Alcohol And Substance Abuse In Canada 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).

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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, stakeholders, non-governmental organizations, researchers, policy analysts and the alcohol industry share the responsibility 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 targets overall drinking rates and 2) the harm reduction approach, which targets high-risk drinking patterns at the individual level (Thomas, 2004).

Canadian Drug Strategy still states that it reflects a balance between reducing the supply of drugs and reducing the demand for drugs. The longterm goal of the strategy remains unchanged: it is to reduce the harm associated with alcohol and other drugs to individuals, families and communities. The goals of CDS are :

Reduce the demand for drugs;

Reduce drug-related mortality and morbidity;

Improve the effectiveness of and accessibility to substance abuse information and interventions;

Restrict the supply of illicit drugs and reduce the profitability of illicit drug trafficking; and

Reduce the costs of substance abuse to Canadian society (Canada’s Drug Strategy, 1998)

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

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

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Education and prevention:-  education and prevention programs currently aim to help people avoid the use of harmful substances and to enhance their ability to control their use.  Education, motivation, and awareness-building are combined with regulation and taxation to achieve the goals, recognizing that different groups have different needs in relation to prevention of substance abuse. As a group, youth and young adults have the highest rates of alcohol, tobacco and marijuana use and require particular encouragement to avoid the associated health risks.  The federal government has a role in measures to encourage healthy choices; these measures include: increasing the price of alcohol and cigarettes; creating more smoke-free and alcohol-free environments; limiting advertising of tobacco and alcohol products; and supporting education programs in schools and media.

Treatment and rehabilitation:-  These programs, which usually address addiction to alcohol and drugs together, include detoxification, early identification and intervention and assessment and referral, basic counselling, therapeutic interventions, clinical follow-up and some workplace initiatives. Treatment centres with specific programs for particular groups are a relatively new phenomenon.  Women, Aboriginal peoples and youth are among the groups to be targeted. People who work in the field suggest that women are more likely to hide their substance abuse problems for fear of stigmatization or lest they might have to give up their children. 

Enforcement and control :- At the federal level, various government bodies are involved in control, detection and enforcement efforts that incur high costs for personnel and equipment.  Efforts to control tobacco and alcohol include advertising restrictions, taxation, and limits on sales.   At the federal level, the 1997 Tobacco Act provides for a broad range of restrictions on the composition of tobacco products, young persons’ access to tobacco products, tobacco product labelling, and tobacco product advertisement endorsement and sponsorship.  For alcohol, the Broadcasting Act and the Code for the Broadcast Advertising of Alcoholic Beverages regulate advertising. (Chenier, 2001)

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

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

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);

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);

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);

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

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

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

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

Impact

Through the continues and effective approach of the Canadian government in the education, treatment and harm reduction approach for alcohol and substance abuse in Canada, overall prevalence is decreased in the Canadian society. According to reports 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 Canadians 15 years and older, the prevalence of past-year cannabis use decreased from 10.7% in 2010 to 9.1%.

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

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

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

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

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

Less than three quarters of youth (70.8%) reported consuming alcohol in the past year. This is a decrease from 2004 when 82.9% of youth reported past-year use of alcohol.

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

Costs & Benefits

In its 1996 assessment of the costs associated with substance abuse,  the Canadian Centre on Substance Abuse (CCSA) concluded that, in 1992 in Canada, substance abuse cost more than $18.45 billion.  This amounted to $649 for every Canadian and was equivalent to 2.7% of the Gross Domestic Product.  Productivity losses from illness and premature death accounted for $11.78 billion, or 64% of all costs.  The cost to the health care system was more than $4 billion and to law enforcement another $1.76 billion.   The Centre estimated that 40,930 deaths were attributable to substance abuse in 1992, representing 21% of the total mortality for that year.

When individual substances are considered, tobacco accounts for more than half of the total costs at $9.56 billion, alcohol for 40% of costs at $7.52 billion, and illicit drugs for 7% at $1.37 billion.  In each case, the largest economic cost is for lost productivity due to illness and premature death.  This study did not calculate the cost of misuse of prescription drugs.

Costs associated with alcohol and substance abuse occur in several areas like health, social, workplace and enforcement.  In addition to the long-term health problems associated with substance abuse, immediate crises can arise if the amount of drug consumed is misjudged, the drug is contaminated or too strong, or several substances are taken in combination. Substance abuse can lead to family breakdown when members are unable to maintain close relationships or to alter their personal lifestyle to accommodate others.   Tardiness, constant absences and inability to work may result from intoxication or drug-induced apathy.  Reduced productivity may lead to unemployment with all its associated social and health costs.  Those addicted to substances have a higher rate of unemployment than average. And talk regarding enforcement – More policing is required to ensure adherence to laws controlling the manufacture and distribution of certain drugs and because some substances produce extremely violent or verbally abusive behavior. 

Conclusions