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Youth in British Columbia who use illicit substances say they have no place to do so under supervision, prompting the province’s children’s watchdog to recommend the creation of supervised consumption spaces specifically for those under 18.

Jennifer Charlesworth said she “of course” anticipates pushback on the idea, as the thought of young people using such harmful substances is shocking.

“But the reality is that these young people are using substances, and it’s our responsibility to do everything in our power to make sure that they are safe,” Dr. Charlesworth said.

Two dozen youths between the ages of 10 and 18 died of illicit drug overdoses last year – double the number from 2016. Another 14 youths fatally overdosed in the first nine months of 2018.

The recommendation for youth-specific supervised drug-use spaces is one of five included in a report released by B.C.'s Representative for Children and Youth on Thursday. Titled Time to Listen: Youth Voices on Substance Use, the 55-page document reflects the views of 100 youths, via focus groups and surveys, as well as a review of 154 critical injury and death reports.

Focus group participants in the Fraser Valley and Vancouver Coastal regions spoke of the value of supervised drug-use sites, but noted they were largely inaccessible to youth, the report stated. Some female youths also expressed safety concerns about using services that were primarily accessed by older men, and those services being located in neighbourhoods with high rates of substance use.

Some also spoke of difficulties accessing harm-reduction supplies such as clean syringes and pipes.

Asked what a youth-specific site might look like, Dr. Charlesworth gestured at the Directions Youth Services centre in downtown Vancouver where the news conference to release the report was being held.

“This is the kind of environment in which youth feel welcome and safe, and there’s an array of services and staff who are deeply connected to community and understand what might be available,” she said.

Marnie Goldenberg, director of Directions Youth Services, said there had already been plans to discuss the feasibility of offering drug-checking services at the centre. She said the creation of a supervised drug-use space is “absolutely within the realm of possibility,” but noted it would be a challenge.

“This space was created for this space, and having new programs makes it hard, especially when people want to be safe from using,” she said. “How do you integrate services that also support people who are using? It’s a balance, but we’re ready to have conversations about how we can up our game as a harm-reduction site.”

Judy Darcy, B.C.’s Minister of Mental Health and Addictions, said she had not received specific requests for such sites, but that if there are barriers to health services including harm reduction, she will work to address them.

“We don’t know where we will land on this, but we take the report very seriously and we will be looking closely at the recommendations,” she said.

At Vancouver’s Insite supervised drug-use site, clients must be at least 16 years old. If they are between 16 and 19, they must agree to be assessed by a nurse, according to Vancouver Coastal Health.

Youth can access harm-reduction supplies – as well as naloxone, an opioid-overdose antidote – at any VCH distribution point. The health-care provider has also made fentanyl strip checking available at the Foundry Youth Clinic in Vancouver and is working to expand drug checking to other youth service sites.

The reports’ other recommendations are: that the Ministry of Mental Health and Addictions ensure that a commitment to youth engagement is embedded in its Mental Health and Addictions Strategy; the development of a training program for foster parents regarding youth substance use; the creation of a single source of information for all publicly funded substance-use services available to youth; and a comprehensive system of substance-use services that will meet the diverse needs of youth.

Dr. Charlesworth’s report is intended to help inform the government’s new Mental Health and Addictions Strategy, expected next spring.

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