The lack of tailored, age-appropriate approaches to and options for substance use care have consistently been cited as barriers to engaging youth in treatment.428,429 Strategies that primary care clinicians and care teams can use to improve retention and engagement in care in youth include: emphasizing confidentiality within and across services; including family members and other caregivers (e.g., trusted Elders, teachers, outreach workers, counsellors, as well as friends and romantic partners) in care when appropriate; fostering respect, trust, and the development of longitudinal therapeutic relationships; offering the full scope of pharmacotherapy when indicated; providing referrals to youth-oriented psychosocial treatment interventions and supports; and ensuring timelines are adequately discussed with youth and that treatment is provided without a pre-determined end date.430-436 Inclusion of peer support staff or referrals to peer support services in the community may also support a youth-centered approach to care.437,438

While this guideline is intended to be applicable to all adults age 18 and above, there are unique considerations for adolescents (age 12-17) and young adults (18-25), collectively referred to as “youth”, that are not addressed in this document. Specific guidance for the screening, assessment, and treatment of OUD in youth (aged 12-25) can be found in the BCCSU, Ministry of Health, and Ministry of Mental Health and Addiction’s Treatment of Opioid Use Disorder for Youth--Guideline Supplement.102