The escalation of prescription opioid utilization in Canada since the 1980s has been profound, propelling the nation to become the world’s second-largest consumer of these medications. Alarming findings from a Canadian survey reveal that a significant portion of recent opioid users, including adolescents have engaged in illicit drug practices, obtained and consumed these substances without valid prescriptions.
Uncovering a troubling trend
The current surge in the opioid epidemic in Canada can be traced back to the significant increase in the use of prescription opioids over recent decades. Starting from the early 1980s, there has been a staggering surge of over 3000% in the volume of opioids dispensed to hospitals and pharmacies across the country. This rise continued with over 20 million prescriptions for opioids being distributed in 2016, which made Canada the second-largest consumer of prescription opioids globally, following the United States (Belzak L et al., n.d.).
The rising concerns regarding prescription opioid harms emerged around 1999, eventually escalating to become the fourth most prevalent form of substance use by 2008, surpassing the usage of heroin or cocaine. A Health Canada survey conducted in 2017 uncovered that almost a third of recent opioid users, particularly teenagers and individuals involved in illegal drug use, consumed these opioids without a prescription (Belzak L et al., n.d.).
Moreover, the emergence of synthetic opioids, particularly fentanyl, has substantially altered the drug landscape, leading to heightened toxicity levels. Fentanyl’s widespread presence in the illegal drug market across all Canadian regions has been identified as a concerning factor. In 2016, the national statistics revealed that 53% of reported opioid-related deaths involved fentanyl. Its prevalence in the illegal substance supply, often combined with other substances, contributed significantly to the alarming rate of deaths (Belzak L. et al, 2018).
In the initial seven months of 2023, British Columbia registered a historic tally of 1,455 fatalities from drug poisoning. This figure exceeds all previous counts for the same period, despite the province declaring a public health emergency on this matter in 2016 (Ellsworth B, 2023). In recent years, data from the B.C. Coroners Service revealed that youth between the ages of 10 and 18 have experienced a higher number of overdose deaths compared to fatalities from vehicle accidents, suicide, cancer, or any other cause (Vikander T, 2023).
Causes and effects explored
Apart from the ready availability of drugs, Canadian youth‘s increased reliance on substances is influenced by several other factors. Specifically, the surge in hydromorphone use, a potent pain reliever stronger than morphine, occurred during the aftermath of the COVID-19 situation. Alleged misinformation from dealers misleadingly claimed that hydromorphone was harmless and beneficial, likely contributing to its increased accessibility and acceptance among Canadian teenagers (Zivo A, 2023).
Adolescents also often succumb to peer pressure and their impulsiveness, leading them to experiment with drugs. Exposure through friends, along with positive reinforcement, significantly increases the likelihood of substance use. The first instance of drug use can initiate physical dependence, leading to the intensification of this cycle and culminating in the development of both physical and psychological dependency (Fletcher S, 2019).
Furthermore, the dependency on one substance can serve as a gateway to reliance on others. Increased tolerance to milder substances like nicotine or alcohol frequently prompts individuals to explore “harder” substances such as synthetic (methamphetamine) or natural opioids (cocaine). This perpetuates a cycle of multiple addictions (Fletcher S, 2019).
It’s important to emphasize that dependency isn’t solely a consequence of substance use. For example, individuals using narcotics for post-operative pain may not necessarily develop dependencies (CMHA, 2023). Addiction is more complex, often tied to personal experiences and behavior patterns. This understanding aligns with findings that over half of Canada’s students admitted to feeling depressed about the future due to COVID-19, with more than a third experiencing profound mental health issues (Yousif N, 2022).
The use of drugs poses a significant risk to young individuals due to ongoing brain development until their mid-20s. Drug use in adolescence can disrupt vital brain developmental processes, impacting decision-making abilities. This impairment may contribute to the onset of various health issues in adulthood, including heart disease, high blood pressure, and sleep disorders (MedlinePlus, 2023).
Prevention and support strategies
The Government of Canada initiated a multi-year campaign in 2018 aimed at increasing opioid awareness, covering overdose signs and the Good Samaritan Drug Overdose Act, while also addressing substance use stigma. This initiative enabled the engagement of over 178,000 teens and young adults through virtual and school sessions via the Know More Opioids program (Government of Canada, 2023).
Additionally, Canada has introduced a national curriculum emphasizing pain management and addiction medicine tailored for physicians. Budget 2023 underscored a significant commitment of about $25 billion to bolster mental health and substance abuse through targeted agreements. Furthermore, the government has allocated up to $4.5 million to bolster Pain Canada, a coalition comprising 14 pain organizations, aiming to enhance national coordination and strengthen care systems (Government of Canada, 2023).
Despite these initiatives, a noticeable increase in pessimism and hopelessness has been observed among youth since the onset of the COVID-19 pandemic. They are experiencing heightened stress levels concerning their housing, employment, and education prospects (UBC Faculty of Medicine, 2022). This has led to concerning findings from BioMed Central (BMC), which revealed that fifty percent of young individuals now show a higher likelihood of needing drug use services, compared to pre-pandemic times (Marchand K. et al., 2022).
Hence, addiction and mental health experts are urging Canada to embrace a more comprehensive strategy in combating widespread opioid prescriptions. Beyond the current initiatives, their recommendations encompass strict adherence to evidence-based prescribing guidelines, setting limits on prescription dosages and durations supported by reliable evidence, and the nationwide implementation of real-time electronic monitoring (Centre for Addiction and Mental Health, 2016).
At Humanium, we advocate for every child to lead a life free from addiction, thriving in a secure environment that nurtures their physical and mental well-being. Developed by human rights defenders, our methodology, involving life coaches, psychologists, and therapists, is focused on safeguarding and helping children fulfill their potential.
If you wish to support our cause, you can make a difference by donating, sponsoring a child, or volunteering. Your participation will positively impact the lives of children and help create a brighter future for generations to come.
Written by Lidija Misic
Bibliography:
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