Weeded out: The Scarcity and Misfit of Youth-Tailored Services for Cannabis Use Disorder in Ontario

Abstract

Background: Cannabis use disorder (CUD) is an increasingly prevalent substance use disorder among youth. Early initiation, particularly before age 16, significantly increases risk of CUD, psychiatric comorbidity, and adverse psychosocial outcomes. Despite this vulnerability, help-seeking remains low, with only 3% of Canadians reporting cannabis use reporting access to professional support. Existing research has documented the harms of cannabis and CUD in youth, but little is known about whether addiction services are structured to meet these needs. Objective: To characterize the publicly funded addiction treatment landscape in Ontario and assess the availability, accessibility, approachability, and appropriateness of addiction services for youth with CUD using Levesque’s framework of healthcare access. Methods: An environmental scan of the ConnexOntario database was conducted (February-March 2025). Of 194 services initially identified under “substance use,” 160 met the inclusion criteria. Publicly available service descriptions were reviewed to extract variables including age eligibility, geographical location, referral requirements, service models, substances explicitly mentioned, treatment philosophy, and populations served. Results: Of 160 services, 64 (40%) indicated serving youth (≤17 years), with only 3.8% identified as youth-exclusive programs. Among youth-serving services, only 34% accepted clients under age 16, despite early initiation as a known risk for CUD. Cannabis was explicitly referenced in only 4.7% of youth-serving services, compared with 48.4% referencing alcohol. Many services emphasized detoxification and rapid access models that are primarily tailored to alcohol or opioid use. Conclusion: Findings reveal a structural mismatch between epidemiologic risk and service design. The current addiction treatment landscape in Ontario demonstrates limited visibility, age-appropriate access, and cannabis-specific programming for youth with CUD. Even when services are available, models often do not align with the typical outpatient and psychosocial needs of youth with CUD. This mapping review highlights the urgent need for accessible, youth-centered, cannabis-specific early intervention to better support help-seeking in youth.