Canadian Centre on Substance Use and Addiction

Reports in the Substance Use in Canada series highlight important issues related to substance use and addiction while identifying areas for action within both policy and practice. By providing an in-depth review of different issues of substance use, the reports give people the chance to consider evidence as they develop and employ more effective prevention and treatment programs. Subjects with which the reports deal include older adults and substance use, cannabis and the developing brain, and childhood pathways to substance use disorders.

Harm Reduction Workers

Harm Reduction Workers Amid Dual Public Health Emergencies

Harm reduction workers are unique to the healthcare systems in Canada. They are tasked with providing an array of services to meet the various needs of people who use substances. Although harm reduction service providers consistently reported moderately high levels of job satisfaction, these providers are encountering chronic, daily stress from structural factors that create a precarious and inequitable working environment. The nature of harm reduction work can be emotionally taxing with constant exposure to trauma and death.

Experiences of Harm Reduction Service Providers During Dual Public Health Emergencies in Canada closely looks at the challenges harm reduction workers face during the concurrent COVID-19 pandemic and toxic illegal drug supply crisis.

Evidence from this study helps fill in some of the gaps in Canada's knowledge and help find ways to improve services and resources for both harm reduction workers and the people they serve. A comprehensive healthcare system that truly integrates harm reduction services will increase access and better meet the needs of both harm reduction workers and the people they serve.

The research evidence from the report found that:

  • Experiences of burnout and secondary traumatic stress were greater than previous reports among multiple healthcare and caregiver professionals, even greater than those reported by hospital healthcare workers during the height of COVID-19.
  • Vulnerability to grief has increased significantly over time.
  • As an overwhelming need to continue the work remains, these pronounced strains on the well-being of harm reduction workers have become normalized.
  • Experiences of stigma toward harm reduction service providers may be decreasing, though this finding may reflect reduced interactions during COVID-19 or stigma becoming more subtle.

For more information, read the full report :

Older Adults and Substance Use

Older Adults and Substance Use

Adults aged 55 and over represent the fastest-growing subgroup of the Canadian population, but also the mostly likely group to have patterns of daily substance use, especially with prescription drugs and alcohol. As older adults continue to make up a larger proportion of the population, it will become increasingly important to understand and adapt to their needs. Current data supports the following conclusions:

  • For some older adults, harms from substance use can be related to difficulties adjusting to the lifestyle changes and challenges of aging, including the loss of meaningful work-related activities, social isolation and the presence of chronic medical conditions.
  • The frequency of daily or almost daily alcohol use peaks in the 65–74 age group, where it is almost three times as high as in the 15–54 age group.
  • While the frequency of prescription opioid use is lower in the 55 and older age group compared to younger age groups, a pattern of daily use is seen more frequently among older adults.
  • Older adults tend to have more physical illnesses and be prescribed more medications, putting them at increased risk for potentially harmful drug interactions.

For more information, see the full report:

Cannabis and the Developing Brain

Cannabis and the Developing Brain

Cannabis is one of the substances most commonly used by Canadian youth. At present, there is a lot of conflicting information about the benefits, risks and harms of cannabis use. To understand the cognitive and behavioural effects of cannabis use by youth, we need to consider adolescent brain development and explore the links between cannabis use and mental illness. This report revealed:

  • Early initiation of regular cannabis use has a negative impact on processes such as planning, decision making, motivation and risk taking.
  • Current evidence suggests a strong relationship between cannabis use and psychosis, with a less clear relationship to other mental illnesses.
  • Approximately 5 to 9% of those who use cannabis will develop dependence, and this rate increases to about 17% for those who start use during adolescence.
  • Comprehensive, school-based prevention programs have been shown to have some effectiveness in reducing cannabis use.

For more information, see the full report:

Childhood Pathways to Substance
Use and Addiction

Childhood Pathways to Substance Use and Addiction

Youth substance use is prevalent in Canadian society. According to the 2017 Canadian Tobacco, Alcohol and Drug Survey report, approximately 77% of youth (age 15–24) have consumed alcohol, 41% have used cannabis and 15% have used illegal substances such as cocaine and methamphetamine. The rates of risky substance use are higher in youth under the age of 25 than for other age groups and the susceptibility of developing a substance use disorder is dependent on a number of factors. At the time of publication, data supported the following conclusions:

  • Two of the most common developmental pathways to substance use disorders are characterized by a) high levels of impulsive risk taking and aggression, and b) anxiety and depression.
  • Adolescents with persistent impulsive-aggressive tendencies are more likely to use substances and develop substance use disorders than youth who outgrow these tendencies.
  • The simultaneous occurrence of internalizing behaviours and substance use disorders likely points to a common vulnerability that increases susceptibility for both.
  • The risk of a child developing problematic substance use later on is influenced by genetic factors, individual differences in brain development, child abuse and neglect, and other environmental conditions and experiences.
  • Understanding substance use from a developmental perspective — addressing personal and contextual risk factors in relation to the developmental stage when they first become relevant — could allow for earlier detection of at-risk individuals and provide an opportunity to build resiliency.

For more information, see the full report:

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