Study exposes ‘critical gap’ in youth addiction care

Study of youth ER visits for substance use in Sudbury reveal a critical gap: 18–24-year-olds lack follow-up care, driving repeat crises.

New research out of Sudbury is highlighting a critical gap in the healthcare system regarding youth experiencing substance use disorder.

“Substance use is a really prevalent issue, especially in northern Ontario,” said Dr. Kristen Morin, a research scientist at Health Sciences North Research Institute and an assistant professor at NOSM University.

“Youth is a higher risk group and so these kinds of studies that we’re conducting are really trying to identify ways to improve the system for vulnerable populations.”

The findings come at a critical time for northern Ontario, where opioid-related mortality rates and emergency department visits consistently outpace the provincial average – a disparity often fueled by geographical isolation and a shortage of specialized youth mental health practitioners.

Morin, along with her team, conducted the research examining health data from 6,500 patients between 2018 and 2023. The data was organized into three categories:

• under 18,
• transitional age youth: ages 18 to 24 and
• adults: 25 and older.

“What we found in our study was that youth presenting to the hospital here in Sudbury, revisit the emergency room within 30 days,” she said.

“They are more frequently or more likely to revisit the emergency room within 30 days than compared to adults.”

Morin said revisits offer an indicator of systemic health.

“It’s a good indicator of whether or not people’s needs were met at the hospital, if appropriate follow-up care was conducted. If they do come back within 30 days, then it means, potentially, we didn’t meet their needs or that they didn’t receive the care that they should have gotten,” she said.

While adults with substance use disorder often face long-term struggles, Morin’s research indicates a “critical window.” If a young person can make it past the first 30 days without returning to the ER, their chance of recovery improves significantly.

The research suggests that this period serves as a ‘make-or-break’ window. Without a ‘warm handoff’ – a direct connection to a community counselor or a peer support worker within 72 hours of leaving the ER – the cycle of crisis and readmission is significantly more likely to repeat.

However, for those in the “transitional” age gap of 18 to 24, the risk remains highest. As patients age out of pediatric systems, they frequently lose access to long-term caseworkers and youth-specific beds, leaving the emergency department as their only remaining safety net.

Morin’s team research suggests that the solution lies in ‘integrated care pathways,’ where a hospital visit automatically triggers a community-based follow-up, ensuring the burden of navigating a complex healthcare system doesn’t fall solely on a young person in the midst of a crisis.

Moving forward, Morin will continue to look at different populations and how care can be improved through additional community partners.

“I am a big advocate for treating people as humans,” she said.

“The issue of substance use affects us all and it’s one of the most prevalent issues of our time.”