Experts Map Eight Ways to Make Opioid Treatment Work for Young People

Opioid agonist treatment is the standard of care for opioid use disorder in Canada and the United States, yet young people aged 16 to 24 continue to use it far less than other groups while overdose among youth remains a serious concern. A qualitative study conducted in British Columbia between March 2024 and March 2025 set out to close that gap by asking experts directly what youth-centred models of care for opioid agonist treatment should look like. The result, published open access in Addiction Science & Clinical Practice, is a set of eight concrete recommendations grounded in the lived experience of young people who have navigated the treatment system themselves.

The research team, led by first author Kirsten Marchand and colleagues, recruited 17 participants purposefully through youth mental health and substance use services across the province. The group included six youth aged 16 to 24 with experience accessing opioid agonist treatment, four caregivers of such youth, five service providers, and two decision-makers. British Columbia was a deliberate choice of setting: overdose is one of the leading causes of accidental death among youth in the province, making the local urgency of the question acute.

Participants took part in semi-structured interviews, and the researchers applied a directed content analysis to the transcribed interviews to synthesize and describe the experts’ recommendations for improving the delivery of opioid agonist treatment to youth. This method allowed the team to organize what participants said into a coherent set of actionable guidance points drawn from across the four participant groups.

The analysis produced eight recommendations. First, services should establish and maintain trusting relationships with youth. Second, providers should regularly check in with young patients about their goals and about the benefits and challenges they experience with treatment. Third, all medication options should be presented alongside their respective benefits and challenges, rather than steering youth toward a single default. Fourth, induction plans for starting medication should be developed collaboratively with the young person rather than imposed on them.

The remaining four recommendations extend beyond the clinical encounter. Opioid agonist treatment should be delivered as part of a comprehensive approach to a young person’s health and life circumstances, not as an isolated prescription. Services should operate in low-barrier and non-judgmental settings that reduce the friction of staying in care. Tapering processes, when a young person chooses to reduce or stop medication, should likewise be developed collaboratively. Finally, caregivers should be empowered and supported, recognizing the role families play in sustaining youth engagement with treatment.

Underlying all eight recommendations, the researchers identified four foundational pillars. These emphasized positive relationships between youth and service providers, flexible treatment plans that can adapt to changing circumstances, and service delivery settings that are both low-barrier and holistic. Together, the pillars frame opioid agonist treatment for youth as a service built on relationships, flexibility, and accessibility rather than on medication alone.

The study’s design carries important limitations. It captured the perspectives of 17 purposively recruited participants in a single Canadian province, so the findings represent expert recommendations rather than tested outcomes. The authors are explicit that future research is needed to examine how youth-centred models of care actually perform once implemented, with specific attention to how these models address the diverse needs of youth across different communities, age ranges, genders, and clinical, social, and cultural contexts.

Even so, the recommendations offer a practical blueprint for services aiming to improve uptake and retention of opioid agonist treatment among young people. By centering trust, choice, collaboration, and caregiver support, the study reframes treatment for youth as a relationship-driven service rather than a purely pharmacological one. Whether these expert-grounded principles translate into measurable improvements in treatment engagement and outcomes will depend on the implementation research the authors call for next.

Subject of Research: Expert recommendations for youth-centred models of opioid agonist treatment in British Columbia

Article Title: Optimizing the quality of opioid agonist treatment for youth: experts’ recommendations for youth-centred models of care

Article References: Marchand, K., Turuba, R., Cameron, V., Eekhoudt, C. R., Fast, D., Knight, R., Marsh, D. C., Ignaszewski, M. J., Sassi, R., Mathias, S., & Barbic, S. (2026). Optimizing the quality of opioid agonist treatment for youth: experts’ recommendations for youth-centred models of care. Addiction Science & Clinical Practice. https://doi.org/10.1186/s13722-026-00729-4

Image Credits: AI Generated

DOI: 10.1186/s13722-026-00729-4

Keywords: opioid agonist treatment, opioid use disorder, youth health, qualitative research, British Columbia, overdose, models of care, addiction medicine, caregivers, service providers, Optimizing, quality