No problem.
Thank you for having me speak to the committee today and for your focus on this concerning health crisis, the opioid overdose crisis, that is affecting young people.
I submitted a statement late last night—that I hope you all do read—in relation to how the opioid crisis is affecting young people. More young people have died from opioid-related deaths than alcohol-related deaths, despite the much higher prevalence of alcohol use amongst young people in Canada. The Ontario OSDUHS study recently reported that, compared to all other drugs, opioid use is increasing amongst young people, and now over 20% of high school students are reporting having tried an opioid in the past year.
There are a number of solutions to addressing addiction. They don't just involve acute treatment and pharmacological interventions. They also involve indicated prevention programs, universal prevention programs, and selective or targeted prevention programs, and that's what I want to speak to you today about.
In my brief, I have highlighted a number of systematic reviews. One was reported by the Surgeon General in 2016 in the U.S. and provides a very thorough overview of the evidence-based prevention programs that are currently available and can provide solutions to the current opioid crisis in Canada. There is also a report by the United Nations Office of Drugs and Crime, as well as a joint report by WHO, UNESCO and UNODC. In all three of these reports, there are programs that have been developed in Canada and tested in Canada, but they are not being widely distributed and made available to young people in this country right now.
I chaired a committee, a working group, focused on the emerging health crisis to find solutions for at-risk and young users of opioids. We reported a systematic review that was published in The Canadian Journal of Psychiatry a few years ago. In this report, we identified two programs—only two programs—that have been shown to prevent the uptake of prescription drug misuse amongst young people. One is the Prosper delivery system that has been widely evaluated in the United States. The second is the personality-targeted prevention program, which was developed in Canada and widely tested in Canada.
With regard to a significant evidence gap with respect to solutions for young people who are using opioids and at very high risk of overdose deaths or transitioning to lifelong experiences of addiction and dependence, we conducted a number of focus groups with at-risk users across the country. A number of recommendations are reported, and I refer you to a number of publications that were published in The Canadian Journal of Addiction. The overwhelming message that came from these qualitative interviews with at-risk users was the need for more youth-oriented programs and the desire for more school-based programs, workshops, face-to-face interactions and discussions related to risk for prescription drug misuse, including addressing underlying mental health challenges, peer pressures and concerns about other people's use.
I would be very happy to go over the evidence in relation to prevention programs that are currently available in Canada and that could be widely implemented. I just want to finish with a number of recommendations to the committee on how we could better address young people's risk for opioid overdoses in this country.
First, communities need help reviewing and making sense of very complex literature on drug and alcohol prevention. I recommend that Health Canada maintain a review process and a registry for evidence-based drug and alcohol prevention programs, similar to what has been made available through SAMHSA in the United States and other state registries for evidence-based prevention programs.
We need more federal funding for drug prevention in this country. As you know, alcohol and drug misuse represent enormous costs to society, but less than 1% of those costs are dedicated to implementing prevention programs in the country. Communities need additional resources to help them in adapting evidence-based programs and evaluating their implementation in new contexts where there are evidence gaps.
In light of the growing health threat to young people brought about by the opioid crisis in North America, Health Canada and the Canadian government should explore ways to incentivize provinces and territories in setting statutory orders and minimum standards for drug prevention so that every child in the country is exposed to an evidence-based program immediately.
We need a more coordinated implementation resource and evaluation tool. This could be easily attached to CIHR's CRISM network, but we need more resources dedicated to research and evaluation of prevention and not just a focus on opioid substitution therapy treatments, which has been mostly what the research has been focused on to date.
Health Canada should also stop investing in drug prevention strategies for which there is limited scientific evidence. I can talk more about that.
Finally, we need better online safety for children and young people. The illicit drug market has transitioned to social media, and that is where kids are being groomed for lifelong substance use and misuse. It's extremely important that we begin to look at new ways of protecting young people online.
Thank you.