Examining the addiction treatment and recovery trajectories of youth in British Columbia’s Lower Mainland

Addiction treatment is critical to addressing the tremendous health and social harms experienced by street-involved youth (SY) with substance use disorders (SUD), including the current fentanyl overdose crisis. To date, the addiction treatment and recovery landscape in British Columbia (BC) reflects a mix of regulated, publicly funded programs (e.g., methadone and Suboxone programs, residential detoxification and treatment programs), as well as unregulated privately and publicly funded programs (e.g., informal recovery houses, Twelve Step programs) that span acute and community healthcare settings. Sustained drug use cessation is an important goal of these programs. However, it is recognized that for many youth their addiction treatment trajectories include periods of engagement, dis-engagement, and re-engagement with various programs, as they move in and out of periods of relapse, increases and reductions in drug use, and drug use cessation. The recovery trajectories of youth who remain largely outside of healthcare settings are also often characterized by this kind of dynamic process.

Dr. Fast will examine and inform ongoing efforts in the Lower Mainland to create a more comprehensive and coordinated system of addiction services for youth, and generate new knowledge to optimize the integration of evidence based addiction treatment across the acute and community healthcare settings accessed by SY. Integrating the methods and perspectives of medical anthropology and implementation science she will advance understandings of how individual, interpersonal, organizational, and structural factors operating in, but also across, acute and community health care settings in the Lower Mainland shape the delivery, uptake, and outcomes of youth addiction treatment interventions.

A nuanced, ethnographic understanding of these places and contexts will inform policy and practice recommendations to improve the addiction services system for adolescents and young adults so that it meets the needs of SY, pursuant to the goal of addressing SUD and the overdose crisis among this population. Dr. Fast will employ innovative and participatory arts-based methods to generate and disseminate policy and practice recommendations that align with the complex realities and everyday lived experiences of SY.