Characterizing the Landscape of Service Provider Needs and Gaps in Services during the Canadian Youth Polysubstance Use Health Crisis

Objectives:This study characterizes service provider needs, gaps, and problem areas in the provision of opioid-related services for young people ages 15 to 25 across Canada.Methods:A total of 154 service providers completed a 25-question survey that was comprised of closed-ended and open-ended questions about opioid-related services for youth. Descriptive statistics were generated using RStudio software and open-ended responses were coded using a content analysis approach.Results:The majority of participants were in the addiction and mental health (35.1%), prevention (18.2%), or housing/shelter (12.3%) sectors, provided services to youth in early adulthood demographic (19-21), and reported both illicit and prescription opioid use among the youth they served. The most common opioid-specific youth services provided were, referrals to other organizations (72.1%), individual therapy (64.9%), assessment/consultation (57.1%), and overdose prevention medication (Naloxone) (49.4%). Open-ended questions revealed needs for both a continuum of care and continuity of care, a lack of accessible and available services, organizational and financial barriers, and a lack of funding. Several respondents indicated that harm reduction services, counselling, and opioid agonist therapy were "well-developed"for youth.Conclusions:The majority of our respondents appear to be working in a polysubstance use context that includes both illicit and prescription opioid use by youth. Despite this, there was an emphasis on referrals to other organizations as the most common type of service for young people. This is a potentially interesting and alarming finding in the context of provider reports of fractured continuums of care and continuity of care for young people using opioids. There was some encouraging awareness of harm reduction and in particular Naloxone availability for young people, although as we noted, it is uncertain whether youth are actually provided with Naloxone and to what extent pharmacological and counselling therapies are made available and accessible (affordable) for them. Our results suggest that there is still a need for programs and initiatives for youth that target polysubstance use (including both illicit and prescription opioid use) for young people.