School of Nursing, University of British Columbia, Vancouver, BC, Canada.
British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada.
Can J Public Health. 2021 Jun;112(3):456-459. doi: 10.17269/s41997-020-00459-3. Epub 2021 Jan 11.
As is the case across Canada, the province of British Columbia is in the midst of an opioid overdose crisis. In response to the devastating impacts of this crisis on youth (under 19 years of age), the provincial government is considering amending the Mental Health Act to allow for involuntary, hospital-based stabilization care of youth following an overdose. This policy change represents one concrete action that the provincial government is exploring in response to public advocacy for enhanced supports for youth who overdose. At this juncture, however, we are concerned that stabilization care requires further interrogation in the context of key, interrelated public health and ethical dimensions pertaining to this legislation. In this commentary, we describe three key areas for public health deliberation: (1) the evidence underpinning stabilization care, (2) ethical considerations, and (3) the potential for unintended and unevenly distributed consequences. We then offer ways forward to guide and provide opportunities for a more equitable public health response to the overdose crisis and its impacts on youth. In doing so, we emphasize the need for meaningful engagement of youth as key stakeholders in the development of evidence- and ethics-informed substance use care and policy interventions.
与加拿大其他省份一样，不列颠哥伦比亚省正处于阿片类药物过量危机之中。为了应对这场危机给年轻人（19 岁以下）带来的破坏性影响，省政府正在考虑修订《精神健康法》，允许在年轻人过量用药后，对其进行非自愿的、基于医院的稳定化护理。这一政策变化代表了省政府为应对公众倡导的加强对过量用药的年轻人的支持而探索的一项具体行动。然而，在这个关头，我们担心稳定化护理需要在与该立法相关的关键的、相互关联的公共卫生和伦理维度方面进行进一步的审查。在这篇评论中，我们描述了公共卫生审议的三个关键领域：（1）稳定化护理的证据基础，（2）伦理考虑，以及（3）意外和不平等分布后果的可能性。然后，我们提供了前进的方向，以指导和为更公平地应对阿片类药物过量危机及其对年轻人的影响提供机会。在这样做的过程中，我们强调需要让年轻人作为利益攸关方，有意义地参与到基于证据和伦理的物质使用护理和政策干预的制定中来。
