Drug Abuse in the Global Village
Canada

Trends in Drug Abuse
Extent of Drug Abuse: Cannabis is reported the most prevalent drug abused in Canada. Annual prevalence is about 6.5 per cent in the adult population, and most significant among those aged 20-24 years (18.4 per cent), according to a 1989 survey. Abuse is more prevalent among men (8.9 per cent), especially those aged 25-34 (23.7 per cent), compared to 4.1 per cent and 13 per cent among the respective women groups (table 1) (HWC 1992a).
Cocaine (or crack) is the next most prevalent drug abused in Canada. Annual prevalence of abuse is about 1.4 per cent in the adult population. It is higher for men (2 per cent), especially among men aged 20-34 years (4 to 5 per cent), compared to (0.8 per cent) and (about 1.8 per cent) in respective groups (table 1) (HWC 1992a).
LSD, speed or heroin are also abused in Canada but their combined annual prevalence is about 0.4 per cent. Reported ever abuse is 4.1 per cent, indicating that abuse is not maintained after initial experimentation (table 1) (HWC 1992a).
Other drugs abused include prescription opiates (codeine, demerol and morphine), with monthly prevalency estimated at 5 per cent, followed by sleeping pills (3.6 per cent), tranquilizers (3.1 per cent), anti-depressants (2 per cent), and diet pills or stimulants (0.9 per cent) (HWC 1992a).

Abuser Characteristics: Abusers of illicit drugs are mostly male. Abuse is pronounced among the 20-34 years of age. Abuse of prescription drugs such as tranquilizers, sleeping pills, anti-depressants, diet pills and stimulants are more prevalent among women, especially those over 45 years of age (HWC 1992a).

Table 1  Proportion of population which used illicit drugs in the 12 months preceding the survey and ever abused, by age, sex, Canada, 1989.

--------------------------------------------------------------------------------------------------                                
Marijuana                     Cocaine                        LSD,Speed
or hash             or Crack                      or Heroin
--------------------------------------------------------------------------------------------------                                
   Ever  Last      Ever     Last      Ever     Last
            year                  year                  year
--------------------------------------------------------------------------------------------------Total
 15+     23.3     6.5       3.5       1.4       4.1       0.4#

Male    28.9     8.9       4.5       2.0       5.1       0.5#

Female 17.7     4.1       2.7       0.8#     3.1       -

15-19   23.2     12.3     2.5#     1.9#     4.5#     2.1#
Male    23.1     14.3     -           -           4.9#     -
Female 23.3     10.3#   -           -           4.2#     -

20-24   43.1     18.4     7.0       3.1#     4.7#     -
Male    51.7     15.2     8.2#     4.0#     6.9#     -
Female 34.4     6.0       5.8#     -           3.3#     -

25-34   25.8     4.5       8.6       3.3       7.5       -
Male    33.6     6.2       10.6     4.9#     8.6       -
Female 18.2     2.8#     6.7       1.8#     6.5       -

35-44   10.0     1.2#     2.3#     -           5.9       -
Male    16.5     -           3.2#     -           7.7       -
Female 3.5#     -           1.5#     -           4.1       -

45-55   2.4#     -           -           -           1.5#     -
Male    3.3#     -           -           -           2.6#     -
Female -           -           -           -           -           -

55-64   -           -           -           -           -           -
Male    -           -           -           -           -           -
Female -           -           -           -           -           -

65+      1.2#     -           -           -           -           -
Male    -           -           -           -           -           -
Female -           -           -           -           -           -
-------------------------------------------------------------------------------------------------- Sample size 11634
Population estimate: 20285000
# High sampling variability.
- Data suppressed.
SOURCE: HWC, National Alcohol and Other Drugs Survey, Canada, 1989 in HWC 1992a.

Regional Variations: Abuse varies in different regions of the country. Annual cannabis abuse is more prevalent in British Columbia (9.6 per cent) and Nova Scotia (7.4 per cent). Rates in Quebec and Alberta correspond to the national average of 6.5 per cent, while all other provinces are below the national average (HWC 1992a). Annual cocaine abuse is most prevalent in British Columbia (2.1 per cent), followed by Quebec (2.0 per cent) and Alberta and Ontario (1.1 per cent) (HWC 1992a).
Trends: Cannabis abuse among adults 18 years and over declined markedly in Canada from 1980-1985. From 1985-1989, abuse is reported to have stabilized (HWC 1992a). Surveys conducted by a number of agencies and centres in recent years have revealed a downward trend in cannabis abuse. However, despite an overall decrease in consumption levels, cannabis remains the most commonly abused illicit drug in Canada (NDIE 1991).
The upward trend in cocaine abuse and availability noted in previous years continued through 1990/1991 in Canada (NDIE 1991, HWC 1992a).
Mode of intake: Patterns of multiple drug abuse are reported. In Canada's 1985 Health Promotion Survey, one in every twenty (5 per cent) Canadians, 15 and older, reported abusing more than one drug. Cocaine abusers are reported to be frequent multiple drug abusers (HWC 1989). According to a 1990 study, 41 per cent of the "street youth" reported injection drug abuse. Multiple substance abuse among them is reported the norm rather than the exception (HWC 1992a).

COSTS AND CONSEQUENCES OF ABUSE
Poison control centre statistics for 1986 report 15,442 cases of drug poisonings by psychotherapeutic agents, sedatives and hypnotics, ASA (acetylsalicylic acid, e.g., Aspirin), acetaminophen (e.g. Tylenol), street drugs, and glues and adhesives (HWC in press)
In 1988, there were 414 deaths reported from drug dependence, non-dependent abuse of drugs, and adverse toxic effects of psychotropic drugs (HWC in press).
In 1988/89, there were 481 admissions for drug-related offence to Canadian federal penitentiaries (which hold prisoners sentenced to a term of two years or more) and another 6,211 admissions to provincial/territorial adult correctional institutions (which hold prisoners sentenced to a term of less than two years) (HWC in press).

NATIONAL RESPONSES TO DRUG ABUSE
National Strategy: Canada Drug Strategy (CDS) is a data driven joint effort of all levels of government, business, law enforcement agencies, and professional and voluntary organizations to reduce both demand and supply of drugs. The Minister of National Health and Welfare leads and coordinates CDS which includes programmes of health promotion, prevention (based on social marketing through radio and other media), training, education, early identification of abusers and early intervention, a wide variety of treatment and rehabilitation modalities, research and information collection and control measures through legislation and enforcement (U.N. 1990, CDS 1987, 1992).
Structure of National Drug Control Organs: The central government unit responsible for liaison and coordination of national drug control policy is the Bureau of Dangerous Drugs within the Health and Welfare Canada.

ACTIONS TAKEN TO IMPLEMENT INTERNATIONAL DRUG CONTROL TREATIES**

Treaty Adherence: Canada is party to the 1961 Convention as amended by the 1972 Protocol, the 1971 Convention and the 1988 Convention.

Measures taken with respect to Drug Control
Recently enacted laws and regulations: Canada has ratified the 1988 Convention and is still in the process of preparing appropriate legislation to implement its obligations under that Convention. In 1991, the drafting of a Psychotropics Substances Control Act continued and new anabolic steroid regulations were drafted so as to control illegal importation and distribution.
Licensing system for manufacture, trade and distribution: There is a government-controlled licensing system. No narcotic drugs or psychotropic substances were reported being manufactured in 1991.
Control system:
(i) Prescription requirement: There is a prescription requirement for supply or dispensation of preparations containing narcotic drugs and psychotropic substances.
(ii) Warnings on packages: The law requires warnings on packages or accompanying leaflet information to safeguard the users of preparations containing narcotic drugs and psychotropic substances.
(iii) Control of non-treaty substances, if any: None reported.
(iv) Other administrative measures: None reported.

Social Measures
Penal Sanctions related to social measures: In 1991, courts applied measures of treatment, education, after-care, rehabilitation or social reintegration for a drug-related offence both as an alternative and in addition to conviction or punishment.
Other social measures: A national drug strategy was launched in 1987 in response to growing awareness that drug-related problems pose a long-term and serious threat to the health and well-being of all Canadians. The drug strategy brings together many groups and individuals in both the public and private sectors into working partnerships. 70 percent of the total funds available for the implementation of the strategy are allocated to prevention, treatment and rehabilitation initiatives. A main component of the strategy are activities in the area of prevention which in 1991 were targeted at young people aged 11-17.

DEMAND REDUCTION ACTIVITIES
Primary Prevention: CDS addresses the prevention of all drug abuse (including alcohol and tobacco) in the context of a wider health promotion strategy. Prevention programmes aim at long term normative change through concerted social marketing and education efforts. These include the enpowering of NGO's, individuals and communities (through self and mutual help programmes) to counteract drug merchants activities (U.N. 1990, HWC 1992b).

Drug prevention programmes, based on research findings, target specific groups according to response needs in a continuum of risk and severity of developing drug related problems. Responses include health promotion, curriculum based educational programmes in schools and universities, mass media campaigns, community programmes and control of availability of the substances. There are also family-based prevention programmes whih aim to change parents' knowledge of, and attitudes towards, alcohol and other drugs; as well as generally improving parenting skills. Finally, prevention programmes seek to sensitizes health professionals to early identification and early intervention as well as effective treatment and rehabilitation (HWC 1992b).

Treatment and Rehabilitation: CDS is based on evaluation research geared towards identifing the most effective treatment and rehabilitation programmes. It aims to offer a wide range of services starting with the early identification of abusers who present a high risk of developing drug dependent behaviour, early intervention to minimize such developement, community and non-residential based self and mutual help programmes complemented by residential treatment when needed (HWC 1992b).
In 1985/86, there were 18,875 cases treated in general hospitals for: drug dependence (2,201), non-dependent abuse of drugs (1,235), and drug psychoses (919); drug dependence in the mother complicating pregnancy, childbirth, and the puerperium (77), suspected damage to the fetus from drugs (4), drug withdrawal syndrome in the newborn (44); poisoning by analgesics, antipyretics, and antirheumatics (5,671), sedatives and hypnotics (2,431), and psychotropic agents (6,293) (HWC in press).
In 1990, 1,459 opiate abusers received treatment or rehabilitation services, while 192 abusers sought treatment for the first time. These figures include patients who were only receiving methadone maintainance (U.N. 1990).
Programmes are also available for inmates in the correctional system, including alcohol and other drug treatment, vocational training and social reintegration (U.N. 1990).

SUPPLY REDUCTION ACTIVITIES
Arrests, Convictions and types of Offences: In 1989, there were 67,882 drug-related criminal offences and 44,650 Canadians were charged under the Narcotic Control Act (which covers offence primarily related to cannabis, cocaine, and heroin) and the Food and Drug acts (which cover controlled and restricted drugs). More than 60 per cent of all drug offences and 64 per cent of drug charges involved cannabis. More than 24 per cent of drug offences and 27 per cent of drug charges involved cocaine (HWC in press).
Excluding cannabis, the Bureau of Dangerous Drugs reported 8,359 convictions in 1988 under the federal Narcotic Control Act, the Food and Drug Act and the Criminal Code. There were 1,138 reported thefts and other cases involving narcotic and controlled drugs and 768 convictions under the Narcotic Control Act for 'multiple doctoring' (patients going to several doctors to obtain illicit prescription drugs) (HWC in press).
In 1990, 6,542 people were arrested for illegal drug possession (74 per cent possessed cocaine) and 5,396 persons were convicted (69 per cent for cocaine possession). Most of those convicted (80 per cent) are males and 42 per cent are over 30 years of age (U.N. 1990).
The total number of people arrested for drug trafficking in 1990 was 5,492 (86 per cent for cocaine traffick). About 4,321 were convicted (81 per cent for cocaine traffick), of these 89 per cent were male and 41 per cent over 30 years of age (U.N. 1990).
Seizures: In 1991, RCMP and Canada Customs reported to have seized more than 850 kg of cocaine, over 80 tonnes of cannabis, 100 kg of heroin and over 469,000 dosage units of LSD (RCMP 1991).
The RCMP seized 55.15 kg of heroin in 1990, a 60 per cent decrease from 1989, and 247.57 kg of cocaine, a 66 per cent decrease from 1989 (NDIE 1990).
Supply Source of Drugs: In Canada, 65 per cent of all heroin seized in 1990, originated in Southwest Asia; up from 21 per cent in 1989. West African heroin trafficking groups have come to view Canada as an entry point to the US market (NDIE 1991). Canadian cocaine trade continues to be dominated by representatives of Colombian trafficking organizations like the Medellin and Cali cartels (NDIE 1991). About 70 per cent of the cocaine in Canada comes from Colombia, 15 per cent from Peru, 10 per cent from Brazil and 5 per cent from Bolivia. About 10 per cent of this drug is destined to other countries, with Canada used only as a transit country (U.N. 1990).
About 25 per cent of the marihuana is cultivated in Canada illicitly. About 20 per cent comes each from Jamaica and Thailand, and 15 per cent from each Colombia and Mexico. About 5 per cent comes from Trinidad and Tobago. Most of the hashish in Canada originates from Pakistan and Afghanistan (60 per cent), Lebanon (30 per cent), and India (15 per cent) (U.N. 1990).

References and Notes

** The Legal, Administrative and Other Action Taken to Implement the International Drug Control Treaties section was prepared by the Secretariat of the Commission on Narcotic Drugs based on Annual Reports Questionnaires for the years 1990 and 1991.

U.N. 1990 Replies to UNDCP Annual Reports Questionnaire for the year 1990.

CDS 1987 and 1992 Canada Drug Strategy, Health and Welfare Canada.

HWC 1989. Licit and Illicit drugs in Canada. Eliany M. Health and Welfare Canada. 1989.

HWC 1992a. Alcohol and other Drug use by Canadians: National Alcohol and Other Drugs Survey (1989). Eliany M. Health and Welfare Canada. 1992.

HWC 1992b. How Effective are Alcohol and Other Drug Prevention and Treatment Programs?. Eliany M. and B. Rush. Health and Welfare Canada. 1992.

HWC in press Illicit Drug Abuse by Canadians Eliany M. et al Health and Welfare Canada, in press.

NDIE 1991. National Drug Intellegence Estimate 1991. Royal Canadian Mounted Police 1991.

RCMP 1991. Canada: Drug Situation. Royal Canadian Mounted Police, 1991.