Teen Substance Use and Mental Health: A Growing Crisis in Ontario
“This survey has always been a good barometer of trends among Ontario teens. It provides insight into the broader landscape of youth experiences and allows us to reflect on what we’re seeing in the teens who come to Pine River.”
Vaughan Dowie, CEO of Pine River Institute
This is the first in a two-part blog series exploring the findings of the 2023 Ontario Student Drug Use and Health Survey (OSDUHS), the November release of the Canadian Mental Health Association (CMHA) report, The State of Mental Health in Canada, and other recent youth mental health and addiction findings. In this blog, we focus on trends in youth substance use. In part two of this blog series, we will examine the mental health challenges highlighted by these reports and their implications.
Ontario teens are experiencing a troubling decline in overall mental health, according to the 2023 OSDUHS.
“Currently, more than half of Ontario students report symptoms of depression and anxiety, and a third of students (31 per cent) rate their ability to cope as fair or poor,” said Dr. Hayley Hamilton, Co-Director of the Institute for Mental Health Policy Research and survey lead at the Centre for Addiction and Mental Health (CAMH). “This trend points to a generation under increasing stress and the need for continued and increased investments in youth mental health.
The OSDUHS, a population survey of Ontario students in grades 7 through 12, has been conducted every two years since 1977. It is the longest ongoing school survey in Canada—and one of the longest in the world. The survey tracks trends in youth substance use, mental and physical health, and risk behaviour.
Substance Use Trends: An Alarming Increase in Opioid Use
The OSDUHS survey highlighted several concerning trends in youth substance use, particularly regarding prescription opioids:
• Non-medical use of prescription opioids (e.g., Percocet, OxyNeo, Dilaudid) surged to 21.8% in 2023, up from 12.7% in 2021, and has doubled since 2019.
“We are seeing a notable increase in the number of teens seeking help for opioid dependency,” said Amanda Ragazzon, Admissions and Community Outreach Director at Pine River Institute. “Their situations are more complex, requiring careful planning to address the risks they face while waiting for a spot and ensuring they have access to tailored detox and medical treatments for Opioid Use Disorder (OUD).”
Gender-Specific Trends in Substance Use
The report also revealed significant shifts in substance use trends among genders:
• Females (26%) are significantly more likely than males (18%) to report non-medical opioid use.
• For the first time in the survey’s history, the percentage of female students using cannabis, alcohol, and vaping has surpassed that of their male peers.
“We’re seeing more female teens referred for treatment, many with complex substance use issues, including opioid dependency,” added Ragazzon. “And overall, we’re hearing from kids and parents of earlier use of substances and an earlier onset of dependency.”
Positive Trends and Emerging Concerns
Despite these challenges, the survey shows a decline in overall substance use among Ontario youth:
• Cannabis use dropped to 17% in 2023, continuing a downward trend since its legalization for adults in 2018.
• Alcohol use declined steadily over 25 years, with only 36% of students reporting consumption in the past year.
“While declines in alcohol and cannabis use are encouraging, the elevated rates of drug use among girls are concerning,” noted Dr. Leslie Buckley, Head of the Addictions Division at CAMH, in the report. “We need more data to understand the underlying factors, but this may reflect increased pressures on girls.”
However, a significant uptick in cannabis-induced psychosis poses a growing concern. A study published in Psychological Medicine estimates that teens using cannabis are 11 times more likely to develop psychotic disorders compared to non-users.
“This suggests the association between cannabis and psychotic disorders may be stronger than previously thought, particularly given the increased potency of today’s cannabis,” stated CAMH, in its release of the report. “For context, the average THC potency in Canada has risen from roughly 1% in 1980 to 20% in 2018.”
This trend is something we’ve been seeing at Pine River Institute. More teens in our programs are grappling with the psychological effects of cannabis use, including cannabis-induced psychosis. Our experience highlights the urgent need to address this issue on multiple fronts.
Pine River contributed to the federal review of cannabis legislation, sharing our observations about the unintended consequences of legalization, particularly for youth. We emphasized the importance of strengthening prevention efforts, limiting youth exposure, and providing investment from the revenue of cannabis sales into resources for treatment and education. You can read/listen to more about our perspective in our previous story on cannabis legislation. Our full submission to the Cannabis Act legislative review in 2022 is here.
Looking Ahead
This article is part one of a two-part blog series on the 2023 OSDUHS findings, the CMHA report The State of Mental Health in Canada, and other recent research insights on teen substance use disorder and mental health. While we’ve explored trends in substance use here, stay tuned for part two, where we’ll examine the mental health challenges facing Ontario’s youth and discuss how organizations like Pine River Institute are working to address them.