THE NATURE OF ADDICTION

A Current Look At Habits, Health, And Current Youth Initiatives In
Canadian Drug Policy

A 2007 HEALTH Canada-sponsored study entitled Substance Abuse in Canada:
Youth in Focus found that age is the strongest determinant for substance
abuse. Although alcohol and drug use tends to increase in the late teen
years, use reaches an apex during the mid-to late-20s. A wide range of risk
factors are identified in the report, such as individual characteristics,
family problems, peer-group influence, school issues, and environment. The
major point the study conveys is that substance use and abuse corresponds to
the period of a person's life in which he or she finishes high school and
moves into the subsequent transition period-for many, the university years.

On the fourth floor of 100 Marie-Curie, the University of Ottawa's
Student Academic Success Service (SASS) offers career advice,
job-search help, and counselling services. These services are free for
all full-time students. The staff members are professionally trained
counsellors-not psychiatrists or doctors. If the problem is beyond
their ability to counsel, they will give a referral to another
institution. SASS counsellors often send students who actively say
they want to stop using alcohol and drugs to the specialized help
offered by addiction counsellors at the Sandy Hill Community Health
Centre.

Donald Martin, counsellor and manager of Counselling and Personal
Development at SASS, has observed that the majority of students who
abuse alcohol and binge drink are in their first year of university.

"It is not unusual for many first-year students to socialize a lot,"
said Martin. "You meet a lot of new friends. You experience new
freedoms. You turn 19. This may lead to increased exposure to and more
experimentation with drugs and alcohol."

The Youth in Focus report reveals that alcohol is by far the most
common substance used by adolescents. A national survey found that 83
per cent of people between the ages of 15 and 24 consider themselves
current or past-year drinkers, with only 39 per cent judging that
their pattern of alcohol use was "light-infrequent". The rest
indicated either patterns of use that were light-frequent,
heavy-infrequent, and heavy-frequent. The second most popular
substance among young people is cannabis, which almost half of 18- and
19-year old Canadians reported using in 2007. Hallucinogenic drugs,
such as psilocybin mushrooms and lysergic acid diethylamide (LSD),
ranked third. Yet despite the number of people who have tried or
consistently use these substances, the report concluded that the
number of young Canadians over the age of 15 who have symptoms
associated with substance abuse is less than one per cent. Why do some
people get addicted when others don't?

Risk factors that lead to addiction

Martin explained that students who do not start to use substances
until their later years of university often start because they have
experienced an event that has had a heavy emotional impact. In
counselling students, Martin finds that those who are more vulnerable
to anxiety, stress, and depression are more likely to abuse substances.

"Quite a few students report using marijuana for purposes other than
just [recreation]; for instance, as a way to reduce stress or to
induce sleep," he said.

The Youth in Focus report illuminates individual risk factors
including attitudes and beliefs about the risks of use, impulsivity
and sensation seeking, and childhood psychological disorders, such as
conduct disorder. Also associated with substance abuse: interpersonal
factors in the family (inadequate monitoring, a low degree of bonding
between parent and child, abuse, family conflict), among peers
(hanging out with friends who use substances and hold similar
attitudes has consistently been found to be among the strongest
predictors of substance use by youth), and at school (academic
failure, lack of commitment to school, and low bonding with other
students and teachers). Other variables, such as prominence of the
"drinking culture" within a student body, can also influence student
substance use.

The report goes on to explain that the cultural and social
environments significantly influence substance use and abuse.
Increased availability and low price of alcohol and drugs increase the
likelihood of use. Substances in popular media and social norms
favourable to substance use also play influential roles.

The report also deems that gender is a strong predictor-males are
typically more likely to use alcohol and drugs and to use them
heavily. However, separate recent surveys show that females are as
likely as males to drink alcohol, binge drink, get drunk, smoke
cigarettes, and use illicit drugs.

The report notes that risk factors for use are different from those
for abuse. The introduction of substance use tends to be due to social
and environmental factors such as peer use and drug availability,
while early use, heavy use, and abuse are generally associated with
biological factors such as genetics, temperament, and psychological
determinants such as childhood abuse, trauma, and psychological disorder.

It is difficult to determine whether mental-health problems make
people more susceptible to abusing alcohol and drugs or result
directly from substance abuse. Broad studies have been inconclusive.
People who are addicted to alcohol and drugs can use them to
self-medicate-like people who use marijuana to combat anxiety. Cocaine
is a stimulant, but the increased feeling of alertness it provides can
make adults with ADHD feel more comfortable and relaxed when they use
the drug.

Dianne Blackburn is a social worker with Meadow Creek, a 28-day
treatment facility in West Carleton that is part of the Royal Ottawa
Hospital's Substance Use and Concurrent Disorders program. She
acknowledged that self-medication can be part of substance abuse.

"Sometimes people with ADHD find that, with a moderate amount of
cocaine, they actually feel more focused," she said. "This is not to
say that it causes the substance-abuse problem. If they are inclined
to have a substance-abuse problem and they have ADHD, [and] if they've
latched onto cocaine, they would find it to have a self-medicating
effect."

Similarly, cannabis is widely regarded for having medicinal
properties. In 2001, the federal government legalized small quantities
of marijuana for patients seeking relief from cancer, AIDS, multiple
sclerosis, asthma, or migraines. However, this requires a lengthy
application and acceptance process, leading many people to obtain
marijuana illegally in order to get relief.

Various kinds of addictions

According to a 2003 study by Toronto's Centre for Addiction and Mental
Health (CAMH), people can be problem drinkers whose alcohol
consumption adversely affects their lives without being physically
dependent. A physical dependence occurs when a person becomes tolerant
to the effects of alcohol and experiences withdrawal once they stop
drinking. Addicts who undergo severe alcohol withdrawal can experience
hallucinations and an increased heart rate, and they can even die if
they are not monitored. The long-term effects of alcohol use are
extensive, ranging from liver disease to an increased risk for certain
types of cancer, not to mention permanent damage to the brain's
cognitive functions and motor skills.

Alcoholism can often be neglected and remain untreated because
drinking can be a much easier habit to support financially than other
drugs, and the habit does not bear the same stamp of illegality.
People who use illicit drugs can run into financial and legal problems
more quickly and consequently find help.

Regular marijuana users are more likely to develop a psychological
addiction. If they do develop a physical dependence, it is usually
mild. Similarly, when people consistently use hallucinogenic drugs
like LSD, mescaline, ketamine, and ecstasy, the dependence is also
psychological. People develop a tolerance to hallucinogens rather than
a physical dependence, and the drug ceases to have a strong effect,
which often leads to users increasing their dosage.

Harder drugs such as cocaine and heroin are considered to be highly
addictive. Although not everyone who uses cocaine becomes addicted, if
it does happen, going without the drug can produce drastic mood swings
and intense cravings. These swings and cravings can even occur a long
time after being clean, which explains why the probability of relapse
is highest among cocaine addicts. At Meadow Creek, Blackburn observed
the powerful effects of cocaine addiction.

"I would say cocaine is a very difficult drug to get and stay off of,"
she said. "We show a film that shows research that suggests that
people are going to struggle with ongoing cravings for two years,
which is longer than other substances."

Along with being the drug that is often the most difficult to quit,
cocaine is dangerous to try even once-it is very easy to overdose on a
small amount. A cocaine overdose has the potential to induce seizures
or even heart failure.

It is recognized that regular dabbling in heroin often leads to
physical and psychological addiction in just two to three weeks. It is
a powerful opiate that has a high potential for both overdose and
death due to often unknown purity and cutting agents.

When people enter rehabilitation centres, they most often enter to
combat alcohol, cocaine, heroin, or a combination of these substances.

Addictions and the U of O student

In 2004, the Health Canada-sponsored Canadian Addiction Survey (CAS)
found that of people who had not completed high school, 34.9 per cent
are lifetime cannabis users, compared with 44.2 per cent of university
graduates and 52.4 per cent of those with some post-secondary
education. In the same year, only 5.1 per cent of past users of
illicit drugs and alcohol reported that it adversely affected work,
study, or employment opportunities.

Martin commented on how substance abuse affects a student's academic
performance and mental health.

"The trend over the past five years or so seems to be that more
students are reporting that they are consuming marijuana on a daily
basis," he said. "Most students we see in counselling do not seem to
think of this as a problem. We notice, however, that regular use over
a period of a few months seems to produce increased feelings of
depression and a decrease in motivation and focus on school work."

However, Martin acknowledged that poor school performance and mental
health is not as consistent a problem among students who do not report
regular or daily usage.

"Many students report using drugs recreationally on weekends or at
parties. This behaviour does not seem to create much negative impact
on academic performance," he said.

At SASS counselling service, the most common drug students report
using is marijuana. Marijuana is currently more popular among young
people and university students than cigarettes. Heather Clark, a
research analyst at the Canadian Centre on Substance Abuse, says that
this data should not be interpreted only to mean that marijuana use
has increased.

"It is mainly a reflection of how much tobacco use has decreased,
rather than how much marijuana use has increased," she said.

Yet people with addictions are capable of continuing their education,
despite falling grades, increased financial pressure, and the health
problems associated with their substance abuse. Martin said that
although various addictions do adversely affect school performance,
current data at the U of O does not suggest that it is a main reason
for many students leaving without completing their degrees.

"We know that many of the students who drop out of the university do
so for personal reasons," he said. "Drugs and alcohol are not always
involved, but when it is the case, we often observe that students will
go away for a semester while they seek treatment, put their lives back
in order, and then return successfully to the university."

Youth initiatives in Canadian drug policy

The Youth in Focus report outlined possible responses to adolescent
addiction problems.

It recommends prevention programs aimed to prevent, delay, or reduce
substance use in youth. Broad awareness campaigns, school
drug-education programs, and a variety of community initiatives should
target adolescents. It recognizes the Drug Abuse Resistance Education
(DARE) program-commonly delivered in Canadian schools by police
forces-for enhancing knowledge concerning drugs and the risks
associated with them, but it criticizes the program for not
stimulating anti-drug attitudes and the prevention of drug use. This
suggests that a new program should be created and implemented.
According to the report, rather than focusing solely on drug-related
knowledge, the program should help adolescents acquire skills they can
use to resist drug abuse, such as improving decision-making capacity
and enhancing self-esteem and resistance to peer pressure.

The report goes on to say that resiliency and protective factors
should be promoted. Resiliency is the ability of a young person to
cope with a situation that cannot be easily changed (such as living
with a parent who abuses a substance), and protective factors are
elements in a person's life that make them less likely to abuse
substances. These elements can include academic success and reading
skills, connection with a supportive adult, feeling part of the school
environment, and participating in extracurricular activities.

The success of substance-abuse treatment programs is debated in the
report. It is noted that there have been few studies on treatment
programs and the report suggests that the success of treatment
programs should be studied further. It proposes that services that
meet young people's needs-schooling, vocational guidance, recreational
activities-have the potential to help. It also recommends integrating
motivational and family therapy models into programs and offering
post-treatment services.

Finally, the report criticizes enforcement and regulatory approaches
aimed at restricting the availability of substances and increasing
their price, such as criminalization of substance use, taxation, and
minimum legal-age requirements. It deems that these methods are only
partially successful and do not constitute a sufficient response to
youth substance use, citing that in Canada, the number of people under
18 charged with drug possession has tripled over the past decade
(1,047 in 1993 and 3,294 in 2003, according to the Canadian Centre for
Justice Statistics). Instead, the report champions alternatives such
as harm-reduction programs-like methadone treatment, needle-exchange
programs, and alcohol-related programs-as well as the implementation
of a legislative framework that requires drug-addicted adolescents to
take part in treatment as an alternative to custody.

Federal and provincial governments are expected to take the Youth in
Focus report into consideration and make policy and budget decisions
based on the report's findings and implications.

Help is available at the U of O

The goal of this article is to inform students to understand the
realities of alcohol and drug use, as the prevalence of substance use
and abuse is highest in the age range most students fall in.