A discussion with a front line youth worker
Jasmine Garcha (she/her) // Managing Editor
Rachel Lu (she/her) // Crew Illustrator
Resources for youth struggling with substance use compiled by the Courier are listed at the bottom of this page*
According to the Coroner’s Services records made publicly accessible via the Government of B.C. website, the leading cause of unnatural deaths among youth in the province during the January 2019 to December 2023 period was unregulated drug overdoses, 83 per cent of which were connected to fentanyl or an equivalent substance.
Jesse Gotfrit, who started working as a front line youth worker at Directions Youth Services in the Downtown Eastside in 2021, says that fentanyl and amphetamines are the most common drugs used by street-involved youth. Sitting down with the Courier to discuss addiction and harm-reduction services in Vancouver, Gotfrit notes how the path from recreational drugs to substances like fentanyl or methamphetamines is remarkably brief; “you see [youth] moving really quickly from smoking weed, drinking alcohol or using recreational drugs like coke and molly, and then they get offered fentanyl or they get offered methamphetamines.”
According to Yale Medicine, addiction is caused by an overloading of the brain’s reward system with dopamine—via substance use—such to the extent that ‘natural rewards’ become insufficient. Recognized as a disease by the World Health Organization and the Canadian Medical Association, people turn to substances and develop addictions for a variety of reasons. Specifically, Gotfrit recognizes factors such as pre-existing emotional or psychological issues, noting that many of the youth he has worked with face psychosis or are struggling with “serious mental health disorders” in addition to trauma experienced early in life.
Gotfrit regards substance use as a form of coping, addressing stigmas around addiction being a choice and something that is often associated with being “irresponsible or compulsive.” He goes on to say that significant change is needed with how society views and treats people struggling with substance use, explaining that better education is a key part of shifting narratives and increasing social understanding.
Strain theory—a sociological theory proposed by Robert K. Merton in 1938 as a way to examine the causes of criminal behaviour, also applicable to juvenile delinquency and related illicit activity—posits that a person experiencing immense stressors (strain) in their daily life will turn to desperate means to relieve their strain. Aligning with Merton’s research, Gotfrit details how the stress of living on the street is in part what leads people to desperate measures of coping, such as substance use. The Covenant House Vancouver website notes that 40,000 young people in Canada experience homelessness yearly, and in greater Vancouver, youth make up 8 per cent of the total homeless population.
Harm reduction programs aim to support the health of people using substances. Commonly discussed examples include safe injection sites, naloxone distribution and opiate substitution. Further examples listed on the HealthLinkBC website include mental health and wellness support programs, impaired driving prevention programs and substance checking services including drug testing.
“We need to adopt more programs with a harm reduction model,” Gotfrit says, “A lot of youth shelters require an abstinence-based criteria for their program.” He mentions that an exception to this is Covenant House Vancouver’s sanctuary program that allows youth to continue using substances while attending and receiving help. However, harm reduction has its own stigmas.
“People think all we’re doing is creating spaces for youth to use drugs,” Gotfrit says, noting that more available treatment options to complement harm reduction programs would make the existence of those programs—in the context of being one piece in a broader system—more “digestible” in the public view. He lists more long-term housing and youth-based detox programs as significant examples of missing pieces in the system of available support.
Although there has been an increase in access to drug-related treatment—namely in the form of beds—as reported by BC Gov News at the start of the year, many services are not directly targeted toward youth. Gotfrit mentions that the existing youth-based resources are, “underequipped to service the amount of youth that need support.”
He notes that there are not enough spaces where youth can get referred to the support that they need in order to recover or get help with their substance use. “In my own experience, I don’t feel like there are enough resources,” says Gotfrit, who went on to mention a youth-based detox program that previously existed within Directions Youth Services. This program specifically targeted youth, a rarity for detox programs in B.C., and used a non-medication based model to treat withdrawal. The British Columbia Centre on Substance Use reported in 2022 that this program was closed due to the province’s withdrawal of funding.
Regarding the closure of this program, Gotfrit mentions a gap left in the system and that this program was specifically notable due to the lower number of requirements for entry. It was designed, “for youth to just get off the street, sometimes for a couple days, and take a break from their substance use. . . and they might go back to it.”
There has been a recent evolution in how drug treatment programs approach the idea of relapse, which is a concern when offering temporary detox or harm reducing treatment. As CTV News reported this year, relapse is now expected by treatment program workers; the CEO of Coast Mental Health, Keir MacDonald, even mentioned to CTV News that their programs “now prefer to identify triggers and try to figure out why the resident returned to drugs.”
Global News reported earlier this year that the federal government has cut funding for safe supply programs despite the push for harm reduction programs. The B.C. government continues to run these programs, such as opiate replacement programs, although people involved in these programs have reported receiving lesser dosages.
The Ministry of Mental Health and Addictions 2024/25 budget plan, as published on the BC Budget 2025 website, outlines its plan of care for young people experiencing issues with substance use, describing a bed-based approach and focus on mental health care. This report mentions expanding the Foundry network, which offers a holistic approach to recovery and connects youth to external resources that may help with housing or detoxification but does not offer these services themselves.
Funding cuts regarding harm reduction and safe supply in B.C. could be detrimental to the health and well-being of local youth facing substance use issues. The lack of youth-specific resources or funding for such programs creates a significant gap, and inevitably, youth struggling with substance use are falling through the cracks.
*Resources available to youth struggling with substance abuse:
Detox: Vancouver Coastal Health, Vancouver Detox (not youth-specific)
Harm Reduction: Directions Youth Services, Foundry, getyourdrugstested.com, Vancouver Coastal Health
Housing: Covenant House Vancouver, Orca Lelum, St. Paul’s Road to Recovery, Young Bears’ Lodge, Vancouver Coastal Health