Skip to main content

The vast majority of Canadian youth being hospitalized for drug-related injuries or overdoses also have a mental-health condition, according to new numbers that show the most common substance behind those hospital stays is cannabis, not alcohol.

The statistics, a one-year snapshot analyzed by the Canadian Institute for Health Information, also reveal a system struggling to manage these cases, particularly with early interventions and follow-up care. According to the data released on Thursday, 65 Canadians aged 10 to 24 were hospitalized each day for harm related to drug use, totalling 23,580 hospital stays, between April, 2017, and March, 2018.

But 17 per cent of these young people were hospitalized more than once over the year. And even more are turning up in emergency departments, where the numbers record five visits for every one hospital stay.

Story continues below advertisement

Collapse

What’s more, these are complex cases: seven out of 10 of the youths hospitalized because of drug use are also dealing with a mental-health issue. Among those, 18 per cent had a psychosis-related disorder such as schizophrenia. This was the second-most-common diagnosis, after mood disorders, such as depression, at 24 per cent.

The report builds on CIHI data released earlier this year that showed the number of children and youth being hospitalized or visiting emergency departments for mental-health reasons has risen significantly across Canada in the past decade – a trend that is no surprise to clinicians working to treat an increasing load of young patients.

Pediatric specialist Nicholas Chadi opened his substance-abuse clinic at Montreal’s Sainte-Justine University Hospital in August, and already has a crowded roster. This includes a 13-year-old hospitalized for an opioid overdose, but also three young people with chronic vomiting brought on by long-term marijuana use. Given the strength of new marijuana on the market, and the fact that many teens use it in edibles and oil concentrates, he said many such cases are likely happening across the country.

While the study predates legalization, cannabis was identified in nearly 40 per cent of the hospitalizations, with alcohol at 26 per cent. This is a reversal of the pattern among older Canadians, the study notes; among those over 25, alcohol is the cause of 58 per cent of hospitalizations related to drug use – six times more than cannabis. Opioids were identified in 10 per cent of youth cases. In one quarter, more than one drug was identified. In 27 per cent of cases, the substance was not identified.

hospital stays for harm

caused by substance use

Percentage among youth involving care for a

concurrent mental health condition, by sex,

Canada, 2017–2018

Both

sexes

Mental health condition

Females

Males

69%

72%

66%

All mental health disorders

Schizophrenia, delusional and

non-organic psychotic disorders

18%

9%

26%

Mood/affective disorders

24%

28%

20%

Anxiety disorders

12%

14%

10%

Selected disorders of adult

personality and behaviour

16%

21%

12%

11%

9%

13%

Neurodevelopmental disorders

13%

17%

9%

Trauma/stressor-related disorders

12%

17%

7%

Other disorders

john sopinski/the globe and mail

source: canadian institute for health

information

hospital stays for harm

caused by substance use

Percentage among youth involving care for a concurrent

mental health condition, by sex, Canada, 2017–2018

Both

sexes

Mental health condition

Females

Males

69%

72%

66%

All mental health disorders

Schizophrenia, delusional and

non-organic psychotic disorders

18%

9%

26%

Mood/affective disorders

24%

28%

20%

Anxiety disorders

12%

14%

10%

Selected disorders of adult

personality and behaviour

16%

21%

12%

11%

9%

13%

Neurodevelopmental disorders

13%

17%

9%

Trauma/stressor-related disorders

12%

17%

7%

Other disorders

john sopinski/the globe and mail, source: canadian

institute for health information

hospital stays for harm caused by substance use

Percentage among youth involving care for a concurrent mental health condition,

by sex, Canada, 2017–2018

Mental health condition

Both sexes

Females

Males

69%

72%

66%

All mental health disorders

Schizophrenia, delusional and

non-organic psychotic disorders

18%

9%

26%

Mood/affective disorders

24%

28%

20%

Anxiety disorders

12%

14%

10%

Selected disorders of adult

personality and behaviour

16%

21%

12%

11%

9%

13%

Neurodevelopmental disorders

13%

17%

9%

Trauma-and stressor-related disorders

12%

17%

7%

Other disorders

john sopinski/the globe and mail, source: canadian institute for health information

The majority of his patients are also struggling with mental illness, Dr. Chadi said. Their care is complicated by a lack of training in this area among emergency-department physicians, limited access to therapy and a shortage of youth-friendly follow-up care in the community. “There is a big gap between being in hospital and going home,” Dr. Chadi said, especially for young patients with more than one diagnosis who need more support to stay in treatment.

This is especially complicated for many older teenagers, who are moving into the adult health-care system and losing the care they received as pediatric patients, pointed out Peter Szatmari, the chief of the Child and Youth Mental Health Collaborative, an initiative of the Centre for Addiction and Mental Health, The Hospital for Sick Children and the University of Toronto.

The CIHI study found that the rate of hospitalization related to drug use was the highest for young Canadians between the ages of 18 and 24. As well, rates of hospitalizations were higher among rural and low-income youth, and those living in Canada’s North, areas where resources to help with those transitions may be even more scarce. The Northwest Territories had the highest rate of hospitalization, at nearly five times the national average.

Story continues below advertisement

Dr. Szatmari said the system needs to provide timely mental-health treatment that includes help for substance use, and easier, one-stop access for teenagers that would help them get well before they end up in a hospital. He said it also needs to ensure “a warm hand-off for chronic cases,” so that patients moving between parts of the health care system remain in treatment, and families aren’t isolated.

“Our system isn’t built for that."

For instance, he said, doctors receive “zero training” to work with youth at the high-risk transition age – those too young to navigate the adult system alone, and too old for hospitals with cartoon stickers in the exam rooms. As a result, “the most vulnerable are the least well served,” he said. “There is a fault line in the way services are put together."

Tracy Masters lost her 30-year-old daughter last spring to an intentional overdose after 15 years of emergency-department visits, hospitalizations and rehab. Now a community advocate in Campbell River, B.C., she started her own substance support group, and she says the longer young people go without supportive treatment, the more hopeless they become – a despair she saw firsthand in her daughter. The challenge for an overwhelmed system, she says, is “connecting with people so they are not left alone,” especially when they leave hospital. “Someone who can sit down and say, ‘Let’s talk.’ ” And perhaps offer young people another door to use for help that doesn’t involve waiting in an emergency room.

Report an error Editorial code of conduct
Due to technical reasons, we have temporarily removed commenting from our articles. We hope to have this fixed soon. Thank you for your patience. If you are looking to give feedback on our new site, please send it along to feedback@globeandmail.com. If you want to write a letter to the editor, please forward to letters@globeandmail.com.

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to letters@globeandmail.com. Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to letters@globeandmail.com. Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff.

We aim to create a safe and valuable space for discussion and debate. That means:

  • Treat others as you wish to be treated
  • Criticize ideas, not people
  • Stay on topic
  • Avoid the use of toxic and offensive language
  • Flag bad behaviour

Comments that violate our community guidelines will be removed.

Read our community guidelines here

Discussion loading ...

Cannabis pro newsletter
To view this site properly, enable cookies in your browser. Read our privacy policy to learn more.
How to enable cookies