Support for harm-reduction among staff of specialized addiction treatment services in Ontario, Canada.

In a mail survey of staff of specialized addiction treatment services in Ontario, respondents from different types of services varied in their level of support for a variety of harm reduction initiatives. Across all types of services support was common for needle exchange services (82-95% in favour) and for short-term non-abstinence goals for clients with alcohol or drug problems (51-98% in favour). However, mean ratings for the effectiveness of methadone maintenance were negative or near zero, and only in assessment/referral and out-patient samples did the majority (61% in each case) have a positive view of methadone maintenance programmes.

Public perception of alcohol policy issues relating directly or indirectly to privatization: results from a 1999 Ontario survey.

Objective: The purpose of this study is to measure public opinion on alcohol policy issues relating to youth, litigation, outlet density, and government action. The authors comment on the implications of public opinion with regard to proposals for privatization of alcohol retailing in Ontario.

Method: Using data from a 1999 provincial survey (n = 1,288), the authors examine the opinions of Ontario adults (male and female over the age of 18) on seven alcohol policy-related items.

Beliefs about the cardiovascular benefits of drinking wine in the adult population of Ontario.

Aims: to explore beliefs about the cardiovascular benefits of drinking wine in the Ontario population.

Design: secondary analysis of data from a provincial survey of adults.

Participants: Ontarians aged 18 or older (n = 606) from Ontario living in households and participating in a telephone survey.

Who works in addictions treatment services? Some results from an Ontario survey.

This paper summarizes results from a survey of staff of specialized addiction treatment agencies in Ontario and includes information on demographic characteristics, education and related issues for those working in different types of agencies. Across all agencies 80% of staff had some sort of post secondary academic qualification and the majority reported taking professional development courses in the previous 12 months. However, only 20% of all respondents were "certified" as either an addictions counsellor or as another type of human service provider.

Alcohol use, alcohol disorders, and the use of health services: results from a population survey.

Data from a population survey were used to explore relationships among drinking levels/patterns, alcohol dependence or abuse, and the use of emergency services, hospital admissions, and frequent visits to general practitioners in the past year. For both males and females, self-reported hospital admissions were less common among daily moderate drinkers than among lifetime abstainers. Among males, drinkers with no history of alcohol dependence or abuse were less likely to report being in hospital in the last year than lifetime abstainers.

Public opinion on the health benefits of moderate drinking: results from a Canadian National Population Health Survey.

Aims: To explore beliefs about the health benefits of drinking alcohol in the Canadian population.

Design: Secondary analysis of data from a national population health survey.

Participants: Canadians age 12 or older (weighted n = 72375) in all provinces but Alberta excluding those living in remote regions, native reserves and armed forces bases.

Who is using cannabis as a medicine and why: an exploratory study.

This article reports on an exploratory study of medical cannabis users. Interviews were completed with 50 self-identified medical cannabis users recruited through notices in newspapers and on bulletin boards. They reported using cannabis for a variety of conditions including HIV-AIDS-related problems, chronic pain, depression, anxiety, menstrual cramps, migraine, narcotic addiction as well as everyday aches, pains, stresses and sleeping difficulties.

The influence of early and frequent use of marijuana on the risk of desistance and of progression to marijuana-related harm.

Background: A significant minority of lifetime marijuana users will eventually receive a diagnosis of abuse or dependence. Yet little is known regarding the effect of age at onset and frequency of lifetime marijuana use on desistance from use and on progression to marijuana disorders.

Methods: To address this issue, data were obtained from a community sample of 2,729 lifetime marijuana users participating in the Ontario Mental Health Supplement.

Drinking and heavy drinking by students in 18 countries.

This paper examines how levels of drinking, daily drinking and heavy drinking are related in 18 countries. There is wide national variation in consumption patterns. The proportions of students drinking and the proportion drinking at least six times in the past month correlated with per capita consumption in the total adult population.

Drug use and drinking among students in 36 countries.

This article summarizes data on alcohol and drug use from studies of high school students in 36 countries. Drug use levels varied greatly among countries, but alcohol and cannabis were used most often, followed by amphetamines, ecstasy, and cocaine. In countries having high levels of cannabis use, the use of other drugs was also more common but there were no consistent differences for alcohol.

Identifying and treating patients with alcohol-related problems.

Problem drinking is a serious health issue, but often patients whose alcohol consumption places them at risk are not diagnosed by physicians. Case finding is an essential component of "best practice." In many cases if given the appropriate advice, counselling and behavioural interventions, problem drinkers can be helped to reduce their use of alcohol and improve functioning in other areas of their lives.

Age at first alcohol use: a risk factor for the development of alcohol disorders.

Objective: This study aimed to describe the natural course of DSM-III-R alcohol disorders as a function of age at first alcohol use and to investigate the influence of early use as a risk factor for progression to the development of alcohol disorders, exclusive of the effect of confounding influences.

Method: Data were obtained from a community sample (N=5,856) of lifetime drinkers participating in the 1990-1991 Mental Health Supplement of the Ontario Health Survey.

Results: Survival analyses revealed a rapid progression to alcohol-related harm among those who reported having their first drink at ages 11-14.

Cannabis users in the general Canadian population.

In a national survey conducted in 1994, 29.3% of all respondents reported that they had used cannabis at least once, 7.3% reported using at least once during the year of the survey, and 2.

Lifetime use of professional and community services for help with drinking: results from a Canadian population survey.

Objective: To determine the lifetime prevalence of help seeking for alcohol problems among Canadian drinkers; to explore the influence on help seeking of age, gender, education, marital status and the number of life areas where alcohol was felt to have caused harm; and to consider any similarities and differences in the rate of help seeking in Canada and in the U.S.

Method: Analyses of data from a survey of 12,155 Canadian adults (response rate 75.

Antecedents of the risk of recovery from DSM-III-R social phobia.

Background: This study reports antecedents of recovery from DSM-III-R social phobia.

Methods: Retrospective data were obtained from 1116 individuals age 15 to 64 participating in a large population health survey in the province of Ontario, Canada

Results: Approximately 50% of the sample recovered from their illness. Survival analysis revealed a median length of illness of 25 years with peak periods of risk of recovery occurring between 30 and 45 years duration.

A framework for the evaluation of activities and programs with harm-reduction objectives.

This paper presents a framework for the evaluation of activities and programs with harm-reduction objectives that draws attention to the logic, implementation, outcomes, costs, and cost-effectiveness of these initiatives and encompasses stakeholder concerns and theoretical models. Evaluations of harm-reduction initiatives are essential if their proponents wish to establish them as viable alternatives to abstinence-oriented approaches. [Translations are provided in the International Abstracts Section of this issue.

Working in addictions treatment services: some views of a sample of service providers in Ontario.

Respondents in a survey of specialized addiction treatment providers indicated a strong commitment to the addictions field. In a multivariate analysis, intention to stay in the addictions field was positively related to a measure of attitudes toward staying or leaving, to age, involvement in an addictions studies program, working in a residential service, and job satisfaction. Intention to stay was negatively related to education and working in a nonresidential setting.

Measuring treatment process beliefs among staff of specialized addiction treatment services.

In a survey conducted in Ontario, front-line staff of specialized addiction treatment services were asked to indicate the extent to which they believed 53 different treatment processes to be necessary for the effective treatment of people with alcohol and drug problems. Cognitive-behavioural processes were generally rated as almost essential for treatment to be effective. Other processes received mixed ratings, while confrontation and pharmacological treatment were, on average, rated as detrimental.

Developing an integrated information system for specialized addiction treatment agencies.

This article outlines the development of an integrated information system for specialized alcohol and drug treatment agencies in Ontario, Canada. The system is being developed following a strategic planning process involving provincial funding ministries and coalitions of service providers. An overview of the system's development is provided and the implementation of one subcomponent, a client-tracking system, is described.

Characteristics of youth and young adults seeking residential treatment for substance use problems: an exploratory study.

In a convenience sample of young people (aged 12-25) seeking help for substance use, those preferring residential treatment had more mental health and addiction problems than those preferring nonresidential treatment. Those seeking residential treatment were also more likely to have had previous treatment experiences. Some clinical and research implications are noted.

People with physical disabilities admitted to a residential addiction treatment program.

This exploratory study used data on admissions to a 28-day residential addiction treatment program to explore differences between disabled and nondisabled cases with respect to patterns of substance use and other characteristics. Relationships between length and type of disability, substance use, and other characteristics were also explored. The focus was on cases aged 18 to 65 identified as having physical disabilities that limit participation in the work force.

Community-based facilities may be replacing hospitals for the treatment of alcoholism: the evidence from Ontario.

We examined hospital utilization and use of community facilities for the treatment of alcohol problems in Ontario using Statistics Canada, Hospital Medical Records Institute records, and other administrative records. Between 1974 and 1986 there was a large drop in utilization of hospital services for treatment of alcohol problems. Rates of alcohol inpatient cases in general hospitals dropped by 47% and in mental hospitals by 33%.