Alcohol And Substance Abuse Health And Social Care Essay

Global Health & Human Services Systems

MADS- 6642

Pro: Dr. Carlos Leon

By : Kishansinh Chavda (1576670)

Table of Contents

Introduction

Alcohol and substance abuse is one of the biggest problems in Canada. Alcohol and substance abuse are the psychoactive substance that causes the greatest harms in terms of social, legal, health and economic costs and problems. By definition, Substance abuse can be medical or non-medical and these substances can be legal or illegal. This paper summarizes the information about the prevalence of alcohol use and substance abuse in Canada and also about the harm related to the use of both of these. The paper also includes talk of reducing harm associated with alcohol and other addictive substances and best overall policy and other activities taken by the Canadian Government to reduce the problem.

The term psychoactive substance refers to a series of substances, licit or illicit, that, when ingested, affect the mind, mood or other mental processes and temporarily vary the way a person feels, thinks or acts.  Many psychoactive substances are lawfully prescribed in Canada each year to treat insomnia , anxiety , depression or to relieve pain. Various forms of some substances, like alcohol & nicotine, are available for purchase without prescription. Others, such as cannabis, heroin and cocaine, are controlled through the enforcement of the Controlled Drugs and Substances Act (CDSA), which prohibits possessing, trafficking, importing, exporting, and producing any such substance.

Background

Substance use and abuse in adolescence is an on-going problem in the Canada. Various problems are associated with adolescent substance abuse and it is affecting on their lives emotionally, socially, legally, economically and physically (Sussman, 2008).

Substance_Abuse.png

Numerous illegal and legal substances usind data drawn maily from 1994, 1995, 1997 and 1999 versions of Canadian Profile:   Alcohol, Tobacco and Other Drugs are described below.

Legal Substance :

Alcohol : -   Drinkers are mostly to be younger men with a post secondary education. According to Canadian Profile, in 1995-1996, stated that alcohol related hospital separations were around 80,946 and among them 1.6% of all hospitalizations for women and 3.9% for men.  The maximum number of alcohol-linked hospital separations were for motor vehicle accidents, alcohol dependence syndrome & accidental falls. The 1996-1997 National Population Health Survey found that one in 13 respondents accepted driving after consuming two or more drinks in the previous hour and this rate was more prevalent among men aged between 20 to 24 years.Out of the 6,503 Canadians who died because of alcohol utilization , the prevalent number of alcohol-related deaths stemmed from alcoholic liver cirrhosis, motor vehicle accidents and alcohol-related suicides. (Chenier, 2001)

Tobacco : -Cigarettes and other tobacco products contains nicotine and nicotine is more addictive . On the basis of results from Health Canada, we can conclude that there was significantly rising in nicotine levels in tobacco between 1968 and 1995 and this rise was around 53% over the time. According 1999 Canadian Tobacco Use Monitoring Survey, 35% of people aged between 20-24 reported that they smoked and the age group of 15 years had the prevalence of 25% overall. In Qubec, Smoking frequency is higher among teens aged 15 to 19 years at 36%. Smoking prevalence was higher in men than women and also individuals with lower levels of education and low income had much higher rates of smoking. The 1999 Canadian Profile offered estimates of tobacco-attributable mortality and morbidity. More than two-thirds of those who die from tobacco-related deaths are men.Almost 34,728 deaths due to tobacco hold the figure of 16.5% of total mortality in Canada for the year of 1996.  35% of tobacco related deaths were due to lung cancers. (Chenier, 2001)

Solvents :- According to the Canadian Alcohol and Drug Survey, less than 0.1% of adults were used solvents. Health problems along with solvent abuse are not properly documented, but it includes liver and kidney disturbances, blood abnormalities, nervous system damage and respiratory difficulties. Usually solvent users have a uniqueness of low education level, troubled family circumstances and poor socioeconomic status. The health problems associated with solvent abuse are not well documented but include, , blood abnormalities and nervous system damage. Solvent abuse is a foremost trouble among young aboriginal people. In 1990 and 1992 surveys of Toronto and Halifax street youth indicated that 8 to 15% of respondents informed that they used solvents in the past. The 1993 First Nations and Inuit Community Youth Solvent Abuse Survey indicated that males of 12 to 19 years of age were most solvent users. The greater part of young people use solvents for social reasons (37.5%) or to experiment (42.3%). (Chenier, 2001)

Prescription Drugs :- The 1996-1997 National Population Health Survey collected data on self-reported use of tranquilizers, sleeping pills, stimulants, anti-depressants, narcotic pain relievers and diet pills. The percentage of Canadians aged 15 years and older used at least one of the five categories was 11.6%. Regionally, tranquilizer use was highest in Quebec, narcotic pain reliever use was highest in Alberta and sleeping pill and anti-depressant use was highest in British Columbia. (Chenier, 2001)

Illegal Substances

Data on the national use of drugs such as LSD, cannabis, heroin and cocaine was last collected in the 1994 Canada’s Alcohol and other Drugs Survey. The Controlled Drugs and Substances Act(CDSA) are currently regulating these substances..  This legislation includes Parts III and IV of the Narcotic Control Act  and the Food and Drugs Act which came into force in May 1997.  Use of the substances is either totally forbidden or strictly controlled under the CDSA.

Cannabis :- When ingested or smoked , cannabis leads to a short-range euphoric effect.  High doses can cause, disorganized thoughts, perceptual deformation and mild hallucinations.In 1994, 23% of the residents over the age of 15 years stated use of cannabis more than once. During the past years in 1994, reported use of cannabis was 19.3% among the 20- to 24-year-olds,  , 23.0% between 18- to 19-years-olds, and 25.4% between 15- to 17-year-olds. In 1994, the percentage of users in Newfoundland were 3.8% and 11.6 % in British Columbia. (Chenier, 2001)

Cocaine :- Cocaine is a short acting, powerful central nervous system stimulant which can be smoked, inhaled or injected, but repeated use of cocaine lead to strong psychological and consequent dependence. Males in the age of 25 to 34 tends to be a lifetime user. In 1994, less than 1% of the inhabitants reported being current crack or cocaine users.Highest prevalence was in British Columbia at 8.1%. In 1996, cocaine offenses reported for 17% of all drug offenses.

Heroin :-Heroin is a narcotic analgesic which is derived from morphine and its favored mode of administration is injection.  Tolerance develops swiftly with regular use. Due to the varying quality of the drug, risk of death from overdose is great  There is also a risk of transmittal of hepatitis or AIDS through shared needles.  By 1994, heroin crimes were at 2.0% of total drug crimes.Regulations produced in 1985 authorize heroin importation for medical use, predominantly for pain control.

  Marijuana :- Marijuana is one of the most commonly used drug in Canada. According to the 2004 Canadian Addiction Survey, 44.5% of respondent said that they used pot at least once in their life , 14.1% stated that they have used marijuana in the past 12 months. Individuals that have used marijuana in the past year varies greatly, with 18.1% reporting to be used daily, , 20.3% was weekly, 16% reported that they used monthly, with 20.8% not having used at all in the past 3 months. The highest prevalence of marijuana was in British Columbia with 52.1% which is drastically higher than the national level. British Columbia also has the maximum past year usage compared to the national average at 16.8%. (Drug Abuse in Canada.)

Intervention

In Canada, many levels of governments, , non-governmental organizations, stakeholders, policy analysts, researchers and the alcohol industry distribute the task for creating and implementing initiatives and measures that will prevent and reduce alcohol-related harms.  There are two basic approaches:  "1) the population health approach, which aims overall drinking rates and 2) the harm reduction approach, which aims high-risk drinking patterns at the individual level (Thomas, 2004).

Canadian Drug Strategy still declares that it shows an equilibrium between reducing the demand for drugs and reducing the supply of drugs. The longterm goal of the strategy leftovers without any change: it is to lessen the harm associated with alcohol and other drugs to individuals, families and communities. The goals of CDS are :

Reduce drug-related morbidity and mortality;

Reduce the demand for drugs;

Reduce the expenses of substance abuse to Canadian society

Improve the efficacy of and ease of access to substance abuse information and interventions;

Confine the supply of illegal drugs and reduce the profitability of illegal drug trafficking (Canada’s Drug Strategy, 1998).

In 1997, $16.5 million of the $34-million total budget was managed by the Office of Canada’s Drug strategy. It is presently managed by the Office of Canada’s Drug Strategy, which gives $14 million to the provinces for treatment and rehabilitation programs. The other $2.5 million was to be paid for program and research management. The Healthy Environments and Consumer Safety Branch was distributing remaining $ 17.5 million in following ares: Medical Marijuana Program ($5.0 million); administration of regulations other than the Marijuana Medical Access Regulations ($5.0 million); policy, research and international affairs ($3.0 million) and drug analytical services ($4.5 million). (Renewal without specified funding, 1997)

The Canadian Government is taking measures mainly in following areas: Education and prevention; Treatment and rehabilitation & reinforcement and control.

http://www.ottawa.ca/calendar/ottawa/citycouncil/hrssc/2006/02-16/ACS2006-CCS-HRS-0002%20E_files/image001.gif

Education and prevention:-  education and prevention programs presently aim to help people keep away from the use of damaging substances and to boost their ability to control their use.  Education, awareness-building and motivation are united with taxation and regulation to achieve the goals, distinguishing that different groups have different requirements in relation to prevention of substance abuse. Youth and young adults have the uppermost rates of tobacco, marijuana and alcohol use and necessitate particular support to avoid the associated health risks. Tertiary Prevention engages rigorous multi-component activities, counting such strategies as substance abuse treatment, birth control, and parenting problems (Nanson, 2000). The federal government has a role in actions to promote healthy choices; these actions include: creating more smoke-free and alcohol-free environments; mounting the price of alcohol and cigarettes; sustaining education programs in schools and media and restraining advertising of alcohol and tobacco products.

Treatment and rehabilitation:-  These programs, which generally address addiction to alcohol and drugs together, include early identification and intervention; detoxification; basic counseling; assessment and referral, clinical follow-up, therapeutic interventions, and some workplace initiatives. Youth, women and Aboriginal peoples are the groups to be targeted. People who work in the countryside recommend that women are more possibly to hide their substance abuse problems for fright of stigmatization or lest they might have to give up their children. 

Enforcement and control :- Various government bodies at the federal level are occupied in detection, control and enforcement efforts that acquire high costs for personnel and equipment.  Hard work to manage tobacco and alcohol include, limits on sales, advertising restrictions and taxation.   At the federal level, the 1997 Tobacco Act offers for a wide range of limitations on young persons’ access to tobacco products, the composition of tobacco product, tobacco product advertisement endorsement and sponsorship & tobacco product labelling.  For alcohol, the Broadcasting Act and the Code for the Broadcast Advertising of Alcoholic Beverages standardize advertising. (Chenier, 2001)

Harm Reduction : Some of the policies implemented by the Canadian Government to shrink the alcohol related harm and to decline its utilization rate are (Thomas, 2004):

Restricted hours and days of sale (in Canada, there is a relatively strict control but in recent years many provinces have extended both their hours and days of sale);

Instituting a minimum legal drinking age (in Canada, the age is 19 except in Manitoba, Alberta and Quebec where it is 18);

Alcohol taxes (e.g., in Canada, federal excise tax; provincial markups and environmental taxes; federal and provincial sales taxes);

Sobriety checkpoints (random or selective testing of drivers at roadside checkpoints);

Public monopolies on the production and/or distribution of alcohol (in Canada, each province and territory has established a liquor authority responsible for the control and sale of alcohol);

Outlet density restrictions (e.g., zoning laws to limit the clustering of retail alcohol outlets in a particular area);

Administrative license suspension (in Canada, suspension may be imposed administratively for a period ranging from 12 hours to 90 days)

Lowered BAC limits (in Canada, 0.08 (Criminal Code) and lower in most provinces (0.05 range));

Brief interventions for hazardous drinkers (early intervention designed to motivate high-risk drinkers to moderate their use of alcohol)

Graduated licensing for novice drivers (in Canada, this policy is established in all provinces and territories, except Prince Edward Island and Nunavut); and

Impact

Overall occurrence is decreased in the Canadian society through the continueus and effective approach of the Canadian government in the education, treatment and harm reduction approach for alcohol and substance abuse in Canada. According to information from the  Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) 2011, following are the figures to justify the effective government action in decreasing the alcohol and substance abuse.

Among youth, aged 15-24 years, past-year use of at least one of 5 illegal drugs ( crack or cocaine , speed and hallucinogens (excluding ecstasy, and heroin) diminished from 11.3% in 2004 to 4.8%.

Among Canadians 15 years and older, the occurrence of past-year cannabis use diminished from 10.7% in 2010 to 9.1%.

The occurrence of past-year cannabis use diminished since 2004 for youth aged 15-24 years (37.0% vs. 21.6%); males (18.2% vs. 12.2%) and females (10.2% vs. 6.2%).

Among Canadians 15 years and older, the occurrence of past-year alcohol use was 78.0%, not statistically unusual from previous years

Drug usage by youth 15-24 years of age remains much higher than that reported by adults 25 years and older: five times elevated for past-year use of any one of five drugs excluding cannabis (4.8% versus 1.1%) and three times elevated for cannabis use (21.6% versus 6.7%)

70.8% of youth reported having alcohol in the past year. This is a decline from 2004 when 82.9% of youth reported past-year use of alcohol.

The rate of past-year psychoactive pharmaceutical use diminished in Canadians aged 15 years and older from 26.0% in 2010 to 22.9%. People who have accepted that they had used a stimulant, an opioid pain reliever, or a tranquilizer or sedative in the past year, 3.2% reported they abused such a drug.

In November 2011, Canadian federal, provincial and territorial health ministers received Canada's Low-Risk Alcohol Drinking Guidelines. Of the five guidelines, the first two affect to all Canadians and deal with chronic effects like liver disease and certain cancers, and acute effects such as overdoses and injuries, correspondingly. In 2011, 14.4% of Canadians aged 15 years and older exceeded the suggested quantity of alcohol outlined in guideline 1 for chronic risk and 10.1% exceeded the suggested quantity of alcohol outlined in guideline 2 for acute risk. (Canadian Alcohol and Drug Use Monitoring Survey (CADUMS), 2011)

Costs & Benefits

In 1996, the Canadian Centre on Substance Abuse (CCSA) revealed the cost of $ 18.45 billion with substance abuse for the year of 1992 in Canada.  This amounted to $649 for every Canadian and was equivalent to 2.7% of the Gross Domestic Product.  From illness and premature death, productivity losses accounted for 64% of all costs or $ 11.78 billion.  The cost for the health care system and for law enforcement was around $4 billion and $1.76 billion respectively.In 1992, the centre predicted 21% of the mortality for the year of 1992 which hold the figure of 40,930 deaths from substance abuse. (Chenier, 2001)

When individual substances are taken in to count, tobacco accounts at $9.56 billion, alcohol at $7.52 billion, and illegal drugs at $1.37 billion.  In each case, productivity loss due to illness and premature death was the largest economic cost. (Chenier, 2001).

Costs related to alcohol and substance abuse occur in numerous areas like social, health, enforcement and workplace.  In addition to the long-term health harms associated with substance abuse, immediate crises can arise if the amount of drug consumed is miscalculated, the drug is too strong or contaminated, or several substances are taken in combination. Substance abuse can guide to family breakdown when members are not able to keep close relationships or to modify their personal lifestyle to accommodate others.  Constant absences, tardiness, and inability to work may result from drug-induced apathy or intoxication.  Reduced productivity may lead to joblessness with all its associated health and social costs.  Those addicted to substances have an elevated rate of unemployment than average. More policing is required to guarantee adherence to laws controlling the manufacture and distribution of certain drugs and because some substances produce extremely verbally abusive or violent behavior. 

Conclusions

As mentioned earlier in this paper, alcohol and substance abuse is having a huge effect on the individual’s health, social and economical status. It will hamper individual’s personal life and drove them into poverty and put a much more burden on the government. It is essential to keep in mind the root issues of alcohol and substance abuse, and the role of an entire community or population can play in mitigating the effects of substance use and misuse. These approaches include providing synchronized and broad services, and understanding drug and alcohol use as a public health issue. (Stockburger, 2003). The Government of Canada identified the problem associated with country residence earlier in the decay of 1990 and 2000. The Canadian Government implemented various policies, both at the provincial level and at the federal level to reduce the use of alcohol and other substances. By implementing various approaches in education, prevention, rehabilitation, treatment and harm reduction, total number people were consuming alcohol and substance abuse was getting down in the year of 2011 and the government is trying to achieve very good results with further decline in consumption rate of this substance for the better development of the Canada.