Estimation of Needs for Addiction Services: A Youth Model.

Objective: In the field of health care services, resource allocation is increasingly determined based on a population needs model. Although service needs models have been developed for adults with substance use problems, it would seem inappropriate to apply them indiscriminately to young people.

Method: The method used proposes six steps: (1) targeting the population, (2) estimating the proportion of the population affected by substance misuse and (3) the proportion of youths who should receive services, (4) identifying categories of services, (5) estimating the proportions of youths who should have access to each category of services, and (6) applying the model to real use of services by youths to recalibrate it.

Results: Youths ages 12-17 from the Province of Québec were classified within a tiered model comprising four levels of substance use severity. Youths in need of services varied from 38% (weak response) to 95% (high response) for the highest severity cases. Service categories retained are detoxification/intoxication, outpatient, and residential, with each one being subdivided into four categories. The proportion of youths from each tier who should access categories and subcategories of services varied widely. After a pre-experimentation, the model was adjusted.

Conclusions: The model can be applied in different jurisdictions, with the caution of adjusting prevalence to local reality. Further improvement will be based on more accurate information concerning the path of clients through services, better strategies to reach youths in need of services, and increased knowledge of optimal service categories. Models adapted to low- or moderate-income countries, where the health care system has minimal services in the areas of mental health and addiction, should be developed.