An interview with Dr. Nicholas Chadi, Canadian Paediatric Society, December 16, 2024

**Available in English and French / Disponible en anglais et francais**

In 2022, a one-time CPSP survey exposed an increasing rate of exposure to opioids, sedatives, and stimulants in youth 12-18 years old. The same team—led by Drs. Matthew Carwana, Nicholas Chadi, and Eva Moore—has recently launched a multi-year study to better understand the trends of this crisis and to identify knowledge gaps for the health care providers treating these young people. We sat down with co-Principal Investigator Dr. Nicholas Chadi, for more information.

[This interview has been edited for clarity and brevity]

CPS: This 3-year study follows from a one-time survey. What were the most striking results from that survey and what led to this longer-term study?

NC: We’ve seen a worrisome trend over the past few years. Since 2022, overdose deaths are the main cause of mortality among adolescents in Western Canada. And this is a phenomenon that evolved quickly, just from the beginning of the pandemic. This led to the first cross-sectional survey. The most striking finding to me was that 14 per cent of respondents reported having seen at least one young person with a severe and acute event related to the use of an opioid, sedative, or stimulant substance in the past two years.

That seemed quite high and meant that paediatricians do intersect frequently with young people with these issues. It also correlates with the national data that we are seeing: an increase in overdose deaths related to illicit drugs. Given these findings, our group was interested in continuing the investigations and learning more about the characteristics of young people who present in situations related to the use of sedatives, stimulants, and opioids, as well as what treatment they received. (Read more – English version) (Entrevue complète en français)

Un reportage de Florence Morin-Martel, avec commentaires de Dr Nicholas Chadi, Le Devoir, 27 novembre 2024

Anxiété, dépression et déficit de l’attention : la proportion de troubles mentaux diagnostiqués chez les jeunes du secondaire au Québec a grimpé depuis environ 10 ans, révèle une étude de l’Institut de la statistique du Québec (ISQ).

Pour réaliser cette troisième édition de l’Enquête québécoise sur la santé des jeunes du secondaire, l’ISQ a interviewé 70 825 adolescents dans 483 écoles publiques ou privées, francophones ou anglophones, réparties partout au Québec.

Les résultats de l’exercice montrent que le taux de troubles anxieux diagnostiqués chez les jeunes a plus que doublé, passant de 9 % en 2010-2011 à 20 % en 2022-2023. En ce qui concerne la proportion de dépressions dans cette population, elle a bondi de 4,9 % à 7 %.

Le trouble déficitaire de l’attention avec ou sans hyperactivité (TDA/TDAH) est lui aussi en hausse chez les adolescents : le quart des élèves ont dit en souffrir en 2022-2023, comparativement à seulement 13 % en 2010-2011. Quant aux diagnostics de trouble de conduites alimentaires, ils sont passés de 1,8 % à 5 % en 12 ans.

En tout, environ 6 % des élèves ont pris des médicaments pour des symptômes d’anxiété ou de dépression, et 16 % en ont pris pour des symptômes de trouble déficitaire de l’attention avec ou sans hyperactivité.

Hormis le TDA/TDAH, les filles sont plus touchées par l’ensemble de ces troubles que les garçons, note l’Institut. « On sait que les filles vont avoir tendance à davantage consulter et à aller chercher de l’aide que les garçons par rapport à la santé mentale », explique le D^r Nicholas Chadi, pédiatre et clinicien-chercheur spécialisé en médecine de l’adolescence au Centre hospitalier universitaire (CHU) Sainte-Justine. (Article complet)

By Nicholas Chadi, Healthychildren.org, American Academy of Pediatrics, November 18, 2024

At some point, most families use prescription medications for specific medical needs. Everyday examples might include meds for attention-deficit/hyperactivity disorder (ADHD), pain relief, anxiety or sleep troubles.

When used for the medical conditions they’re meant to treat, and taken as prescribed, these drugs are generally safe. But every year, hospitals and medical offices see thousands of young patients who take controlled prescription medications for other reasons or not as prescribed—sometimes with deadly results.

Prescription medications most commonly used nonmedically

Nonmedical use of prescription medications can start at any age. However, it is seen more often in young people from middle school through young adulthood. The medications usually involved are:

• Stimulants, including ADHD medicines prescribed to help with energy and focus
• Sedatives, including prescriptions for anxiety or sleep
• Pain relievers, especially opioids

Young people who use prescription medications nonmedically may assume they are safe. But prescriptions may have strong ingredients that can cause harm when they’re not taken exactly as directed. Worse yet, what might look like a prescription medicine—right down to the pharmacy bottle and printed label—could be a copycat drug laced with something more dangerous, such as fentanyl. (Read more)

AAP News, with comments from Dr. Nicholas Chadi, November 18, 2024

The American Academy of Pediatrics (AAP) warns that the nonmedical use of controlled prescription medications carries high risk. While teens and young adults might think a pill is safe because it appears to be a prescribed drug or comes from a trusted source, they can be tragically mistaken.

In a new clinical report, “Nonmedical Use of Controlled Medications by Adolescents and Young Adults,” the AAP says adolescents and young adults are especially vulnerable to risky behavior related to nonmedical use of controlled medications. This is in part due to developmental imbalances as the brain matures.

The clinical report, published in the December 2024 Pediatrics details ways to reduce risk, including a recommendation that pediatricians counsel families about safely storing their medications.

Prescription drugs commonly misused by young people

“Young people may be seeking a ‘high’ or taking a friend’s stimulant medication that was prescribed for ADHD, or attempting to self-medicate,” said Nicholas Chadi, MD, MPH, FRCPC, FAAP, lead author of the clinical report, written by the AAP Committee on Substance Use and Prevention.

“The nonmedical use of prescriptions is common among youth. But often they can’t be certain about the ingredients in that medication or how their body will react to it, and increasingly, we see the potency of substances going up,” Dr. Chadi said.

“Sometimes a pill may look like it came from someone’s medicine cabinet but is a copycat or “counterfeit” pill that contains dangerous ingredients such as fentanyl, a synthetic opioid.” (Read more)

Also, see accompanying educational video and AAP news blog article

Interview with Laurence Brisson Dubreuil with comments from Nicholas Chadi, CTV News, Montreal, October 27, 2024

As synthetic drugs grow stronger, experts warn that overdoses pose an even greater threat, particularly to young people.

Dr. Nicholas Chadi, a pediatrician at Sainte-Justine Hospital, is sounding the alarm about the rising dangers of these substances.

“Substances that are circulating are getting stronger and stronger,” said Chadi.

According to Chadi, children as young as 11 are increasingly exposed to these synthetic drugs, including non-medical use of prescription medications, opioids, and various sedatives.

While Chadi notes that fewer young Quebecers are using drugs compared to two decades ago, those who do are encountering more potent substances.

“The fact that one pill can be so strong that it can lead to overdose is quite concerning,” he said.

Chadi pointed to data from Western Canada, where drug overdoses are now the leading cause of death among youth aged 10 to 18.

“This isn’t a trend that we’ve documented in Quebec or Ontario yet,” Chadi explained, “but we are hearing anecdotal cases of very young people using pills for the first time and having an overdose.” (Full article and video report available here)

Un reportage de Jean-Philippe Bourdeau, avec commentaires du Dr Nicholas Chadi, J.E bureau d’enquête, TVA Nouvelles, le 25 octobre 2024

Des adolescents québécois aussi jeunes que 11 ans sont de plus en plus exposés à de puissantes drogues de synthèse vendues sur le marché noir. Dans certains cas, un seul comprimé peut créer une dépendance, voire pire, une surdose.

«Je vois maintenant des enfants de 11 ou 12 ans avec des enjeux de substances», déplore le Dr Nicholas Chadi, l’un des rares pédiatres canadiens spécialisés en toxicomanie.

Le médecin qui pratique à l’Hôpital Sainte-Justine à Montréal observe que même si les jeunes Québécois consomment moins de drogue qu’avant, ceux qui le font ont un accès de plus en plus en grand à de puissantes substances de synthèse.

«La tendance est marquée depuis quelques années. […] Il y a une augmentation de l’accès et de la circulation de substances plus fortes, parfois mal identifiées, et qui posent des risques vraiment importants», lance le spécialiste en entrevue à l’émission J.E, qui sera diffusée ce soir à 20 h à TVA.

En 2017, le Québec avait recensé 7 décès par surdose chez les moins de 20 ans. Ce nombre a presque que doublé avec 13 décès en 2020 et 12 en 2023. (Article complet et pour visionner le reportage vidéo (J.E bureau d’enquête)

Un reportage produit par Urbania, animé par Hugo Meunier, Jean Bourbeau, Sara Buzzell, avec commentaires du Dr Nicholas Chadi, Canal Savoir, 9 octobre 2024.

Le Xanax et les benzodiazépines, souvent prescrits pour réduire le stress et améliorer le sommeil, sont aussi détournés à des fins récréatives. Leur usage croissant chez les jeunes et leur potentiel addictif suscitent des inquiétudes. Sara Buzzell explore cette réalité.

Visionner le reportage