Mental Health and Well-Being Snapshot: April 2022
 
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Substance Use and Youth
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Why we're focusing on substance use

Substance use by humans - whether for relaxation, stimulation, medication, or experimentation - is not a new phenomenon. A drug history timeline compiled by the University of Victoria starts with evidence of beer making in 10000 BCE! However, substance type, availability, and attitudes toward use have shifted over time. We live in an age in which some substance use has been somewhat normalized, while users of other substances may be highly stigmatized.  This complex picture is part of the reason it is so important to revisit the topic of substance use.

Another reason we are highlighting substance in this snapshot is because, like it or not, youth will be exposed to substances before they become adults. Some statistics from the most recent McCreary Adolescent Health Survey give an idea of the prevalence of youth substance use in BC, as well as the varied and changing attitudes youth have toward substances:

•  44% of youth surveyed in grades 7-12 had tried alcohol
•  16% of youth had tried a substance other than marijuana or alcohol - 12% had misused prescription pills
•  Over 25% of youth surveyed had vaped in the last month
•  Almost half of youth surveyed felt that their friends would be upset with them if they got drunk
•  Marijuana use had decreased over 10 years

That picture of youth substance use is important, as are the trends we are seeing across society. Since a public health emergency was declared in 2016, deaths due to toxic drugs have risen 400%, and in 2021, an average of over six people were dying daily in BC due to drug toxicity. These are frightening statistics, but it is important for our older children and students to understand this reality as they develop the skills to look after themselves and others in their community.

For parents and caregivers of youth, the complex picture this information presents poses a challenge: How do we find the right balance of protecting our young people from potential harms while equipping them with the skills and knowledge to make healthy choices on their own?
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Addiction and the importance of connection

Dr. Gabor Maté has a theory that addiction is strongly tied to problems developing attachment and authenticity in childhood. Long-lasting difficulties in both of those areas can stem from trauma. According to this theory, addiction is a coping mechanism that seeks to fill in the void caused by a lack of attachment or an inauthentic sense of self.

In this video, Dr. Maté explains his theory, and clarifies that addictions can be present with any behavior and are not necessarily tied to substance use. Importantly, Dr. Mate points out that reconnection with self and others is the way toward healing damage from past difficulties with attachment or past traumas.

Stories to eliminate stigma

Stigma surrounding people who use substances can be damaging and over the longer term, reinforce unhelpful coping mechanisms. The Canadian Mental Health Association points out that understanding the components of stigma - prejudice and discrimination - help clarify its negative impact. They also point out that for many people experiencing stigma, they may experience prejudice and discrimination for a number of reasons, including sexual orientation or culture. Each "layer" of stigma makes it that much harder for that person to access help or support for substance use or mental health.

There are some important ways we can all combat stigma - by being open about our own experiences with mental health or substance use, by seeking out direct contact with people with lived experience, and by using non-stigmatizing person-centered language.

In addition, we can reduce stigma by listening to the stories of those with lived experience. The UNITE project at BC Mental Health and Substance Use Services seeks to help people change their worldview by turning those stories into animated short "documentaries." Watch the first one via the button on the right, or access all of the videos here.
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Substance fact vs fiction
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Have questions? Start here

Foundry's substance use resource hub has in-depth info organized into manageable chunks and focused on a variety of substances - with sections on basic info, problematic use, laws, health and mental health effects, as well as coping strategies, tools and supports.

Vaping

Vaping is the use of any vapourizer product (e-cigarette, vape pen, vape) to smoke the vapour or heated aerosol of various chemical liquids (typically glycerol, propylene glycol, and nicotine with flavours, though not all vape products contain nicotine). While for an adult cigarette smoker, vaping can provide some harm reduction benefits in a journey towards quitting nicotine altogether, for youth, it is often a pathway to getting addicted to nicotine. This FAQ Handout from BC Lung Foundation gives a good overview of vaping.

There are additional concerns about vaping products as well, and the reality is that the products are just too new for anyone to fully understand the long term consequences of frequent use. This handy tip sheet from Health Canada outlines some of what we know about the health consequences of vaping.

To get a picture of youth vaping during the pandemic, the McCreary Centre Society surveyed 3500 youth in BC to get a snapshot of their use and perspectives. Interestingly, although 27% of youth surveyed had vaped within the last month, youth were less likely to have started or increased vaping during the pandemic. See part of the infographic below, and access the full infographic here.
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Cannabis

Cannabis, marijuana, or weed, is an increasingly accessible substance with its recent legalization and subsequent commercialization in various edible, drinkable, and smokable forms. It's easy to be dismissive of the harms of cannabis considering its legal (for adults) status, and when we look at this drug relative to other drugs such as opioids which dominate news coverage due to their toxicity. However, cannabis use, especially by youth with still developing brains, can be harmful. 

The Canadian Centre on Substance Use and Addiction has done extensive research into cannabis use and youth. They have produced some useful documents, including harm-reduction oriented guides such as this one about lower risk cannabis use. They also have helpful documents that can support conversations about cannabis use, such as the following infographic dispelling some myths about marijuana use (see full infographic plus recommended resources here).
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Substance conversations at home
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Starting points for parents

Sometimes as parents it is tough to know how to start a hard conversation, or best ways to approach a tough topic. To help with that, Kelty Mental Health has outlined some essential facts about substance use, indicators that youth may be using substances, and strategies for broaching helpful discussions about substance use at home.

Some key takeaways:
•  Seeking out new experiences - including substance use - is common for youth as they age
•  There are increased risks associated with substance use during the developmental years before age 25
•  Open and honest discussion is important - start early

When talking to youth:
•  Listen without judgement
•  Stick to the facts
•  Work together and focus on their well-being
•  Consider the ways you can set an example in your own choices
•  Be aware and available
•  Learn about trauma and its impacts
•  Short, recurring conversations can be more powerful than one long talk

Parents Like Us

"You are not alone. We are a group of parents from Victoria, British Columbia, who care for young people with substance use disorder. By sharing our experiences and reading our stories, we hope you will find refuge, support and the courage to reach out for help."

That introduction begins this much-needed handbook for parents of youth with substance use disorder. The book is filled with personal anecdotes of lived experience, enmeshed with practical tips about navigating a complex mental health system, responding to overdose, staying connected with your young person, and caring for yourself. Readers will get a sense of what has worked for others, get a firmer grasp on available resources in their community, and almost certainly feel less alone in their journey after reading this book. Available for free as a pdf via the link, or as a hard copy available through the Foundry youth clinic.
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Books to develop resilience

While we are probably not having in-depth discussions with younger children about substance use, we can still help them develop protective factors to make positive choices as they grow up. Resilience is an attribute we have discussed before - the ability to bounce back from adverse experiences, ideally learning and growing along the way. Books can provide great material to reflect on and discuss resilience, as we make connections between protagonists' lives and our own situations.

This list of children's books that build resilience is a great starting point, but your school's Learning Commons teacher will likely have some excellent suggestions as well!
Community resources

Discovery Youth and Family Services

Discovery Youth and Family Substance Use Services offers free community-based counselling services, access to residential care and treatment for youth struggling with substance use. 

Discovery’s services are available to anyone in the community directly or indirectly impacted by substance use. 

This includes:
•    Youth aged 13 to 19 who have concerns about alcohol or drug use
•    Families/Caregivers who are concerned about a youth using alcohol or drugs 
•    Any support person who is worried about a youth’s use of alcohol or drugs
•    Youth who are affected by someone else’s use of alcohol or drugs 
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FNHA Virtual Substance Use & Psychiatry Service

Virtual Substance Use & Psychiatry Service is an FNHA service providing virtual specialist support in addictions medicine and psychiatry. This service requires a referral from a health and wellness provider who can support the individual on their journey.

The FNHA and other organizations provide culturally safe and trauma-informed cultural, emotional, and mental health services to Indigenous people in BC.

Local Youth Clinics

While any doctor can be a valuable resource for youth hoping to understand how substance use is impacting their health, the two local youth clinics can often facilitate connections with other supportive professionals within the same building such as counsellors or youth workers - an approach that can be helpful if there are concurrent mental health disorders. 

Foundry Victoria offers a range of wellness services for young people ages 12-24, including physical and mental health care, substance use supports, social services and peer support. Foundry is located in downtown Victoria and operates 5 days a week. They also offer a virtual service.

The Peninsula Youth Clinic offers a similar model on a smaller scale. The clinic is open from 5:30-7:30PM on Thursday nights, and operates out of the Shoreline Medical Clinic in Sidney.
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Living Life to the Full

For some people, substances can be a way to cope in the short term with stresses or mental health challenges. In those cases, developing coping skills other than substances is an important step toward more long-term solutions. Living Life to the Full is a FREE program that aims to equip youth with those skills. From their website:

Living Life to the full is a mental health promotion program and it is for everyone! Whether you are just curious or are dealing with anxiety, you can benefit from the tools the program offers. Group-based and led by a youth-certified facilitator, it equips youth 13-18 with the skills they need to face challenges in life. The course includes fun activities and group challenges to help youth practice and develop their skills.

Click the link to the left for more info, or register for the May 3rd group here.
Online resources and apps
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Wellness Together Canada

This online resource hub provides learning and self-development videos and articles, guided courses, and connections to supportive professionals. Their resources page is a good starting point and can be tailored for youth or adults. Many of the self-directed resources can be accessed for free, and you can sign up for courses or to connect with a counsellor.

Specific to substance use, there are some good materials about exercises to manage cravings, talking to loved ones about their use, and getting support for problematic use.

Toward the Heart

Toward the Heart is part of the BC Centre for Disease Control, and is a hub of resources and education centered around harm reduction. Access this site for information about where to find take home naloxone kits, a free course and videos on how to administer naloxone, and information about opioids.
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Lifeguard App

This app is designed to protect people who use substances alone and help prevent overdose deaths. The app user sets the timer when they start using a substance, before the timer runs out, it will prompt the person to stop the notification. In the event that the person doesn't respond to the app in time, it will automatically alert emergency responders. The app also includes a naloxone and CPR guide, as well as direct links to crisis services.

SD63's Mental Wellness Hub updated every month

This site compiles both local and online mental health and wellness resources for families and educators, and is updated monthly with new resources.
SD63's Mental Wellness Hub