i­den­tial fa­cil­i­ties.

Doc­tors are en­cour­aged to screen all youth for sub­stance-use dis­or­ders and men­tal-health dis­or­ders, and to re­fer pa­tients to ad­dic­tion physi­cians with ex­pe­ri­ence treat­ing youth with opi­oid-use dis­or­der.

Physi­cians should also work to en­sure their young pa­tients are pro­vided con­tin­u­ing treat­ment as they en­ter adult­hood, with fu­ture care­givers iden­ti­fied early to pre­vent scram­bling to get them into an­other pro­gram, said Vi­pler, an ad­dic­tions spe­cial­ist who works at a de­tox cen­tre in Sur­rey, which has six beds for youth.

“What we’re say­ing is that if you are a clin­i­cian pro­vid­ing care for an in­di­vid­ual who is go­ing to age out im­mi­nently or even in the fore­see­able year or so, that process should start as soon as that thought comes into mind,” she said.

The guide­lines also call for in­volve­ment of fam­ily so youth have the emo­tional sup­port they need. How­ever, the In­fants Act in B.C. says chil­dren younger than 19 may con­sent to a med­i­cal treat­ment on their own if the health-care provider is sure the treat­ment is in the child’s best in­ter­est and if the child un­der­stands its po­ten­tial risks and ben­e­fits.

“Parental par­tic­i­pa­tion in the treat­ment of youth should be ac­tively en­cour­aged, and fam­ily mem­bers should be sup­ported with suf­fi­cient in­for­ma­tion and train­ing,” say the new guide­lines.

Sta­ples, whose son was found dead from an over­dose at the fam­ily’s home, said she and her hus­band, Brock Eurchuk, couldn’t legally get in­volved in El­liot’s care with­out his con­sent af­ter he was hos­pi­tal­ized for a bone in­fec­tion re­lated to drug use.

“To have guide­lines, great. But there also has to be a time and place where adults can in­ter­vene for the child’s wel­fare. Be­cause if their brain is soaked in opi­oids like El­liot’s was, they can­not make a ra­tio­nal de­ci­sion to ac­cept treat­ment.”

Sta­ples said her son ini­tially over­dosed in hospi­tal and was re­vived when a nurse ad­min­is­tered nalox­one, but she and her hus­band weren’t given any in­for­ma­tion in­di­cat­ing the se­ri­ous­ness of his ad­dic­tion be­cause he in­sisted he was OK and didn’t want them in­volved.

The B.C. Cor­ners Ser­vice re­ported there were 1,449 il­licit drug over deaths in 2017, an in­crease from 992 deaths from a year ear­lier. The ser­vice said 23 peo­ple be­tween the ages of 18 and 23 died in 2017, and 270 of them were ages 19 to 29.

El­liot Eurchuk died of an ac­ci­den­tal drug over­dose in April.

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