The complete report referred to in this article may be
viewed at the following URL:
http://www.cma.ca/journals/cmaj/vol156/issue10/1387.htm

Drug use worries Atlantic provinces
By Wallace Immen
Medical reporter

Health officials in Atlantic Canada plan to devise a new
education strategy to combat a dramatic increase in the
numbers of teens who drink, smoke and use drugs.

The problem is highlighted by the release today of a survey
of Nova Scotia students that shows most categories of drug
use have risen substantially over the past five years.

While only 17 per cent of Nova Scotia students in Grades 7
through 12 reported using cannabis in 1991, 32 per cent in
the new survey reported they use it.

Smoking was reported by 34.9 percent of students, compared
with 26 per cent in 1991; the number of students who drink
alcohol has risen to 54 per cent from 50 per cent. LSD use
is up to 12 per cent from 7.1 per cent in 1991. Cocaine and
crack use has risen to 3.6 per cent from 2.5 per cent and
heroin use is up from 2.1 per cent from 1.6 per cent.

Drugs are also being used together. Nearly 22 per cent of
students surveyed reported that they use not only alcohol,
but also tobacco and cannabis.

The survey, financed by the Nova Scotia Health Department
included 3,790 students from randomly selected classes
throughout the province who were asked about their substance
use in the previous 12 months. The results are reported in
today's issue of the Canadian Medical Association Journal.

Prince Edward Island, New Brunswick and Newfoundland have
done similar surveys, which are also showing substantial
increases in substance use by teens, said Christiane Poulin,
assistant professor of health and epidemiology at Dalhousie
University, who authored the Nova Scotia study.

Dr. Poulin said health authorities from the four provinces
are planning to work together over the next year to prepare
a regional drug education strategy.

But the rise in teenaged drug abuse isn't limited to the
Atlantic provinces, Dr. Poulin said. Both Ontario and
British Columbia last year reported sharp rises in illicit
drug use by teens. Reasons given for the trends include
economic hard times in the Maritimes and more
permissive attitudes among parents and authorities.

But Dr. Poulin believes the current drugeducation programs
haven't been effective because their goal is abstinence,
which doesn't meet the needs of the large number of students
who are experimenting with substances.

"We have programs for abstainers and abusers. What we don't
have is a range of programs for the middle of the spectrum,
to teach those who might be tempted to use more how to make
less dangerous decisions."

Dr. Poulin said schools have to acknowledge that students
are experimenting with drugs. "It's difficult for schools to
broach the topic because the students are underage and
cannabis is not legal. Talking about it is almost like
condoning it."

She suggests the creation of programs that are similar to
safesex programs; teaching that if you are going to
experiment, you should make responsible choices. "We need to
provide opportunities for students that are meaningful to
their lives and to how they are behaving."

Dr. Poulin said a special target of programs should be
students who mix drugs. The students who reported using
multiple substances tended to smoke the most cigarettes and
become drunk regularly and they are at particular risk of
becoming abusers.

While boys are slightly more likely than girls to use
addictive substances, the trends are the same and both sexes
should be included in the campaigns, Dr. Poulin suggested.

Peer pressure can also be as important as information
campaigns. "The increase in smoking is very disturbing," Dr.
Poulin said. Teenagers know tobacco is addictive and a
health hazard and in 1994 the province imposed tough
controls on sales of tobacco to minors. "Despite all that,
we've lost ground," Dr. Poulin said.

She added that the more students smoke, the more others join
in. "They feel everybody is doing it because they see it all
around them. It sends the message it is the norm."