Youth Substance Use: A Critical Analysis of Tensions Between Federal Policy Discourse and Frontline Service Provision in Ontario

Substance use ranging from experimentation to problematic use and addiction is most common among youth and young adults. Evidence shows that the earlier in life individuals begin to use substances, the higher the risk for substance misuse. Adolescence and young adulthood are life stages when behaviours and habits become established. They are also periods of social and developmental change as youth navigate through challenges and transition through social roles. In order to respond to substance use issues in Ontario, the substance use service provider arena is guided by federal policies and offers a range of services from both public and private domains, intended to support youth experiencing substance use issues.

My dissertation had three objectives: 1) to assess the experience of frontline service providers to shed light on their perspectives on challenges faced by youth who use substances; 2) to critically evaluate representations of substance use among youth in a federal substance use strategy document that informs provincial level practice; and 3) to assess the policy implications of the tensions between dominant representations of substance use in policy documents and the lived experience of frontline service workers in the field of substance use for policy, practice and equity. To achieve these objectives, I conducted an online survey of Ontario service providers recruited from youth-oriented addiction substance use treatment organizations, I followed up with qualitative key informant interviews of a sub-sample of willing survey participants, and I assessed dominant representations of the problem of substance use using the critical policy approach of WPR (Bacchi, 1999), through an examination of the National Canadian Drugs and Substance Use Strategy (CDSS).

My findings revealed significant tensions between theory and practice. While frontline providers expressed the need for harm-reduction, non-pharmacological and prevention initiatives for youth, the National Strategy downplayed this need, as well as the significance of the social determinants of health, while largely framing the behaviours of users of substance as falling under the jurisdiction of the criminal justice system. I offer policy recommendations on how to reduce the identified gaps between dominant representations and practice and propose strategies to encourage policy makers to develop youth-appropriate substance use reduction policies.