Summer 2007

 

Addiction in Ontario

Addiction issues are read in the news quite regularly and the past several months have been no exception. Normally, addiction issues, specifically substance addiction, are highlighted in the news when celebrities are pulled over for DUIs and drug possession. They enter a now familiar cycle of being charged, sent to rehab, released, and then pulled over again for the same charges.

So why the vicious cycle? Why do 20 per cent of people in Ontario [PDF] personally experience addiction issues in their lifetime, while most others will be indirectly affected by the addiction or mental illness of a family member, friend, or colleague. The facts may lie in the misunderstanding the public still has towards such issues.

Substance abuse, specifically alcoholism, has the hallmarks of other diseases, including specific and predictable symptoms and outcomes. However, still today, it is treated and publicly viewed differently from other diseases. In the past, its "physical basis was a complete mystery," writes Michael Lemonick, columnist for TIME Magazine. Lemonick continues by explaining that since no one forces alcoholics to drink, alcoholism was and is still seen as somehow voluntary.

Addictions, simply defined by Joseph Frascella, director of the division of clinical neuroscience at the National Institute on Drug Abuse (NIDA), are "repetitive behaviors in the face of negative consequences, the desire to continue something you know is bad for you". Addictions easily lead into interpersonal problems, financial problems, and problems in daily living due to excessive drinking, explains Bridget F. Grant, chief of the Laboratory of Epidemiology and Biometry at the U.S. National Institute on Alcohol Abuse and Alcoholism. It also costs a lot of money. In the document Ontario Election 2007: Focus on Addiction and Mental Health [PDF], substance abuse in Canada is said to cost $34 billion: mainly due to workplace absenteeism, enforcement, and healthcare costs.

The causes for addiction are multi-faceted and include early exposure, stress, depression, and other lifestyle attributes. Other causes can be narrowed down to the physiological make-up of people — with some being more prone to addictions than others. Research in this area needs to continue so we may have a better understanding of the issue.

Addiction treatment is one of four pillars of health promotion with prevention, harm-reduction, and enforcement being the other three. Although it takes a collaborative approach to making substantial changes in the health of people, more resources would be a welcomed step, specifically in the treatment field. Dr. Martin Paulus, professor of psychiatry at the University of California, mentions that addiction treatment hasn't improved much over the last decade despite continual strides in research. "You have a better chance to do well after many types of cancer than you have of recovering from methamphetamine dependence", he describes quite pointedly. Dr. Adam Bisaga, addiction psychiatrist at the New York State Psychiatric Institute, identifies the continued lack of: adequate awareness; understanding of the illnesses; service delivery; and treatment of addiction issues all leading to devastating consequences for public health.

Similarly, the document Ontario Election 2007: Focus on Addiction and Mental Health [PDF], identifies that in Ontario, the addiction system remains poorly funded, and poorly prepared to face the challenges of meeting increased demand, and retaining qualified staff. One of the first steps the document identifies is finalizing and implementing a provincial drug strategy. The addiction treatment field seems to be crossing their fingers for big things to come out of the October election.

Canada's drinking age

In most provinces, you are allowed to enter a bar if you are nineteen years of age. However, in Quebec, Alberta, and Manitoba, you are allowed to drink alcohol at eighteen years of age. Ted Morton, PC Cabinet Minister in Alberta would like to change that in his province.

Morton, with public support, has indicated increasing the drinking age to 19 years of age to be more consistent across the country. Provincial Liberal leader Kevin Taft agrees with the issue and feels the debate should be taken seriously, citing the carnage from impaired driving and other public health issues and problems resulting from irresponsible alcohol use.

Studies in the United States and Europe have shown that increasing the drinking age may decrease social harms, as summarized in the Alberta Alcohol and Drug Abuse Commission's Legal Drinking Age Summary Review [PDF]. However, AADAC clearly shows [PDF] through research and experience that

"a comprehensive approach incorporating a combination of strategies is required to reduce underage drinking and alcohol-related harms … Strategies to reduce underage alcohol consumption must be multi-dimensional. Approaches found to be effective in other jurisdictions include a combination of better enforcement of existing laws, raising the legal driving age, increasing excise taxes on alcoholic beverages, liability laws for retailers who sell alcohol to minors, developing school alcohol and drug policies, and public education".

Promising research to lead discussions when cabinet reconvenes on the issue.