In high-income countries, more children are diagnosed with anxiety disorders than any other mental health condition. In BC, this means an estimated 42,000 children aged four to 18 likely meet criteria for an anxiety disorder at any given time. To receive such a diagnosis, young people must experience anxiety that is severe enough to cause considerable distress or impair functioning or both. And because many children do not receive treatment for their anxiety disorders, these disorders often persist into adulthood — taking a substantial toll.

For more information, see Vol. 18, No. 4 of the Children’s Mental Health Research Quarterly.

Findings from a systematic review by the Children’s Health Policy Centre suggest six implications to better serve young people in BC who are experiencing opioid use disorder:

• Ensure that all young people in need can access timely treatment. Every young person experiencing opioid use disorder needs quick access to effective treatments — and needs to know how to get help in safe ways. While efforts are being made to increase access to this vital form of care, many young people still lack even a primary health care provider. As well, treatments may need to continue over extended periods, or be restarted, given frequent reoccurrence of opioid use following discontinuation of treatment.
• Match the treatment to the individual. Young people with opioid use disorder require a treatment plan that fits with their stage of recovery. For example, abruptly stopping opioid use can cause painful withdrawal symptoms. So for young people at the beginning of their treatment, managing withdrawal symptoms through buprenorphine/naloxone can be helpful.
• Help youth by helping family members. When a young person is struggling with opioid use, everyone around them is deeply affected. Family members often experience great challenges — both in supporting the young person and in coping with the consequences in their own lives. Interventions that include family members are therefore always worth considering.
• Ensure strong practitioner supports. The Compass Mental Health program at BC Children’s Hospital provides support to health care providers treating children and youth with substance use challenges. The BC Centre on Substance Use, through its Provincial Opioid Addiction Treatment Support Program, also provides additional education and training for prescribers, including online courses and preceptorships.
• Conduct more research with young people. Rigorous research is greatly lacking on treatments for opioid use disorder in young people. As a result, practitioners must resort to prescribing medications that have not been optimally evaluated. So new treatment research is urgently needed.
• Remember prevention. Even with adequate treatment, preventing opioid misuse is crucial to meet the collective goal of having fewer young lives harmed or cut short. Prevention is also the most effective way to enable more young people to enjoy years of positive development by avoiding opioid use disorder.

For more information, see Vol. 18, No. 3 of the Children’s Mental Health Research Quarterly.

To determine how many BC youth with opioid use disorder are treated with medications, researchers reviewed prescriptions in health administrative databases. They found that of 446 adolescents with this diagnosis, 36.5% were prescribed a related medication between 1996 and 2018. Among these young people, 60.1% received buprenorphine/naloxone and 38.0% methadone. Still, researchers found that teens were about half as likely to receive a medication for opioid use disorder compared with older adults — despite this treatment being an important component in addressing the opioid crisis.

For more information, see Vol. 18, No. 3 of the Children’s Mental Health Research Quarterly.

A large US study offered insight on how variations in opioid prescribing can increase risk for detrimental outcomes — namely, opioid use disorder or opioid overdose. Researchers searched a comprehensive database of health insurance claims for individuals with employer-provided coverage, identifying more than three million 11- to 25-year-olds by their first opioid prescription. They found that longer-acting medications led to 159% increased risk of being diagnosed with opioid use disorder or experiencing an opioid overdose in the year following the initial prescription — compared with outcomes for shorter-acting formulations.

Duration also made a difference. Prescriptions for 15 days or longer increased risk by 96%, while those for seven to 14 days increased risk by 15% — compared with prescriptions for three days or fewer. As well, higher daily doses (i.e., morphine equivalents of 90 milligram or greater) increased risk for detrimental outcomes by 23% compared with doses of less than 30 milligrams. These findings highlight the importance of using caution when prescribing opioids to young people.

For more information, see Vol. 18, No. 3 of the Children’s Mental Health Research Quarterly.

Image credit: CIRA

This year marks the 30th anniversary of National Indigenous Peoples Day. Held annually on June 21, National Indigenous Peoples Day celebrates the cultures, traditions and contributions of First Nations, Métis and Inuit peoples.

The day was originally declared as National Aboriginal Day by Governor General Roméo LeBlanc in 1996, following years of consultation and calls for the creation of such a day by the Assembly of First Nations and other Indigenous groups. It was renamed National Indigenous Peoples Day in 2017. June 21 was chosen because it is the summer solstice, a day of spiritual and cultural significance for many Indigenous peoples.

Every year, Indigenous communities hold events to celebrate and share their diverse cultures. You can find a list of public gatherings in British Columbia at Indigenous Tourism BC.

Cultural connections, like those celebrated during the summer solstice, can promote the wellbeing of Indigenous children and youth. For example, research suggests that strengthening these connections can help lower rates of suicide for Indigenous young people. For more information, see Vol. 17, No. 1 of the Children’s Mental Health Research Quarterly.