Learn about addiction services for children and youth in Ontario.
Many young people experiment with alcohol or other drugs without becoming dependent on these substances, or developing an addiction. In other words, they are able to stop or cut down on their use without help. But some people cannot do this alone.
People can develop problems with legal drugs, such as alcohol or prescription drugs. Or they can develop problems with illegal drugs, such as marijuana or cocaine. Most addiction programs focus on treating substance use problems. Some newer programs treat other addictions that young people might develop, called “behavioural” or “process” addictions. These are behaviours that are repeated so often that they do harm to the person’s well-being.
For example, a young person may develop:
- a gambling problem
- Internet or technology addiction
- addiction to gaming (e.g., video gaming)
- addiction to sex or pornography
Mental health and addiction problems
People with an addiction are more at risk of developing a mental health problem, such as anxiety, depression, or an eating disorder. People with mental health challenges are also more likely to develop an addiction.
For example, someone who has experienced trauma such as being abused or bullied as a child, who has been a refugee, or who has experienced unstable housing may develop a dependency on marijuana or alcohol as a way to feel calmer or less worried and to distract themselves from difficult circumstances.
Because of this link between mental health problems and addictions, many programs provide services that address both of these problems at the same time. When someone has both a mental health and an addiction problem, they have concurrent disorders.
For youth in Ontario, there are many more services available to treat mental health problems than there are for addictions.
Especially for youth
Finding the right addiction service for a young person can be tricky, especially for transitional youth. These are young people who are “transitioning” between child and adult services. They are no longer children, but they also aren’t quite adults yet.
Most children’s services in Ontario are funded through the Ministry of Children and Youth Services for young people up to age 16. Adult programs are for people 16 and older and are funded by the Ministry of Health and Long-Term Care.
Because young people develop and mature at different ages, youth needing services don’t always fit neatly into these age categories. Youth programs can be for anyone aged 12 to 25. What ages are served may vary greatly from program to program. For example, one addiction agency might have a program for youth aged 14 to 18. Another program could be for youth aged 13 to 21.
Youth vs. adult programs
Youth addiction services differ in many ways from adult programs.
Because many youth still live at home, services will focus on the young person’s environment, which often includes the family and school. There will usually be support and information available to family members separately, as well as together with the young person.
Youth addiction services also usually adopt an approach that focuses on harm reduction. Reducing harm means minimizing or decreasing the risks associated with an addiction and cutting back according to the individual’s goals — and what seems realistic for them.
Note that in residential treatment programs, however, the young person is required to abstain or stop using altogether while living in the facility.
Getting into treatment
Generally, agencies don’t require a doctor or other professional to make a referral, but an assessment prior to admission may be necessary. If a professional referral is required, this information should be available from the agency.
Most youth addiction services will accept self-referrals, which means that youth themselves can call to access services.
Parent or other family member
A parent or another relative can call about a young person if they have concerns about the young person’s substance use. Depending on the agency, the intake worker may ask to speak to the youth to see if he or she consents to treatment and understands what they are agreeing to. Or the agency may invite the family member to visit the agency to get information, support and counselling for themself without necessarily involving the youth, or at least not at the beginning, if the youth is not ready to get treatment.
Most addiction programs recognize that young people may lose motivation to seek treatment if they are forced to wait. For this reason, they may offer an assessment or orientation session in advance of the person being accepted into treatment.
Wait lists vary for each agency, but are generally a few months long. The wait period is usually the longest for residential treatment programs. But private agencies—the ones you pay for—tend to have little or no wait list.
What to expect
There are several steps that occur between first contact with the agency and the beginning of treatment.
Step 1: Intake
The first step is usually to call the agency and speak to an intake worker over the phone. The worker will ask basic information about what you are looking for and determine whether the agency offers the type of service you need. The worker will also tell you briefly about the various options available to you.
Step 2: Assessment
The next step is a comprehensive assessment that looks at all aspects of your addiction. For example, the worker may ask:
- how long and how much you have used a substance or practised a behaviour
- what effect your addiction has had on your life (for example, on your relationships, your family life, and your attendance and performance at school or work)
- what your goals are for treatment
An assessment usually takes place in person. But if you live far away, an assessment can sometimes be done over the phone, through Skype or videoconferencing.
Step 3: Developing a Treatment Plan
The next step involves developing a plan specially designed for the kinds of services the individual will need. This plan is made by the young person together with the family (if possible) and the counsellor.
The plan will take into account the “stages of change,” which refers to the youth’s readiness to get help for your addiction. For example, youth might be asked:
- Are you still contemplating if you want or even need services?
- Have you already stopped using and are prepared to stick to a plan?
What to consider when seeking treatment
Many services are available. The important part is to find a program or service best suited for the young person.
To help find the right service, consider the following questions:
- Is there a match between what the young person is hoping for and what the service offers?
- Is the wait time manageable?
- Is the service convenient—for example, located in your neighbourhood or available by transit?
- Is the service affordable?
- Is the young person available and willing to get treatment?
If the young person is not willing to go for treatment, family members can still ask for tips about how they can speak with their relative to get him or her ready. Family members should try not to decide ahead of time what kind of treatment is needed. The addiction agency will be able to help young people figure out what would be most helpful in each individual situation.
Inquire about privacy or confidentiality with the service or program. In general, a counsellor must keep what the young person says confidential, unless the youth gives the counsellor permission to talk to the parents. The counsellor may also have a duty to report to the local child protective services office if there is a child welfare matter for someone under the age of 16.
Kinds of treatment programs
Finding addiction treatment usually doesn’t mean finding just one service. Someone may start by getting outpatient support, then go to a day treatment program or even a residential treatment centre if less intensive support has not worked.
People often receive more than one service at once. For example, someone may see an addiction counsellor and also go to a support group and get family therapy.
These are the main types of services:
- Crisis support. The main way to get support during a mental health crisis is to call a 24-hour crisis line such as Kids Help Phone or a Distress Centre. If it is a medical emergency, call 911 or go the emergency department of your nearest hospital.
Although rare, some walk-in clinics may also be available.
- Private therapist. Some people will seek out a therapist to talk about emotional difficulties they are struggling with that could be contributing to their addiction problems. Or they could seek out a therapist that specializes in certain types of addictions, such as Internet addiction or problem gambling. You usually you have to pay for a private therapist, unless you have coverage through workplace extended health insurance.
- Self-help and peer support groups. Self-help groups are groups made up of people with similar problems (peers) who can support and listen to each other, and really understand what the person is going through. Some 12-step programs such as Alcoholics Anonymous have groups specifically for youth in larger cities, such as Toronto Ontario Young People in AA (TOYPAA). There are also groups such as Alateen for teenagers and Al-Anon for families, and groups for many other types of addictions besides alcohol.
- Outpatient treatment. A counsellor may meet with the young person one-on-one, together with the family, or in a group with other youth. How often people meet varies widely. Meetings may be once or twice a week and continue off and on for years; or, there might be only a few sessions.
Most agencies hold meetings in their offices. But sometimes counsellors will meet with the youth or families in their home, or someplace else in the community.
- Day treatment. Day treatment takes place all day, Monday to Friday. It usually involves a combination of individual, group and family therapy and some schooling at the centre, so youth can get secondary school credits. Day treatment usually lasts for at least two months but can last more than a year.
- Residential treatment. This is more intensive treatment. Living in a residential treatment facility is usually the last resort when outpatient or day treatment has not worked.
Residential treatment is different than in-patient treatment, in that residential tends to be longer term. Although limited, there are beds both for youth with addiction problems and for youth with concurrent disorders. These programs last anywhere from about three weeks to several months.
- Supportive housing. Some supportive housing is available for transitional youth (for example, group homes with different levels of support). But the supply is very limited, which often makes supportive housing difficult to get into.
- Adult withdrawal management, sometimes referred to as “detox.” It involves helping the young person withdraw from or “get off” of the substances he or she has been using. There are no withdrawal management services in Ontario specifically for youth, but there are some adult services where youth 16 or over can go.
Note: Medical concerns about the young person withdrawing safely from alcohol or other drugs should be discussed with a family doctor.
Approaches to therapy
Depending on the intensity and focus of treatment, services may include:
- individual or one-on-one therapy with an addiction counsellor
- group work
- family therapy
Common approaches include:
- cognitive-behavioural therapy (CBT), which focuses on changing how someone thinks and behave around a problem
- motivational interviewing, which looks at the person’s motivation to get treatment by exploring their ambivalence or mixed feelings about getting help
- dialectical behaviour therapy (DBT), which combines CBT with mindfulness or other group work to help people manage intense or overwhelming emotions.
Most addiction services in Ontario are free, but an OHIP card is required if the service is in a hospital. There are some private addiction facilities, both in Ontario and the United States, which charge for their services. Some extended health insurance plans may cover, or partially cover, these costs.
Where to find addiction services
Use the following information-providers to find addiction services in Ontario.
Health Care Options
Drug and Alcohol Helpline
Ontario Problem Gambling Helpline
Centre for Addiction and Mental Health Info Line
1-800-463-6273, or e-mail firstname.lastname@example.org
Kids Help Phone