Substance use and addictions are defined in different ways. The Centre for Addiction and Mental Health defines addiction as "the presence of the 4 Cs: craving; loss of control of amount or frequency of use; compulsion to use; use despite consequence".[1] Addictions can be to substances like alcohol and drugs or to an activity, like gambling.
Why is this important?
Problematic substance use and addictions can impact all areas of a person's life. Addiction impacts a person's physical and mental health, brain functioning, employment and relationships.[2]Addictions and mental health are also closely related. Addiction and mental health issues can impact a person's education, ability to connect with others and their community, life expectancy, quality of life and use of health care services.[3]
Indicators
Alcohol Use |
Measure: Proportion of Residents (age 19+) who exceed Canada's First and/or Second Low Risk Alcohol Drinking Guideline (LRADG)Canada's Low-Risk Alcohol Drinking Guidelines were established to help Canadians better decide how to consume alcohol to best reduce their long-term health risks. The first guideline recommends that women do not drink more than 10 drinks in one week, with no more than 2 drinks a day most days; and that men do not drink more than 15 drinks in one week, with no more than 3 drinks a day most days. The second guideline recommends that men and women should limit themselves in one sitting to no more than 4 and 3 drinks, respectively.[14] Alcohol use and frequency is collected within the Canadian Community Health Survey (CCHS). Those who are under the age of 19, who are pregnant and/or who are breastfeeding/lactating are excluded from this calculation. Key FindingsAs people age they are less likely to exceed the first and/or second low-risk alcohol drinking guidelines (LRADGs). From 2015 to 2017, people ages 19 to 34 years old in Wellington County (including Guelph) and people in Ontario were more likely (70% and 62%, respectively) to report exceeding the first and/or second low-risk drinking guidelines when compared to all other age groups, followed by people 35 to 54 years old (53% and 46%, respectively) and people ages 55-74 years (37% and 34%, respectively). People 75 years and older were least likely to report exceeding the same guidelines (Wellington County results should be interpreted with caution). Locally, a higher percentage of people ages 19 to 74 years old reported exceeding the first and/or second LRADGs, when compared to Ontario.
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*Results for people 75+ in Wellington County should be interpreted with caution due to high variability *** Wellington County does not include the City of Guelph Source: Canadian Community Health Survey (CCHS). Statistics Canada, Annual Content (2015-2017), Ontario Share File distributed by the Ontario Ministry of Health and Long-Term Care. Prepared by: Wellington-Dufferin-Guelph Public Health. Last updated May 2019. Why is Alcohol Consumption Important?Alcohol use can range from not drinking at all to occasional to frequent drinking. A person can range from being a moderate to a heavy drinker. Heavy drinking can lead to immediate and long-term consequences, including injury, acute illness, physical or verbal fights, family and interpersonal issues, and issues with employers. Severe cases of alcohol poisoning can lead to death. Other consequences of heavy drinking include alcohol dependence, nervous system degeneration, liver diseases, some forms of cancer, and depression. Fetal brain development can be impacted when a mother drinks alcohol during pregnancy.[4] LimitationsSelf-reported alcohol use is generally a reliable and valid method to predict alcohol use within the population. However, some variation may be present. Some caution is advised.[12] Looking for more information?Please download the excel file below for more information about this measure
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Illicit Drug Use |
Measure: Use of Illicit Drugs in the Previous 12 MonthsIllicit drug use and frequency of drug use was captured as part of the Canadian Community Health Survey (CCHS). Questions were asked about use of Marijuana, Cannabis, or Hashish, Cocaine in any form (crack, freebase, powder, snow), Speed (Amphetamines), Ecstasy (MDMA), Hallucinogens (PCP, LSD, acid, magic mushrooms, mescaline, angel dust), Sniffed Substances (glue, gasoline, other solvents), Heroin, and Steroids. "Refusal", "Don't Know", "Not Stated" and "Not Applicable" responses were not included in the analysis to ensure only those who provided a "Yes" or "No" answer were evaluated. Key FindingsFrom 2015 to 2017, 13% of Wellington County (including Guelph) residents 12+ years old and Ontario residents reported using illicit drugs (including cannabis).
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Source: Canadian Community Health Survey (CCHS). Statistics Canada, Annual Content (2015-2017), Ontario Share File distributed by the Ontario Ministry of Health and Long-Term Care. Prepared by: Wellington-Dufferin-Guelph Public Health. Last updated May 2019. Why is Illicit Drug Use Important?Illicit drug use is the non-medical use of illegal drugs.[6] Legal and illegal drugs can be addictive and dangerous. Negative consequences of drug use or addiction include injuries, anxiety, depression, blackouts, relationship problems, spending money on drugs rather than basic needs like food or rent, and feeling hopeless.[7] Limitations of this MeasureThe prevalence of the use of illicit drugs may be underreported because of the illegal nature of these substances.[13] Cannabis was included in the list of illicit drugs respondents were asked about. The use of cannabis for recreational purposes became legal in Canada in October 2018.Looking for more information?Please download the excel file below for:
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Marijuana and Hashish Use |
Measure: Marijuana and Hashish UseMarijuana is the name often used for cannabis (a hemp plant that can be used as a drug). Hashish is taken from a cannabis plant.[8] Marijuana/Hashish use and frequency of use was captured as part of the Canadian Community Health Survey (CCHS). "Refusal", "Don't Know", "Not Stated" and "Not Applicable" responses were not included in the analysis. Key FindingsFrom 2015 to 2017, 12% of residents 12+ years old in Wellington (including Guelph) and Ontario reported using marijuana or hashish in the past 12 months.
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Data for people ages 35-54 years old in Wellington County should be interpreted with caution due to high variability. Source: Canadian Community Health Survey (CCHS). Statistics Canada, Annual Content (2015-2017), Ontario Share File distributed by the Ontario Ministry of Health and Long-Term Care. Prepared by: Wellington-Dufferin-Guelph Public Health. Last updated May 2019. Why is Marijuana Use Important?Cannabis use can affect cognition (such as short-term memory and attention), psychomotor function (for example, ability to drive, use machinery), mental and physical health. Health risks are higher for people who start using during adolescence or use frequently. Limited research suggests that cannabis may be an effective medical treatment for certain medical conditions.[8] LimitationsDue to the illegal nature of the use of these substances (at the time the survey was conducted), the prevalence may be underreported.[13] Looking for more information?Please download the excel file below for:
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Smoking |
Measure: Proportion of Population that Smokes CigarettesSmoking refers to taking-in tobacco smoke through cigarettes.[9] Smoking status was captured as part of the Canadian Community Health Survey (CCHS) by incorporating information about whether respondents have smoked more than 100 cigarrettes in their lifetime, smoked a whole cigarette, ever smoked cigarettes daily and the type of smoker (daily, occasional, not at all). For the purpose of this report, respondents were considered "Current Smokers" if they are daily, occasional (former daily) or always occasional smokers. "Not Stated" responses were not included in the model. Key FindingsFrom 2015 to 2017, people in Guelph and Wellington County were slightly less likely (14% and 15%, respectively) to be current smokers when compared to Ontario, as a whole (16%).
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**Data for all ages reported for Wellington County, should be interpreted with caution due to high variability in the sample. Source:Canadian Community Health Survey (CCHS). Statistics Canada, Annual Content (2015-2017), Ontario Share File distributed by the Ontario Ministry of Health and Long-Term Care. Prepared by: Wellington-Dufferin-Guelph Public Health. Last updated May 2019. Why is Smoking Important?Smoking is a preventable cause of serious health conditions including lung cancer, heart disease, and stroke.[10] LimitationsDue to the socially undesirable nature of cigarette smoking, the prevalence of current smokers may be underestimated.[16] Looking for more information?Please download the excel file below for:
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Overdose |
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An overdose is when a "person takes more of a drug than their body can handle."[11] When a person is overdosing they may have "dilated pupils; changes in their body temperature, blood pressure, heart rate and breathing rate; bluish skin; loss of consciousness; and/or seizure. Wellington Dufferin Guelph Public Health presents local information about overdose and drug use through the Substance Harm Information & Education Dashboard (SHIELD). Public Health Ontario has created an Interactive Opioid Tool which presents information about opioid-related morbidity and mortality in Ontario. |
Note
The CCHS is a cross-sectional survey that uses probability sampling to collect information related to health status health care utilization and health determinants for the Canadian population and is conducted annually by Statistics Canada.[15]
In probability sampling, each person in the sample represents (besides themselves) several other persons in the sample. A sample weight is calculated based on the number of people that that person represents within the population. For example, in a random sample of 1% of the population, each person in the sample would represent 100 persons in the population.[5]
References
[1] Centre for Addiction and Mental Health (2012). What is Addiction. Available at: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/dug-use-addiction/Pages/addiction.aspx
[2] Centre for Addiction and Mental Health (N.D) Mental Health and Addiction 101 Series: Introduction to Addiction. Available at: http://www.camhx.ca/education/online_courses_webinars/mha101/introtoaddiction/Introduction_to_Addiction_.htm
[3] Ratnasingham, S., Cairney, J., Rehm, J., Manson, H., Kurdyak, P. (2012). Opening Eyes, Opening Minds: The Ontario Burden of Mental Illness and Addictions Report. Available at: https://www.publichealthontario.ca/en/eRepository/Opening_Eyes_Report_En_2012.pdf
[4] Butt, P., Beirness, D., Stockwell, T., Gliksman, L., Paradis, C. (2011). Alcohol and Health in Canada: A Summary of Evidence and Guidelines for Low-Risk Drinking. Ottawa, ON: Canadian Centre on Substance Abuse
[5] Statistics Canada (2015). Canadian Community Health Survey - Annual Component (CCHS). Available at: http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226
[6] World Health Organization (2017). The World Health Report Chapter 4: Addictive Substances. Available at: http://www.who.int/whr/2002/chapter4/en/index6.html
[7] Centre for Addiction and Mental Health (2012). Mental Health and Addiction Information A-Z. Available at: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/Pages/default.aspx
[8] Abramovici, H. (2013). Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids. Health Canada
[9] Health Canada (2008). Health Concerns: Terminology. Available at: http://www.hc-sc.gc.ca/hc-ps/tobac-tabac/research-recherche/stat/ctums-esutc_term-eng.php
[10] Statistics Canada (2016). Non-medical determinants of Health. Available at: http://www.statcan.gc.ca/pub/82-221-x/2013001/def/def2-eng.htm#hb2tos
[11] Government of Canada (n.d). Information about Substance Abuse. Available at: https://www.canada.ca/en/health-canada/services/substance-abuse/about-substance-abuse/about-substance-abuse.html?wbdisable=true
[12] Del Boca, Frances K., and Jack Darkes. The validity of self-reports of alcohol consumption: state of the science and challenges for research. Addiction 98.s2 (2003): 1-12.
[13] Harrison, Lana. The validity of self-reported drug use in survey research: an overview and critique of research methods. NIDA Res Monogr 167 (1997): 17-36
[14] Centre for Addiction and Mental Health. Canada's Low-Risk Alcohol Drinking Guidelines. Available at: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/alcohol/Pages/low_risk_drinking_guidelines.aspx
[15] Statistics Canada (2015). Canadian Community Health Survey - Annual Component (CCHS). Available at: http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226
[16] Fendrich M, Mackesy-Amiti ME, Johnson TP, et al. Tobacco-reporting validity in an epidemiological drug-use survey. Addictive Behaviors 2005; 30: 175-81