Sign in or 
- EasyEdit
- Edit tags
-
(what's this?What are these tools?
People just like you can add or edit the content on this site. If you want to try editing, but aren't ready to add to this site, try our demo area.
Read more about editing pages at Wetpaint Central.
) - Report page
Share this
Understanding Nature, Prevalence of Substance Abuse (EE)
This initial or rough draft of a summary (formatted in a Encyclopedia Entry format) has been started by the International School Health Network from a previous Canadian project. Visitors to and members of this wiki-based web site are welcome to edit the draft (using the Easy Edit" tool found at the top of the page or to comment on the draft by using the "thread" tool found at the bottom of the page. (All previous versions of this page are automatically saved by the system, so don't hesitate to edit this page). Eventually, when time and resources permit, this initial draft will be formatted in accordance with the outline for glossary terms, encyclopedia entries and handbook sections used in this knowledge exchange program for health,safety, educational and social development interventions.
This summary introduces a discussion of a common problem in school health promotion and other human development programs. Often a program or intervention is funded and started to respond to a specific, urgent health or social issue and people are responding to the symptoms of the problem rather than a deeper understanding of the underlying causes, prevalence and burden of the problem.
The International School Health Network, in its statement on braod implementation strategies in school health p[romotion suggests that:
1.5. Programs should be based on a clear, evidence-based understanding of the nature and prevalence of the health or social problems being addressed.
Application to school substance abuse prevention
(Please add items here that identify good practices or implications derived from the point made on this page.)
Much attention is given to preventing substance use problems among adolescents. This makes sense, for while there are very significant drug issues among other populations, it is during adolescence that most substance use begins. Moreover, young people tend to use substances in more hazardous ways than older people and these patterns can result in significant harms, in the short and longer term. During the course of a young person’s development, numerous factors interact in complex ways to determine whether a person will experiment with substances and whether use may become problematic. The terms “protective factors” and “risk factors” are often used to identify aspects of a person and their environment that make the development of a given problem less (i.e., protective) or more likely (i.e., risk).[i] Although there is much that remains unclear[1], it is commonly accepted that the factors linked to a young person trying or “experimenting” with a substance differ from those that are linked to harmful use by some students.
Personal factors Through the course of normal adolescent development, young people experience a number of needs that alcohol and other drugs can, in their own way, address. These needs include: taking risks, demonstrating autonomy and independence, developing values distinct from parental and societal authority, signalling entry into a peer group, seeking novel and exciting experiences, and satisfying curiosity.[ii]
Whether a young person chooses to use a substance is linked to their perception of risk associated with that drug. As perceived risk linked to a drug increases, rates of use decline.[iii] The reverse is also true, so an emerging drug may experience a “grace period” during which there is little information available about risks or harms.[iv] Substances may be used or combined with little knowledge of the possible effects, so even initial or experimental use can be hazardous.[v]
Interpersonal factors Beyond the personal influences there are interpersonal influences involved in a young person’s decisions to experiment with substances. Family norms and substance use patterns are of course highly influential. Young people are also influenced strongly by their perception of how common or “normative” substance use is. For example, if one’s friends smoke, drink or use other substances or if there is a sense that others in their networks do, a young person is more likely to do so. Some young people may use substances as consumer items, along with clothes and music, to establish an identity or image for themselves.[vi]
Broad factors Young people in Canada are growing up in an environment that is tolerant of various forms of substance use, both medical and non-medical. A vast array of mood altering substances in the form of alcohol, tobacco, pharmaceuticals, alternative medicines, nutraceuticals and illegal drugs in Canada, locally and through the Internet has created easy access. An unprecedented level of access to media by young people has meant that more young people than ever are “consuming” a globalized pop culture that tends to tolerate substance use.[vii] The powerful marketing capacities of the alcohol and tobacco industries contribute to this environment by directing much of their attention to a youthful market.[viii] Even these capacities, however, are dwarfed by the scale of the illicit drug industry, which has been estimated to account for approximately 8% of world trade – more than iron and steel and about the same as textiles.[ix] This is occurring in a world that is fast-paced and highly unpredictable, as one commentator puts it, a "runaway world".[x] Community factors such as general attitudes toward alcohol and other substance use as well as the leisure options perceived by youth affect their substance use decisions.
Because all students are exposed to most of these influences in some measure, it is not surprising that the use of alcohol, cannabis and tobacco is common among Canadian students regardless of whether they are viewed as being at higher or lower levels of developmental risk. Any substance use presents the potential for problems. Even a single drug-using experience or occasional use by a naïve user can result in harm through, for example, overdose, an injury event, or in the case of illegal drugs, criminal prosecution.[xi] Many youth who do experiment with or continue to use substances do so in risky ways (e.g. large amounts in unsafe settings).
In fact, some contend that all young people, by virtue of the developmental changes they all undergo, and the various societal factors they all experience, should be considered a population “at risk”. One observer questions the value of distinguishing between a mainstream who are “OK” and a minority who are at risk, suggesting that the pace of social change means many young people will experience risk factors such as depression or unemployment at some point or another in their lives.[xii] While there is some merit to this view, some young people and families clearly experience more risk factors than the norm.
The picture that emerges from research is that of two populations of youth with different trajectories – those that are subject to the usual range of environmental and social influences and who engage in some amount of deviant and risky behaviour as part of normal adolescent development, and a second population that experiences more severe challenges through their life course and whose deviance may be more extreme and long-term (i.e. adolescence-limited vs. life-course deviance).[xiii]
B. Factors contributing to substance use problems
When children begin school, they already bring different experiences that will serve to protect them or to place them at risk (e.g. fetal exposure to alcohol and tobacco, early nurturance, attachment to their mothers, neglect, good nutrition, or early onset behavioural problems). A developmental pathway continues to take form as the child’s characteristics interact with the school and family environment through the early school years to influence academic failure and success, behaviour, relationships with peers and teachers and attitudes to school.[xiv]
These interactions form a complex web of causation at any given point in a child’s life, and opportunities for shifting a trajectory exist at these various points. For example, changes in parenting practices will affect, and be affected by a young person’s personality at a particular developmental point.[xv] Through the school years these earlier factors will interact with a child’s academic and social experiences and for some, lead to characteristics that are linked to substance use problems, for example, having anti-social or substance-using friends, or engaging in truancy and other anti-social behaviour.
Risk and protective factors by life stage
The levels of risk and protection may shift through the life course and their impact varies with when they occur. Below is a summary, drawn (unless otherwise indicated) from a review by Loxley and colleagues (2004), which provides the best available evidence on when, during the life course, various factors have the greatest impact (bearing in mind that risk factor research is a work in progress).[xvi]
Prior to birth:
Parental substance use problems: Maternal alcohol use may result in lifelong cognitive, behavioural and social deficits that increase risk for a range of difficulties including harmful substance use; smoking prior to birth, and environmental tobacco smoke are risk factors for impaired child development; this impairment may initiate a pathway of poor child adjustment, leading to harmful substance use.
Genetic factors: Although there is much yet to learn, it is likely that a combination of genetic factors influence behaviour through their interaction with environmental factors. Material poverty: Being born or raised in a family experiencing extreme economic deprivation is a risk factor for harm associated with substance use. Poor family management and breakdown: Low level of parent-child attachment, and being born or raised in a sole parent household is a risk factor for more frequent substance use in adolescence.[xvii]
Infancy and early childhood:
Parental abuse and neglect: Child neglect and abuse is a risk factor for impaired child development and this impairment may initiate a pathway of poor child adjustment leading to harmful substance use. Temperament and early behaviour: Easy temperament in early childhood is a protective factor for positive child adjustment and reduces the influence of other risk factors, leading to lower rates of involvement in harmful substance use. Aggression in early childhood is a strong risk factor for later delinquency and substance use problems.[xviii]
Later childhood
Shy temperament and personality: shy and cautious temperament in childhood is a protective factor, reducing the influence of risk factors for early adolescent multiple and illegal substance use in early adulthood.
Child social and emotional competence: Social and emotional competence in childhood is a protective factor, reducing the influence of risk factors for alcohol and other substance use.
Conduct disorder: Conduct disorder in childhood is a risk factor for higher levels of alcohol consumption in adolescence. The influence of conduct disorder on alcohol abuse may be increased by family vulnerability to alcohol problems or by earlier age alcohol use.
Aggression: Aggression in childhood is a risk factor for early adolescent multiple-drug use and adult alcohol abuse. Unsettled home situations: a study found that young people living on the street in Victoria, British Columbia were less likely to have a history of abuse than a history of frequent moves and dislocation (for example, from one guardian’s house to another, or from foster home to foster home).[xix]
School failure: Early school failure is a risk factor for various later problems including alcohol use problems.
Adolescence
Gender: while rates of use are similar between girls and boys, boys are more likely to use in hazardous and harmful ways.
Low positive contact with adults: Low involvement in activities with adults in adolescence is a risk factor for early adolescent multiple-drug use.
Community disadvantage and disorganization: Community disadvantage and disorganization in adolescence has been associated with adolescent substance use.
Favourable attitudes toward drug use: Favourable attitudes towards drug use behaviour in early adolescence are associated with an increased involvement in subsequent drug use.
Family attachment: Attachment to the family in adolescence is a protective factor, reducing risk factors for early adolescent multiple-drug use.
Parental harmony and parent-adolescent conflict: Low parental conflict (parental harmony) from late childhood and in adolescence is a protective factor, reducing alcohol problems, and parent-adolescent conflict is a risk factor for early age substance use.
Parental attitudes toward substance use: Favourable parental attitudes to substance use from late childhood through adolescence is a risk factor for early age initiation of the same substance.
Alcohol and other drug problems in the family: Parental alcohol and other drug problems early in their offspring’s adolescence is a risk factor for earlier age alcohol use and higher levels of alcohol use later in adolescence. The Canadian Task Force on Preventive Health Care has estimated that one million children in Canada under the age of 19 live with an alcohol dependent parent.[xx]
Parental communication and monitoring: Parental communication in early adolescence is a protective factor, reducing the influence of risk factors for harmful youth substance use. Youth with greater expendable income (e.g. larger allowances) have been shown to be more likely to drink hazardously than other youth.[xxi]
Family rules and discipline: Parental rules permitting substance use in childhood or early adolescence is a risk factor for early age substance use. Peer relationships: Relationships with peers who are involved in substance use in late childhood or adolescence is a risk factor for problematic alcohol and other substance use. However, the phenomenon of peer influence as a risk factor is complex; some research concludes that peers are less a factor in starting to use than in encouraging and maintaining a certain level of use that fits with group norms.[xxii]
Externalizing behaviour problems—delinquency and conduct problems: Delinquency in adolescence is a risk factor for problematic alcohol and other substance use.
Sensation seeking and adventurous personality: in adolescence are risk factors for multiple-drug use.
Religion: Religious involvement in adolescence is a protective factor, reducing the influence of risk factors for harmful substance use.
This summary introduces a discussion of a common problem in school health promotion and other human development programs. Often a program or intervention is funded and started to respond to a specific, urgent health or social issue and people are responding to the symptoms of the problem rather than a deeper understanding of the underlying causes, prevalence and burden of the problem.
The International School Health Network, in its statement on braod implementation strategies in school health p[romotion suggests that:
1.5. Programs should be based on a clear, evidence-based understanding of the nature and prevalence of the health or social problems being addressed.
Application to school substance abuse prevention
(Please add items here that identify good practices or implications derived from the point made on this page.)
- Good/promising practice 1: schools need to base their substance use policies and programs on the best available local information on the nature and extent of student substance use and substance use problems; substance use needs to be understood in relation to age, gender, culture and ethnicity among other factors. (Canadian Association for School Health, p. 9)
Much attention is given to preventing substance use problems among adolescents. This makes sense, for while there are very significant drug issues among other populations, it is during adolescence that most substance use begins. Moreover, young people tend to use substances in more hazardous ways than older people and these patterns can result in significant harms, in the short and longer term. During the course of a young person’s development, numerous factors interact in complex ways to determine whether a person will experiment with substances and whether use may become problematic. The terms “protective factors” and “risk factors” are often used to identify aspects of a person and their environment that make the development of a given problem less (i.e., protective) or more likely (i.e., risk).[i] Although there is much that remains unclear[1], it is commonly accepted that the factors linked to a young person trying or “experimenting” with a substance differ from those that are linked to harmful use by some students.
A. Factors influencing experimentation with substances
All young people can be seen as being at some risk by virtue of a range of influences that everyone is exposed to in some measure. The influences or factors can be organized according to the following “spheres”: · Personal factors (genetic, personality) · Interpersonal factors (family, peer) · Broad, social cultural factors (socio-economic status, norms)Personal factors Through the course of normal adolescent development, young people experience a number of needs that alcohol and other drugs can, in their own way, address. These needs include: taking risks, demonstrating autonomy and independence, developing values distinct from parental and societal authority, signalling entry into a peer group, seeking novel and exciting experiences, and satisfying curiosity.[ii]
Whether a young person chooses to use a substance is linked to their perception of risk associated with that drug. As perceived risk linked to a drug increases, rates of use decline.[iii] The reverse is also true, so an emerging drug may experience a “grace period” during which there is little information available about risks or harms.[iv] Substances may be used or combined with little knowledge of the possible effects, so even initial or experimental use can be hazardous.[v]
Interpersonal factors Beyond the personal influences there are interpersonal influences involved in a young person’s decisions to experiment with substances. Family norms and substance use patterns are of course highly influential. Young people are also influenced strongly by their perception of how common or “normative” substance use is. For example, if one’s friends smoke, drink or use other substances or if there is a sense that others in their networks do, a young person is more likely to do so. Some young people may use substances as consumer items, along with clothes and music, to establish an identity or image for themselves.[vi]
Broad factors Young people in Canada are growing up in an environment that is tolerant of various forms of substance use, both medical and non-medical. A vast array of mood altering substances in the form of alcohol, tobacco, pharmaceuticals, alternative medicines, nutraceuticals and illegal drugs in Canada, locally and through the Internet has created easy access. An unprecedented level of access to media by young people has meant that more young people than ever are “consuming” a globalized pop culture that tends to tolerate substance use.[vii] The powerful marketing capacities of the alcohol and tobacco industries contribute to this environment by directing much of their attention to a youthful market.[viii] Even these capacities, however, are dwarfed by the scale of the illicit drug industry, which has been estimated to account for approximately 8% of world trade – more than iron and steel and about the same as textiles.[ix] This is occurring in a world that is fast-paced and highly unpredictable, as one commentator puts it, a "runaway world".[x] Community factors such as general attitudes toward alcohol and other substance use as well as the leisure options perceived by youth affect their substance use decisions.
Because all students are exposed to most of these influences in some measure, it is not surprising that the use of alcohol, cannabis and tobacco is common among Canadian students regardless of whether they are viewed as being at higher or lower levels of developmental risk. Any substance use presents the potential for problems. Even a single drug-using experience or occasional use by a naïve user can result in harm through, for example, overdose, an injury event, or in the case of illegal drugs, criminal prosecution.[xi] Many youth who do experiment with or continue to use substances do so in risky ways (e.g. large amounts in unsafe settings).
In fact, some contend that all young people, by virtue of the developmental changes they all undergo, and the various societal factors they all experience, should be considered a population “at risk”. One observer questions the value of distinguishing between a mainstream who are “OK” and a minority who are at risk, suggesting that the pace of social change means many young people will experience risk factors such as depression or unemployment at some point or another in their lives.[xii] While there is some merit to this view, some young people and families clearly experience more risk factors than the norm.
The picture that emerges from research is that of two populations of youth with different trajectories – those that are subject to the usual range of environmental and social influences and who engage in some amount of deviant and risky behaviour as part of normal adolescent development, and a second population that experiences more severe challenges through their life course and whose deviance may be more extreme and long-term (i.e. adolescence-limited vs. life-course deviance).[xiii]
B. Factors contributing to substance use problems
When children begin school, they already bring different experiences that will serve to protect them or to place them at risk (e.g. fetal exposure to alcohol and tobacco, early nurturance, attachment to their mothers, neglect, good nutrition, or early onset behavioural problems). A developmental pathway continues to take form as the child’s characteristics interact with the school and family environment through the early school years to influence academic failure and success, behaviour, relationships with peers and teachers and attitudes to school.[xiv]
These interactions form a complex web of causation at any given point in a child’s life, and opportunities for shifting a trajectory exist at these various points. For example, changes in parenting practices will affect, and be affected by a young person’s personality at a particular developmental point.[xv] Through the school years these earlier factors will interact with a child’s academic and social experiences and for some, lead to characteristics that are linked to substance use problems, for example, having anti-social or substance-using friends, or engaging in truancy and other anti-social behaviour.
Risk and protective factors by life stage
The levels of risk and protection may shift through the life course and their impact varies with when they occur. Below is a summary, drawn (unless otherwise indicated) from a review by Loxley and colleagues (2004), which provides the best available evidence on when, during the life course, various factors have the greatest impact (bearing in mind that risk factor research is a work in progress).[xvi]
Prior to birth:
Parental substance use problems: Maternal alcohol use may result in lifelong cognitive, behavioural and social deficits that increase risk for a range of difficulties including harmful substance use; smoking prior to birth, and environmental tobacco smoke are risk factors for impaired child development; this impairment may initiate a pathway of poor child adjustment, leading to harmful substance use.
Genetic factors: Although there is much yet to learn, it is likely that a combination of genetic factors influence behaviour through their interaction with environmental factors. Material poverty: Being born or raised in a family experiencing extreme economic deprivation is a risk factor for harm associated with substance use. Poor family management and breakdown: Low level of parent-child attachment, and being born or raised in a sole parent household is a risk factor for more frequent substance use in adolescence.[xvii]
Infancy and early childhood:
Parental abuse and neglect: Child neglect and abuse is a risk factor for impaired child development and this impairment may initiate a pathway of poor child adjustment leading to harmful substance use. Temperament and early behaviour: Easy temperament in early childhood is a protective factor for positive child adjustment and reduces the influence of other risk factors, leading to lower rates of involvement in harmful substance use. Aggression in early childhood is a strong risk factor for later delinquency and substance use problems.[xviii]
Later childhood
Shy temperament and personality: shy and cautious temperament in childhood is a protective factor, reducing the influence of risk factors for early adolescent multiple and illegal substance use in early adulthood.
Child social and emotional competence: Social and emotional competence in childhood is a protective factor, reducing the influence of risk factors for alcohol and other substance use.
Conduct disorder: Conduct disorder in childhood is a risk factor for higher levels of alcohol consumption in adolescence. The influence of conduct disorder on alcohol abuse may be increased by family vulnerability to alcohol problems or by earlier age alcohol use.
Aggression: Aggression in childhood is a risk factor for early adolescent multiple-drug use and adult alcohol abuse. Unsettled home situations: a study found that young people living on the street in Victoria, British Columbia were less likely to have a history of abuse than a history of frequent moves and dislocation (for example, from one guardian’s house to another, or from foster home to foster home).[xix]
School failure: Early school failure is a risk factor for various later problems including alcohol use problems.
Adolescence
Gender: while rates of use are similar between girls and boys, boys are more likely to use in hazardous and harmful ways.
Low positive contact with adults: Low involvement in activities with adults in adolescence is a risk factor for early adolescent multiple-drug use.
Community disadvantage and disorganization: Community disadvantage and disorganization in adolescence has been associated with adolescent substance use.
Favourable attitudes toward drug use: Favourable attitudes towards drug use behaviour in early adolescence are associated with an increased involvement in subsequent drug use.
Family attachment: Attachment to the family in adolescence is a protective factor, reducing risk factors for early adolescent multiple-drug use.
Parental harmony and parent-adolescent conflict: Low parental conflict (parental harmony) from late childhood and in adolescence is a protective factor, reducing alcohol problems, and parent-adolescent conflict is a risk factor for early age substance use.
Parental attitudes toward substance use: Favourable parental attitudes to substance use from late childhood through adolescence is a risk factor for early age initiation of the same substance.
Alcohol and other drug problems in the family: Parental alcohol and other drug problems early in their offspring’s adolescence is a risk factor for earlier age alcohol use and higher levels of alcohol use later in adolescence. The Canadian Task Force on Preventive Health Care has estimated that one million children in Canada under the age of 19 live with an alcohol dependent parent.[xx]
Parental communication and monitoring: Parental communication in early adolescence is a protective factor, reducing the influence of risk factors for harmful youth substance use. Youth with greater expendable income (e.g. larger allowances) have been shown to be more likely to drink hazardously than other youth.[xxi]
Family rules and discipline: Parental rules permitting substance use in childhood or early adolescence is a risk factor for early age substance use. Peer relationships: Relationships with peers who are involved in substance use in late childhood or adolescence is a risk factor for problematic alcohol and other substance use. However, the phenomenon of peer influence as a risk factor is complex; some research concludes that peers are less a factor in starting to use than in encouraging and maintaining a certain level of use that fits with group norms.[xxii]
Externalizing behaviour problems—delinquency and conduct problems: Delinquency in adolescence is a risk factor for problematic alcohol and other substance use.
Sensation seeking and adventurous personality: in adolescence are risk factors for multiple-drug use.
Religion: Religious involvement in adolescence is a protective factor, reducing the influence of risk factors for harmful substance use.
[1] Studies do not use common measures of a substance use problem; for example, some studies analyze various factors against ‘past year use’, which provides little information on the nature and extent of use.
[i] Spooner, C., Hall, W., & Lynskey, M. (2001). The structural determinants of youth drug use. Retrieved September 30, 2007, from http://www.ancd.org.au/publications/pdf/rp2_youth_drug_use.pdf
[ii] Evans, A. & Bosworth, K. (1997). Building effective drug education programs. Retrieved September 30, 2007, from http://www.pdkintl.org/research/rbulletins/resbul19.htm
[iii] Johnston, L.D., O'Malley, P., & Bachman, J.G. (2000). Monitoring the future: National survey results on adolescent drug use: Overview of key findings, 1999. Retrieved September 30, 2007, from http://www.monitoringthefuture.org/pubs/monographs/overview1999.pdf
[iv] Johnston, L.D., O'Malley, P., & Bachman, J.G. (2002). Monitoring the future: National survey results on adolescent drug use: Overview of key findings, 2001. Retrieved September 30, 2007, from http://www.monitoringthefuture.org/pubs/monographs/overview2001.pdf
[v] Lenton, S., Boys, A., & Norcross, K. (1997). Raves, drugs and experience: Drug use by a sample of people who attend raves in Western Australia. Addiction, 92(10), 1327-1337.
[vi] Paglia, A. (1998). Tobacco risk communication strategy for youth: A literature review. Ottawa, Canada: Health Canada.
[vii] European Monitoring Centre on Drugs and Drug Abuse. (2005). Youth media: A thematic report, 2005. Retrieved August 29, 2007, from http://www.emcdda.europa.eu/attachements.cfm/att_10234_EN_youthmedia.pdf
84 Collins, R.L., Ellickson, P., McCaffrey, D., & Hambarsoomians, K. (in press). Early adolescent exposure to alcohol advertising and its relationship to underage drinking. Journal of Adolescent Health.
[ix] Elvins, M. (2003). Anti-drugs policies of the European Union: Transnational decision-making and the politics of expertise. Hampshire: Palgrave MacMillan.
[x] Williams, L., & Parker, H. (2001). Alcohol, cannabis, ecstasy and cocaine: Drugs of reasoned choice amongst young adult recreational drug users in England. International Journal of Drug Policy, 12, 397-413.
[xi] Lenton, S., Boys, A., & Norcross, K. (1997). Raves, drugs and experience: Drug use by a sample of people who attend raves in Western Australia. Addiction, 92(10), 1327-1337.
[xii] Eckersley, R.M. (2005). 'Cultural fraud': the role of culture in drug abuse. Drug and Alcohol Review, 24(2), 157-163.
[xiii] Spooner, C., & Heatherington, K. (2004). Social determinants of drug use [Tech. Rep. No. 228]. Retrieved September 30, 2007, from http://ndarc.med.unsw.edu.au/ndarcweb.nsf/website/Publications.reports.TR228
[xiv] Toumbourou, J.W., Rowland, B., Jefferies, A., Butler, H., & Bond, L. (2004). Preventing drug-related harm through school re-organisation and behavior management [Prevention research evaluation report No. 12]. Melbourne: Australian Drug Foundation. Retrieved September 30, 2007, from http://www.druginfo.adf.org.au/downloads/Prevention_Research_Quarterly/PRQ_04Nov_Early_intervention_in_schools.pdf
[xv] Lerner, R.M., & Castellino, D.R. (2002). Contemporary developmental theory and adolescence: Developmental systems and applied developmental science. Journal of Adolescent Health, 31, 122-135.
[xvi] Loxley, W., Toumbourou, J.W., & Stockwell, T. (2004). The prevention of substance use, risk and harm in Australia: A review of the evidence. Retrieved September 30, 2007, from http://www.aodgp.gov.au/internet/wcms/publishing.nsf/content/health-pubhlth-publicat-document-mono_prevention-cnt.htm
[xvii] Bray, J., Adams, G.J., Getz, J.G., Baer, P.E. (2001). Developmental, family, and ethnic influences on adolescent alcohol usage: A growth curve approach [Electronic version]. Journal of Family Psychology, 15, 301-314.
[xviii] Webster-Stratton, C., & Taylor, T. (2001). Nipping early risk factors in the bud: Preventing substance abuse, delinquency, and violence in adolescence through interventions targeted at young children (0–8 Years). Prevention Science, 2(3).
[xix] Benoit, C., & Jansson, M. (2006). Risky business? Experiences of street youth. Victoria, Canada: Centre for Youth and Society, University of Victoria. Retrieved August 29, 2007, from http://www.youth.society.uvic.ca/activities/research/cahr/KnowlEdge_19mar06.pdf
[xx] McNamee, J.E., & Offord, D.R. (1994). Children of alcoholics. In Canadian Task Force on the Periodic Health Examination (Ed.), Canadian guide to clinical preventive health care (pp. 470-485). Ottawa, Canada: Health Canada. Retrieved August 29, 2007 from http://www.phac-aspc.gc.ca/publicat/clinic-clinique/pdf/s6c41e.pdf
[xxi] Bellis, M.A., Hughes, K., Morleo, M., Tocque, K., Hughes, S., Allen, T., et al. (2007). Predictors of risky alcohol consumption in schoolchildren and their implications for preventing alcohol-related harm. Substance Abuse Treatment, Prevention, and Policy, 2(15).
[xxii] Ministry of youth development. (2003). Effective drug education for young people: literature review and analysis. Retrieved August 29, 2007, from http://www.myd.govt.nz/uploads/docs/00.7.1.1%20effective%20overview.pdf
Canadian prevalence data
Canadian prevalence data
This page summarizes facts about Canadain youth use and abude of substances. Contributors from other countries can create a nhew page to add summaries of the situation in their own countries or regions. Please go back to the previous page 1.6 on understanding the prevalence and nature of the problem and select the "add page" tool in the left hand margin. If you want to comment on these canadian facts use the thread tool found at the bottom of this page or edit the text directly on the page by using the "easy edit" tool at the top of the page.
Substance use patterns of students in Canada are determined by many factors and are constantly evolving. It is important that school-based and school-linked initiatives base their activity as fully as possible on data that accurately describe current patterns of use. Age at first use, the proportion of users to non-users, gender, age and cultural differences, the point of peak use and the extent of hazardous use and consequent harms all hold important implications for intervention aims, timing and key messages. This section reviews the most recent national and provincial surveys of student substance use.[1]
Student surveys typically give an indication of the substance use patterns of youth in grades between 7 and 12. The surveys do not generally include students in private schools, in institutions, those being home schooled, those absent from school or school drop-outs.[2] This is noteworthy because youth who have left school or are at risk of leaving school are at higher risk for substance use problems.[i]
Short-term trends (1998-2005) Various national and provincial surveys have updated findings in the past four or five years from surveys published in the late 1990s, allowing for reporting of shorter term trends. [3]
Rates of use: According to available evidence, rates of past-year alcohol use have stabilized or declined. Rates of cannabis use appear more mixed, having continued to rise (NB, NL), stabilize (ON, PEI, NS, MB) or decline (BC), depending on the jurisdiction (perhaps reflecting timing of the various surveys). The most dramatic change is the decline in the percentage of students using tobacco reported by all surveys during this decade. National and provincial school surveys show that estimates of past-year smoking (more than a few puffs) among junior and senior high school students range from 14% to 27%[ii] [iii] [iv] [v] [vi] [vii] – a steep decline from the late 1990s.
It appears that rates of use of other substances have generally declined. For example, the 2005 OSDUS reports that rates of use for 15 of 22 substances show a decline from 1999 (Adlaf and Boak, 2005). Use of cocaine appears to be an exception with rates having increased among Ontario students since 1999. It is important to bear in mind that, in spite of some declines from the late 1990s (during which rates of use were at or near historic highs), rates remain relatively high.[viii]
Age at first use: Early first use of substances is a major risk factor for later substance use problems.[ix] From information limited to Ontario, the age at which young people begin to use the most common substances – tobacco, alcohol and cannabis – has gone up (i.e. they’re starting at an older age). For example, in 2005, 29% of 7th-graders used alcohol by grade 6, compared to 42% in 2003 and 50% in 1981.[x]
Hazardous patterns: The percentage of students engaging in hazardous behaviours, such as drinking to intoxication, drinking under the influence, or being a passenger in a car driven by someone under the influence, have not changed significantly since the late 1990s, and remain a serious concern because of the immediate harms linked with these behaviours.[xi]
Attitudes: Attitudes toward various substances constantly shift and are important to monitor because a shift in disapproval or perceived level of risk for a substance has been found to precede a shift in use patterns for that substance.[xii] There is some indication that more students disapprove or see a risk of harm in experimenting with various substances (i.e. ecstasy, LSD, smoking 1 or 2 cigarettes a day, trying cannabis) than was the case in the late 1990s.[xiii]
Non-use: About 25-40% of Canadian high school students (i.e., grade 7-12) used no drug (including alcohol or tobacco) in the past year, with younger students and girls being more likely to be non-users.[xv]
Most commonly used substances: Half to two-thirds of junior and senior high students are current users of alcohol. A significant minority (around 40%) limit their use to special occasions. Approximately one quarter to one third of students report past year cannabis use, depending on the jurisdiction. Past-year cigarette smoking (more than a few puffs) by junior and senior high school students ranges from 14% to 27%.[xvi] [xvii] [xviii] [xix] [xx] [xxi]
Moderately common substances: Rates of use for drugs other than alcohol, cannabis and tobacco have large regional variations, but the next most commonly used drugs appear to be hallucinogens (e.g., psilocybin, mescalin and to a lesser extent, LSD) and amphetamines non-medically, with between 5-15% of students reporting past year use. Ritalin has important medical value in the treatment of attention-deficit hyperactivity disorder (ADHD) but is sometimes used non-medically (ranging from around 6% in Atlantic Canada to 2.4% in Ontario).[xxii] [xxiii] [xxiv] [xxv] [xxvi]
Less common substances: Typically less than 5% of junior/senior high school students report use of ecstasy, cocaine, heroin, PCP and non-medical use of other medications. Less than 2% of Ontario students (the only province collecting this information) used Ketamine, Rohypnol (roofies) or GHB, so-called date rape drugs, in the past year.[xxvii] Although the abuse of certain drugs such as methamphetamine (including crystal meth or ice) and OxyContin is raising concerns in some parts of Canada, available statistics show that past-year use among students for each is relatively low, 2-3%[xxviii] [xxix] and 1%[xxx] respectively.
Age differences: When considering the above figures it’s important to note that the percentage of students using substances increases quite dramatically from Gr. 7 to Gr. 12. For example, in Nova Scotia 52% of Gr. 7-12 students used alcohol in the previous year but within that average is a 5-fold increase from Gr. 7 to Gr. 12 from 16% to 81%.[xxxi] Solvent/inhalant use is an issue in some communities – in these cases use goes down during the high school years after peaking in early junior high.[xxxii]
Age at first use: Canadian studies show that the average age of first tobacco use is about 12, first alcohol use and first intoxication is about 13, while the first use of cannabis and other drugs usually occurs at about 14.[xxxiii] [xxxiv]
Gender differences: When discussing differences in consumption between males and females, it is important to note that girls and women have a lower threshold to the effects of alcohol. Given the same amount of alcohol, women will become more intoxicated, get intoxicated faster and stay intoxicated longer.[xxxv] While the percentage of girls using various substances has converged with or is approaching that of boys in recent years, boys tend to engage in more hazardous patterns (see below). Nevertheless, young women tend to experience problems and dependence at about the same rate as men.[xxxvi]
Hazardous patterns: All substance use poses some level of risk but some patterns are more risky than others. Adolescents, along with young adults, are more likely than other age groups to use substances in risky ways, and older and male students are generally more likely still: ·
In Canada, 4.4% of the population identify themselves as Aboriginal.[lxiii] Less information is available on the extent of substance use among Canadian Aboriginal students. A good source is a B.C. survey of students in Grades 7-12 which sampled 2,478 students who identified themselves as Aboriginal within a larger sample of 30,500 students, a replication of studies conducted in 1998 and 1992.[lxiv]
The resulting report, Raven’s Children II, found that the percentage of Aboriginal students (Gr. 7-12) who have tried alcohol is higher than their non-Aboriginal counterparts, with 67% reporting having ever tried alcohol compared with 57%. The Aboriginal rate reflects a steady decline, from 80% in 1992 to 67% in 2003. Aboriginal females were more likely to report having tried alcohol than Aboriginal males (69% vs. 64%), and were just as likely as males to report binge drinking in the past month (49% of those reporting drinking). This compares to 44% of non-Aboriginal youth.
Overall, marijuana use among Aboriginal students mirrors the long-term trend among BC students generally, having increased between 1992 and 1998, from 46% to 60%, and decreasing to 53% in 2003. However, Aboriginal youth (53%) are much more likely than non-Aboriginal students (36%) to report having ever used marijuana. As with alcohol, Aboriginal females are slightly more likely to have used marijuana than males (51% and (55% respectively).
Rates of use for various illegal drugs other than marijuana were stable or declined from 1998. The most commonly used illegal substances other than cannabis were mushrooms (psilocybin) (21%) and other hallucinogens (10%).
Aboriginal youth are a diverse population so the results of this survey of British Columbia Aboriginal students should not be seen as representative of the Canadian population. Socio-economic factors that affect educational attainment are among the layers of complexity that need to be considered when reviewing reported Aboriginal youth substance use in Canada rates. Additional challenges faced in closing the educational gap are discussed in Section IX. B: Cultural Competence and Aboriginal Students.
While a significant proportion of Canadian middle school students do not use any substance, the use of alcohol becomes normative in the high school years and cannabis and tobacco use becomes common. Students in Grades 7 and 8 may be more accurately termed “not-yet-users” rather than “non-users”, particularly in relation to alcohol. With increasing age, the rate of hazardous patterns of use also increases, and use of tobacco is a marker for these patterns. Addressing early use of tobacco, alcohol and cannabis needs to be a priority for school prevention programs. Because significant numbers of older students use these and other substances in hazardous ways, and given the significant immediate harms that can arise from these patterns, prevention that explicitly aims to prevent hazardous use and possible harms needs to considered for the high school prevention agenda.
Substance use patterns of students in Canada are determined by many factors and are constantly evolving. It is important that school-based and school-linked initiatives base their activity as fully as possible on data that accurately describe current patterns of use. Age at first use, the proportion of users to non-users, gender, age and cultural differences, the point of peak use and the extent of hazardous use and consequent harms all hold important implications for intervention aims, timing and key messages. This section reviews the most recent national and provincial surveys of student substance use.[1]
Student surveys typically give an indication of the substance use patterns of youth in grades between 7 and 12. The surveys do not generally include students in private schools, in institutions, those being home schooled, those absent from school or school drop-outs.[2] This is noteworthy because youth who have left school or are at risk of leaving school are at higher risk for substance use problems.[i]
A. Recent trends in use
Long-term trends (1977-2005) Ontario’s Centre for Addiction and Mental Health has sponsored the longest ongoing Canadian survey of student substance use, the Ontario Student Drug Use Survey (OSDUS), and provides an indication of long-term trends. This series of surveys shows that, after peaking in 1979, the percentage of students using various substances – legal and illegal – declined steadily until the early 1990s. During the 1990s the percentage of students using these substances generally increased, and have since stabilized or declined.Short-term trends (1998-2005) Various national and provincial surveys have updated findings in the past four or five years from surveys published in the late 1990s, allowing for reporting of shorter term trends. [3]
Rates of use: According to available evidence, rates of past-year alcohol use have stabilized or declined. Rates of cannabis use appear more mixed, having continued to rise (NB, NL), stabilize (ON, PEI, NS, MB) or decline (BC), depending on the jurisdiction (perhaps reflecting timing of the various surveys). The most dramatic change is the decline in the percentage of students using tobacco reported by all surveys during this decade. National and provincial school surveys show that estimates of past-year smoking (more than a few puffs) among junior and senior high school students range from 14% to 27%[ii] [iii] [iv] [v] [vi] [vii] – a steep decline from the late 1990s.
It appears that rates of use of other substances have generally declined. For example, the 2005 OSDUS reports that rates of use for 15 of 22 substances show a decline from 1999 (Adlaf and Boak, 2005). Use of cocaine appears to be an exception with rates having increased among Ontario students since 1999. It is important to bear in mind that, in spite of some declines from the late 1990s (during which rates of use were at or near historic highs), rates remain relatively high.[viii]
Age at first use: Early first use of substances is a major risk factor for later substance use problems.[ix] From information limited to Ontario, the age at which young people begin to use the most common substances – tobacco, alcohol and cannabis – has gone up (i.e. they’re starting at an older age). For example, in 2005, 29% of 7th-graders used alcohol by grade 6, compared to 42% in 2003 and 50% in 1981.[x]
Hazardous patterns: The percentage of students engaging in hazardous behaviours, such as drinking to intoxication, drinking under the influence, or being a passenger in a car driven by someone under the influence, have not changed significantly since the late 1990s, and remain a serious concern because of the immediate harms linked with these behaviours.[xi]
Attitudes: Attitudes toward various substances constantly shift and are important to monitor because a shift in disapproval or perceived level of risk for a substance has been found to precede a shift in use patterns for that substance.[xii] There is some indication that more students disapprove or see a risk of harm in experimenting with various substances (i.e. ecstasy, LSD, smoking 1 or 2 cigarettes a day, trying cannabis) than was the case in the late 1990s.[xiii]
B. Current picture (Gr. 7-12)
Although rates of use vary from region to region in Canada, alcohol, cannabis and tobacco are the most popular substances among young people in this country (as with all Western nations). Alcohol is by far the most commonly used psychoactive substance among Canadian students. Cannabis (marijuana, hash, hash oil) is by far the most used illegal substance world-wide, and Canadian students have rates of use among the highest in the world.[xiv] More Canadian students have used cannabis in the past year than have used tobacco (more than a puff), a shift which began in the late 1990s due to a dramatic decline in tobacco use.Non-use: About 25-40% of Canadian high school students (i.e., grade 7-12) used no drug (including alcohol or tobacco) in the past year, with younger students and girls being more likely to be non-users.[xv]
Most commonly used substances: Half to two-thirds of junior and senior high students are current users of alcohol. A significant minority (around 40%) limit their use to special occasions. Approximately one quarter to one third of students report past year cannabis use, depending on the jurisdiction. Past-year cigarette smoking (more than a few puffs) by junior and senior high school students ranges from 14% to 27%.[xvi] [xvii] [xviii] [xix] [xx] [xxi]
Moderately common substances: Rates of use for drugs other than alcohol, cannabis and tobacco have large regional variations, but the next most commonly used drugs appear to be hallucinogens (e.g., psilocybin, mescalin and to a lesser extent, LSD) and amphetamines non-medically, with between 5-15% of students reporting past year use. Ritalin has important medical value in the treatment of attention-deficit hyperactivity disorder (ADHD) but is sometimes used non-medically (ranging from around 6% in Atlantic Canada to 2.4% in Ontario).[xxii] [xxiii] [xxiv] [xxv] [xxvi]
Less common substances: Typically less than 5% of junior/senior high school students report use of ecstasy, cocaine, heroin, PCP and non-medical use of other medications. Less than 2% of Ontario students (the only province collecting this information) used Ketamine, Rohypnol (roofies) or GHB, so-called date rape drugs, in the past year.[xxvii] Although the abuse of certain drugs such as methamphetamine (including crystal meth or ice) and OxyContin is raising concerns in some parts of Canada, available statistics show that past-year use among students for each is relatively low, 2-3%[xxviii] [xxix] and 1%[xxx] respectively.
Age differences: When considering the above figures it’s important to note that the percentage of students using substances increases quite dramatically from Gr. 7 to Gr. 12. For example, in Nova Scotia 52% of Gr. 7-12 students used alcohol in the previous year but within that average is a 5-fold increase from Gr. 7 to Gr. 12 from 16% to 81%.[xxxi] Solvent/inhalant use is an issue in some communities – in these cases use goes down during the high school years after peaking in early junior high.[xxxii]
Age at first use: Canadian studies show that the average age of first tobacco use is about 12, first alcohol use and first intoxication is about 13, while the first use of cannabis and other drugs usually occurs at about 14.[xxxiii] [xxxiv]
Gender differences: When discussing differences in consumption between males and females, it is important to note that girls and women have a lower threshold to the effects of alcohol. Given the same amount of alcohol, women will become more intoxicated, get intoxicated faster and stay intoxicated longer.[xxxv] While the percentage of girls using various substances has converged with or is approaching that of boys in recent years, boys tend to engage in more hazardous patterns (see below). Nevertheless, young women tend to experience problems and dependence at about the same rate as men.[xxxvi]
Hazardous patterns: All substance use poses some level of risk but some patterns are more risky than others. Adolescents, along with young adults, are more likely than other age groups to use substances in risky ways, and older and male students are generally more likely still: ·
Binge drinking is common among junior/senior high school students. Past-month binge drinking was reported by 23% of Ontario students, 29% of Nova Scotia students, 34% of BC students, 36% of students on the island of Newfoundland. The prevalence of drinking and binge drinking (69% and 44% in the past year) reported by Quebec students is notably higher than other Canadian provinces.[xxxvii] [xxxviii] ·Gender differences: While the percentage of males and females who have used various substances has converged and is similar in many cases, males tend to use more frequently and heavily. They are also appear much more likely to drive after drinking (NL: males=26%; females=11%/ON=29%; females=13%). Harms reported: As discussed in Section II, Impact of Substance Use on Health and Learning, substance use can result in a wide range of short- and long-term physical (e.g. poisoning, overdose, cancers, dependence), social (e.g. family problems, damaging property), and academic (e.g. truancy, academic failure) harms. Due to risky patterns of use among some students, prevalence of harms reported by students is high relative to other population groups and is a cause of significant concern. Harms reported by students in particular jurisdictions include the following: ·
Driving under the influence of any substance is dangerous. The prevalence of driving after drinking has been in steep decline over the long-term in this country. However, among older students who drive, driving within an hour of consuming 2 drinks still occurs (e.g. 13% (ON); 35% (PEI) in the past year). ·
Among older students who drive, driving after using cannabis has become more common than driving after using alcohol in jurisdictions reporting this information (e.g. 20% (ON); and 26% (NS). Use of both cannabis and alcohol together is raising concern among road safety experts.[xxxix] ·
About one in four students have been passengers in a motor vehicle with a driver who has been drinking alcohol on at least one occasion in the past year (NL: 22%; NB: 26%; NS: 23%; ON: 29%). ·
Unplanned sexual activity and substance use often go together for young people. About 10% of students in junior high and high school are likely to have unplanned sexual intercourse while under the influence of alcohol, and a similar proportion are likely to do so while under the influence of drugs.[xl] Of sexually active youth in Nova Scotia, 35% reported having unplanned sex while under the influence of a substance, at least once during the course of the year.[xli] ·
A significant percentage of students report having used more than one substance in the past – usually some combination of alcohol, cannabis and tobacco. ·
Using more than one substance at a time can be particularly risky and may lead to unpredictable and serious harms. The extent to which Canadian students use multiple drugs on an occasion are not known, but it is generally agreed that this is not uncommon.[xlii] ·
It appears that frequent use of cannabis (6 or more times in the past year), as well as daily cannabis use, is higher than in the past. About 3-5% of students report daily cannabis use in Canadian surveys.[xliii] It should be noted that even small percentages can represent quite a few students (for example, 3% in Ontario represents 27,000 students). ·
While tobacco use among high school students has declined significantly (between 14-27% past year use among in various surveys), it is increasingly considered to be a marker for hazardous substance use patterns. According to an analysis of a national survey (2004), young people who smoke are more likely to binge drink, use cannabis frequently and use other substances.[xliv] In Ontario, surveys show that very few students use only tobacco; smokers use at least one other substance, usually alcohol.[xlv] ·
Injection drug use poses risk of blood borne infection and overdose. Age of first injection among the few that use this method often occurs in late adolescence and early adulthood. Among provinces providing this information, less than 1% of students report injecting drugs.[xlvi] [xlvii]
Driving while under the influence of alcohol or other drugs remains a major cause of injury and death for young people in Canada. In 2001, 25% of drivers aged 19 and younger who died behind the wheel and were tested were over the legal alcohol limit.[xlviii] ·
Causing damage to property and causing injury to oneself are some of the most common harms associated with alcohol and drug use among students.[xlix] [l] [li] [lii] ·
School problems arising from drinking or drug use are an issue for a small percentage of students. For example, 5.1% of Senior 4 (Gr. 12) students in a non-representative sample of Manitoba students reported missing classes as a result of alcohol use, while 3% of Nova Scotia students (Gr. 7-12) reported that school work or exams had been affected by their drinking. [liii] [liv] ·
17% of Ontario students in Grades 7-12 reported being drunk or high at school at least once in the past year. This ranges from 3% of Grade 7s to up to about 25% of 11th and 12th graders. Further, about 23% of Ontario students report that they’ve been offered or sold an illegal drug on school property in the past year.[lv] ·
Provincial surveys show that about 5% of junior high and high school students report having been in trouble with the police because of their alcohol or drug use.[lvi] [lvii] [lviii] [lix] ·
About 6% of Canadian youth aged 15–19 may be dependent on alcohol, and about 3% may be dependent on an illicit drug[lx]. Provincial surveys have found that about 6–8% of students who use cannabis showed signs of dependence.[lxi] [lxii]
Aboriginal students:
In Canada, 4.4% of the population identify themselves as Aboriginal.[lxiii] Less information is available on the extent of substance use among Canadian Aboriginal students. A good source is a B.C. survey of students in Grades 7-12 which sampled 2,478 students who identified themselves as Aboriginal within a larger sample of 30,500 students, a replication of studies conducted in 1998 and 1992.[lxiv]
The resulting report, Raven’s Children II, found that the percentage of Aboriginal students (Gr. 7-12) who have tried alcohol is higher than their non-Aboriginal counterparts, with 67% reporting having ever tried alcohol compared with 57%. The Aboriginal rate reflects a steady decline, from 80% in 1992 to 67% in 2003. Aboriginal females were more likely to report having tried alcohol than Aboriginal males (69% vs. 64%), and were just as likely as males to report binge drinking in the past month (49% of those reporting drinking). This compares to 44% of non-Aboriginal youth.
Overall, marijuana use among Aboriginal students mirrors the long-term trend among BC students generally, having increased between 1992 and 1998, from 46% to 60%, and decreasing to 53% in 2003. However, Aboriginal youth (53%) are much more likely than non-Aboriginal students (36%) to report having ever used marijuana. As with alcohol, Aboriginal females are slightly more likely to have used marijuana than males (51% and (55% respectively).
Rates of use for various illegal drugs other than marijuana were stable or declined from 1998. The most commonly used illegal substances other than cannabis were mushrooms (psilocybin) (21%) and other hallucinogens (10%).
Aboriginal youth are a diverse population so the results of this survey of British Columbia Aboriginal students should not be seen as representative of the Canadian population. Socio-economic factors that affect educational attainment are among the layers of complexity that need to be considered when reviewing reported Aboriginal youth substance use in Canada rates. Additional challenges faced in closing the educational gap are discussed in Section IX. B: Cultural Competence and Aboriginal Students.
C. Conclusion
While a significant proportion of Canadian middle school students do not use any substance, the use of alcohol becomes normative in the high school years and cannabis and tobacco use becomes common. Students in Grades 7 and 8 may be more accurately termed “not-yet-users” rather than “non-users”, particularly in relation to alcohol. With increasing age, the rate of hazardous patterns of use also increases, and use of tobacco is a marker for these patterns. Addressing early use of tobacco, alcohol and cannabis needs to be a priority for school prevention programs. Because significant numbers of older students use these and other substances in hazardous ways, and given the significant immediate harms that can arise from these patterns, prevention that explicitly aims to prevent hazardous use and possible harms needs to considered for the high school prevention agenda.
[1] Recent student surveys, from the Atlantic Provinces (2002/2005), Ontario (2005), Manitoba (2004), Alberta (2005), and British Columbia (2004) as well as Canada’s contribution to the International Health Behaviours of School Age Children study (Boyce, 2004) have been reviewed.
[2] Students with more days absent from school are more likely to be having substance use issues. In fact, their absence may be the result of suspension for alcohol or other drug use, or their inability to attend school due to excessive use the previous evening. This may lead to student surveys underreporting the prevalence and severity of substance use patterns (Patton, Wiebe, and Begin, 2003).
[3] Youth Smoking Survey 2002-2004; Nova Scotia, New Brunswick and Prince Edward Island reported changes between 1998 and 2002; Newfoundland and Labrador; 1998-2003; Ontario: 1999-2005; Manitoba: 2001-2004; British Columbia: 1998-2003
[i] ter Bogt, T., Fotiour, A., & Nic Gabhainn, S. (2004). Cannabis use. In C. Currie, C. Roberts, A. Morgan, R. Smith, W. Settertobulte, O. Samdal, & V. Barnekow-Rasmussen (Eds.), Young people's health in context. Health behaviour in school-aged children (HBSC) study: International report from the 2001–2002 survey. Retrieved September 30, 2007, from http://www.euro.who.int/eprise/main/who/informationsources/publications/catalogue/20040518_1
[ii] Health Canada. (n.d.). Youth smoking survey: Summary of results of the 2004-05 youth smoking survey. Retrieved May 23, 2007, from http://www.hc-sc.gc.ca/hl-vs/tobac-tabac/research-recherche/stat/survey-sondage/2004-2005/result_e.html
[iii] Poulin, C., Martin, D.S., & Murray, M. (2005). Newfoundland and Labrador student drug use survey 2003: Summary report. Retrieved September 30, 2007, from http://www.health.gov.nl.ca/health/publications/pdfiles/sdus.pdf
[iv] Poulin, C., & Wilbur, B. (2002). Nova Scotia student drug use survey 2002: Technical report. Retrieved September 30, 2007, from http://www.gov.ns.ca/heal/downloads/2002_NSDrugTechnical.pdf
[v] Van Til, L. & Poulin, C. (2002). 2002 Prince Edward Island student drug survey: Technical report. Charlottetown, Canada: PEI Department of Health and Social Services, PEI Department of Education, and Dalhousie University.
[vi] Liu, J., Jones, B., Grobe, C., Balram, C., & Poulin, C. (2002). New Brunswick student drug use survey 2002: Highlights report. Retrieved September 30, 2007, from http://www.gnb.ca/0378/pdf/tech-report2002revised-Final11.pdf
[vii] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[viii] ibid
[ix] Grant, B.F., & Dawson, D.A. (1997). Age of onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: Results from the national longitudinal alcohol epidemiological survey. Journal of Substance Abuse, 9.
[x] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[xi] ibid
[xii] Johnston, L.D., O’Malley, P.M., Bachman, J.G., & Schulenberg, J.E. (2007). Monitoring the future national results on adolescent drug use: Overview of key findings, 2006. Retrieved September 30, 2007, from http://www.monitoringthefuture.org/pubs/monographs/overview2006.pdf
[xiii] ibid
[xiv] ter Bogt, T., Fotiour, A., & Nic Gabhainn, S. (2004). Cannabis use. In C. Currie, C. Roberts, A. Morgan, R. Smith, W. Settertobulte, O. Samdal, & V. Barnekow-Rasmussen (Eds.), Young people's health in context. Health behaviour in school-aged children (HBSC) study: International report from the 2001–2002 survey. Retrieved September 30, 2007, from http://www.euro.who.int/eprise/main/who/informationsources/publications/catalogue/20040518_1
[xv] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[xvi] Poulin, C., Martin, D.S., & Murray, M. (2005). Newfoundland and Labrador student drug use survey 2003: Summary report. Retrieved September 30, 2007, from http://www.health.gov.nl.ca/health/publications/pdfiles/sdus.pdf
[xvii] Poulin, C., & Wilbur, B. (2002). Nova Scotia student drug use survey 2002: Technical report. Retrieved September 30, 2007, from http://www.gov.ns.ca/heal/downloads/2002_NSDrugTechnical.pdf
[xviii] Van Til, L., & Poulin, C. (2002). 2002 Prince Edward Island student drug survey: Technical report. Charlottetown, Canada: PEI Department of Health and Social Services, PEI Department of Education, and Dalhousie University.
[xix] Liu, J., Jones, B., Grobe, C., Balram, C., & Poulin, C. (2002). New Brunswick student drug use survey 2002: Highlights report. Retrieved September 30, 2007, from http://www.gnb.ca/0378/pdf/tech-report2002revised-Final11.pdf
[xx] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[xxi] Lane, J. (2005). Alberta youth experience survey (TAYES) 2005. Summary report. Retrieved September 30, 2007, from http://www.aadac.com/documents/TAYES05_summary_report.pdf
[xxii] Van Til, L. & Poulin, C. (2002). 2002 Prince Edward Island student drug survey: Technical report. Charlottetown, Canada: PEI Department of Health and Social Services, PEI Department of Education, and Dalhousie University.
[xxiii] Liu, J., Jones, B., Grobe, C., Balram, C., & Poulin, C. (2002). New Brunswick student drug use survey 2002: Highlights report. Retrieved September 30, 2007, from http://www.gnb.ca/0378/pdf/tech-report2002revised-Final11.pdf
[xxiv] Poulin, C., & Wilbur, B. (2002). Nova Scotia student drug use survey 2002: Technical report. Retrieved September 30, 2007, from http://www.gov.ns.ca/heal/downloads/2002_NSDrugTechnical.pdf
[xxv] Poulin, C., Martin, D.S., & Murray, M. (2005). Newfoundland and Labrador student drug use survey 2003: Summary report. Retrieved September 30, 2007, from http://www.health.gov.nl.ca/health/publications/pdfiles/sdus.pdf
[xxvi] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[xxvii] ibid
[xxviii] Patton, D., Mackay, T.L., & Broszeit, B. (2005). Alcohol and other drug use by Manitoba students. Retrieved September 30, 2007, from http://www.afm.mb.ca/pdf/Alcohol%20and%20other%20drug%20use%20by%20Manitoba%20students%202005%20report.pdf
[xxix] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[xxx] ibid
[xxxi] Poulin, C., & Wilbur, B. (2002). Nova Scotia student drug use survey 2002: Technical report. Retrieved September 30, 2007, from http://www.gov.ns.ca/heal/downloads/2002_NSDrugTechnical.pdf
[xxxii] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[xxxiii] Boyce, W. (Ed.). (2004). Young people in Canada: Their health and well-being. Retrieved September 30, 2007, from http://www.phac-aspc.gc.ca/dca-dea/publications/hbsc-2004/pdf/hbsc_summary_2004_e.pdf
[xxxiv] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[xxxv] Harrison, S., & Ingber, E. (2004). Working with women. In S. Harrison, & V. Carver (Eds.), Alcohol and drug problems: A practical guide for counsellors. Retrieved September 30, 2007, from http://www.camh.net/Publications/Resources_for_Professionals/Alcohol_and_Drug_Problems/index.html
[xxxvi] Gliksman, L., Demers, A., Adlaf, E.M., Newton-Taylor, B., & Schmidt, K. (2000). Canadian campus survey 1998. Toronto, Canada: Centre for Addiction and Mental Health.
[xxxvii] Centre for Addiction and Mental Health. (2006, September/October). CAMH population studies e-bulletin. How does Ontario student drug use compare with other regions of Canada? Retrieved August 29, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/eBulletins/ebv7n5_Canada_Ont_2002YSS.pdf
[xxxviii] Perron, B., & Jacynthe, L. (2003). Portrait of the situation in 2002 and main comparisons with 2000, Québec survey of tobacco use in high school students, 2002 (Summary results). Retrieved September 30, 2007, from http://www.stat.gouv.qc.ca/publications/sante/tabac/faits_saillants/fascicule_jeux_an.pdf
[xxxix] Weekes, J. (2005). Drugs and driving FAQs. Retrieved September 30, 2007, from http://www.ccsa.ca/NR/rdonlyres/6E9ED99A-BA61-4E19-8FB9-32C512098CD6/0/ccsa0111402005.pdf
[xl] Paglia-Boak, A., & Adlaf, E. (2007). Substance use and harm in the general youth population. Retrieved September 30, 2007, from http://www.ccsa.ca/NR/rdonlyres/5D418288-5147-4CAC-A6E4-6D09EC6CBE13/0/ccsa0115212007e.pdf
[xli] Poulin, C., & Wilbur, B. (2002). Nova Scotia student drug use survey 2002: Technical report. Retrieved September 30, 2007, from http://www.gov.ns.ca/heal/downloads/2002_NSDrugTechnical.pdf
[xlii] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[xliii] ibid
[xliv] Davis, C. (2006). Risks associated with tobacco use in youth aged 15–19. Retrieved September 30, 2007, from http://www.ccsa.ca/NR/rdonlyres/2E6DC505-71FD-4CF7-8953-F63B3E409BEC/0/ccsa0113462006.pdf
[xlv] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[xlvi] Poulin, C., & Wilbur, B. (2002). Nova Scotia student drug use survey 2002: Technical report. Retrieved September 30, 2007, from http://www.gov.ns.ca/heal/downloads/2002_NSDrugTechnical.pdf
[xlvii] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[xlviii] Thomas, G. (2004). Alcohol-related harms and control policy in Canada. Retrieved September 30, 2007, from http://www.ccsa.ca/NR/rdonlyres/EF556B91-72B8-4FB5-AB3D-ADDD96A9D895/0/ccsa0048402004.pdf
[xlix] Poulin, C., & Wilbur, B. (2002). Nova Scotia student drug use survey 2002: Technical report. Retrieved September 30, 2007, from http://www.gov.ns.ca/heal/downloads/2002_NSDrugTechnical.pdf
[l] Van Til, L., & Poulin, C. (2002). 2002 Prince Edward Island student drug survey: Technical report. Charlottetown, Canada: PEI Department of Health and Social Services, PEI Department of Education, and Dalhousie University.
[li] Poulin, C., Martin, D.S., & Murray, M. (2005). Newfoundland and Labrador student drug use survey 2003: Summary report. Retrieved September 30, 2007, from http://www.health.gov.nl.ca/health/publications/pdfiles/sdus.pdf
[lii] Liu, J., Jones, B., Grobe, C., Balram, C., & Poulin, C. (2002). New Brunswick student drug use survey 2002: Highlights report. Retrieved September 30, 2007, from http://www.gnb.ca/0378/pdf/tech-report2002revised-Final11.pdf
[liii] Patton, D., Mackay, T.L., & Broszeit, B. (2005). Alcohol and other drug use by Manitoba students. Retrieved September 30, 2007, from http://www.afm.mb.ca/pdf/Alcohol%20and%20other%20drug%20use%20by%20Manitoba%20students%202005%20report.pdf
[liv] Poulin, C., & Wilbur, B. (2002). Nova Scotia student drug use survey 2002: Technical report. Retrieved September 30, 2007, from http://www.gov.ns.ca/heal/downloads/2002_NSDrugTechnical.pdf
[lv] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[lvi] Liu, J., Jones, B., Grobe, C., Balram, C., & Poulin, C. (2002). New Brunswick student drug use survey 2002: Highlights report. Retrieved September 30, 2007, from http://www.gnb.ca/0378/pdf/tech-report2002revised-Final11.pdf
[lvii] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[lviii] Poulin, C., Martin, D.S., & Murray, M. (2005). Newfoundland and Labrador student drug use survey 2003: Summary report. Retrieved September 30, 2007, from http://www.health.gov.nl.ca/health/publications/pdfiles/sdus.pdf
[lix] Poulin, C., & Wilbur, B. (2002). Nova Scotia student drug use survey 2002: Technical report. Retrieved September 30, 2007, from http://www.gov.ns.ca/heal/downloads/2002_NSDrugTechnical.pdf
[lx] Tjepkema, M. (2004). Alcohol and illicit drug dependence. Supplement to health reports. Retrieved September 30, 2007, from http://www.statcan.ca/english/freepub/82-003-SIE/2004000/pdf/82-003-SIE20040007447.pdf
[lxi] Lane, J. (2005). Alberta youth experience survey (TAYES) 2005. Summary report. Retrieved September 30, 2007, from http://www.aadac.com/documents/TAYES05_summary_report.pdf
[lxii] Adlaf, E.M., & Paglia-Boak, A. (2005). Drug use among Ontario students: Detailed OSDUS findings, 1977-2005. Retrieved September 30, 2007, from http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/OSDUS2005_DrugDetailed_final.pdf
[lxiii] Statistics Canada. (2001). Aboriginal peoples of Canada: A demographic profile. Ottawa, Canada: 96F0030XIE2001007. Retrieved September 30, 2007, from http://www12.statcan.ca/english/census01/products/analytic/companion/abor/pdf/96F0030XIE2001007.pdf
[lxiv] van der Woerd, K.A., Dixon, B.L., McDiarmid, T., Chittenden, M., Murphy, A., & The McCreary Centre Society. (2005). Ravens children II: Aboriginal youth health in BC. Vancouver, Canada: The McCreary Centre Society. Retrieved September 30, 2007, from http://www.mcs.bc.ca/r_ahs.htm
dmccall |
Latest page update: made by dmccall
, Jan 26 2010, 11:09 PM EST
(about this update
About This Update
Edited by dmccall
4554 words added 6 words deleted 1 image added view changes - complete history) |
|
More Info: links to this page
|
There are no threads for this page.
Be the first to start a new thread.
