Proceedings of the Special Committee on
Illegal Drugs
Issue 19 - Evidence
MOUNT PEARL, Tuesday, June 4, 2002
The Special Senate Committee on Illegal Drugs met this day at 8:34 a.m. to reassess Canada's anti-drug legislation and policies.
Senator Pierre Claude Nolin (Chairman) in the Chair.
[English]
The Chairman: Good morning, everyone, and welcome to our hearings.
The purpose of this meeting is to enhance public discussion regarding Canada's anti-drug legislation and policies on cannabis.
We are pleased to be welcomed by the people of Mount Pearl, and the City of Mount Pearl officials. We were greeted by one of your counsellors last night. We thank the population of Mount Pearl for accepting our invasion.
Yesterday evening, we heard from some panellists and from a few member of the public. This morning we will hear from local and regional NGOs on the subject of illegal drugs, focusing on cannabis.
Our first witness this morning is the Deputy Mayor of the City of Mount Peal, Mr. Steve Kent.
Mr. Steve Kent, Deputy Mayor, City of Mount Pearl: On behalf of city council, I would welcome this Senate committee and your support staff to our city and, of course, to our new city hall. We are delighted to host such an important process in this country, and we hope you are enjoying your stay thus far, and we wish you another productive and enjoyable day here today with us.
In my capacity as Deputy Mayor of Mount Pearl City Council, I co-chair Mount Pearl's Municipal Drug Strategy with Councillor John Walsh, who you met yesterday evening. In addition to municipal responsibilities, I serve as Executive Director of Big Brothers/Big Sisters of Eastern Newfoundland, and I am past chair of Mount Pearl's Youth Crime Prevention Committee. Councillor Walsh is a principal of one of our local high schools here in Mount Pearl.
As a municipal government, our role is the overall development and enhancement of a healthy community. Our mandate is carried out in the context of respect, involvement, support, partnership, leadership, collaboration, accountability and best practices. We believe the development and well-being of community encompasses the social, economic, physical, mental and environmental health of all who live, work, and visit in our city. Our city is a very vibrant place in which to live and in which to raise a family. We are centrally located within the Northeast Avalon Region, and we play a key role in the region's growth and economic development.
Mount Pearl has a population of just over 25,000, with almost 47 per cent under the age of 30. Our demographic profile was a major reason we were selected as one of nine municipalities to participate in the Confederation of Canadian Municipalities' Municipal Drug Strategy Program. The program provides us with an opportunity to focus on alcohol and drug related issues facing our community's young people. This municipality is a strong middle class community, not without its socio-economic problems or concerns. Mount Pearl is generally considered to be a fairly affluent community in the provincial context, and well able to pay its way. This, of course, can lead to its own set of middle-class problems at times, such as ready access to money among youth, two busy, working parents with sometimes demanding schedules that leave children home alone, both on weekdays and weekends, and sometimes the casual acceptance of alcohol.
Cannabis is readily available in our community, and readily available among our youth population. There seems to be increasing social and cultural acceptance of cannabis use. There is strong evidence of casual usage among youth. In fact, our summer park patrol has shown us that some young people show little concern for being caught. As well, the age of experimentation with alcohol and cannabis seems to be decreasing, and drug use is a growing concern in junior high schools. As community leaders, we can speak for parents, educators, and the community at large, in saying that this is a real concern in our community. For this reason, we applaud your initiative in conducting this kind of community consultation.
We are extremely encouraged and support the public process undertaken by the special Senate committee to more clearly focus on the issues around the illegal distribution, selling, use, and criminal influences of drugs, particularly cannabis.
The issue of the legalization of cannabis is a complex one, and I certainly do not claim to be an expert on the subject. Though not officially polled, it is doubtful that the legal age population of Mount Pearl would support the decriminalization of cannabis. At the same time, there are compelling arguments to be made on both sides of this debate. We know it costs approximately $400 million annually for cannabis enforcement in Canada. In terms of impact on society, the burden of carrying a criminal record for cannabis possession at social, professional, and economic levels is enormous. We also know there are inadequate resources for necessary prevention and treatment programs. I also believe that a segment of our population would ask the question: ``To what extent do we want the law to tell us about our own health behaviours? What line do we draw?''
The City of Mount Pearl believes it is necessary to more clearly educate the public and those involved in policy decision-making roles on the scientific evidence and expertise that better define the illegal drug environment, and particularly its influences on population health. There is a lack of awareness and real understanding about this complex issue. Canadians need to be better informed to be in a position to participate in valuable public dialogue that will ultimately influence public policy decisions. As a municipal government body, we are not in a position to make a decision about a policy that legalizes any drug. We, as a city, however, are advocates for the development and sustainability of an overall healthy community.
The Municipal Drug Strategy Program is a project focusing on a community-wide integrated response to drug and alcohol misuse in our community. The project is based on four key pillars: awareness and education; prevention; enforcement; and treatment. Another strong component to this program is partnerships. We are working with youth- serving agencies, youth groups, schools, police, community health providers, and the Department of Parks and Recreation to encourage youth involvement and participation. Again, based on our early findings, we would strongly encourage public and government support from all levels for the development and enhancement of municipal drug strategy programs.
The Special Senate Committee on Illegal Drugs consultation process provides the opportunity for municipalities to recommend to governments that we endorse programs that improve population health for all citizens but, more particularly, our youth. This committee process has created an environment that refocuses our attention on issues facing our young people. An environmental scan continues to reveal that services to youth are fragmented and that there are gaps in the kinds of services that are available to youth throughout our region.
Using the model of overall community development and health, we would advocate for the enhancement of programs that can be accessed through a one-stop-shop model so that youth can access supports from health providers, and through recreational activities, employment opportunities and youth advocacy initiatives. We believe that this type of development creates an environment that encourages the strengthening of community capacity and collaboration of services to youth.
Based on our experiences and our municipal government mandate, we would make the following recommendations.
First, we support a continued process of consultation that provides the opportunity for public input, education, and awareness.
Second, we support the funding of programs that aid in the development of our youth population, for instance, demonstration and pilot projects, such as the Municipal Drug Strategy of the Federation of Canadian Municipalities, school monitoring programs, and so on.
Third, we support public policies aimed at the prevention and intervention of negative consequences of drug and alcohol use.
Fourth, we support and encourage the continuous gathering of information and scientific expertise that provides opportunities for informed policy decision making.
Fifth, the city supports the special Senate committee in a facilitation role to stimulate debate and encourage public consultation on drug issues that require public policy.
Finally, we support an ongoing commitment from the federal government for sustainable funding for municipalities to support new ways of working with and providing services to youth and families that encourage a focus on healthy living.
I thank you very much for the opportunity to present this brief on behalf of the City of Mount Pearl this morning. I certainly wish you the best of luck in your deliberations, and I hope you enjoy the remainder of your stay in our beautiful province.
I would invite any questions that you may have for me this morning.
Senator Banks: Thank you very much for your hospitality and for making this presentation this morning. What do you need to know in the City of Mount Pearl? You referred several times to research and more information. What kinds of information do you need that you do not have now about cannabis in particular?
Mr. Kent: My belief is that there is a lack of real information and real awareness among the general public. As I said, I believe that the majority of our citizens would not be in favour of the decriminalization of cannabis today. However, my sense is that there is a real lack of awareness and real understanding of both sides of the argument. I think that may be reflected in the kind of turn out we saw last night, and that perhaps we will see today. There has been an overwhelming response from the community in terms of taking part in this process, and I wonder if that is due to a real lack of education and information on the issue.
I see a need for further real scientific research, supported by government, to provide Canadians with more solid, definitive information and conclusions on illegal drugs such as cannabis. I have heard compelling arguments on both sides of the debate. However, as a young person who has grown up in this community, most of what I have heard is hearsay, and it is from various informal sources. I have not seen a lot of compelling research or evidence that clarifies the issue for me as to whether cannabis should be legalized and what the real effects of that would be.
Senator Banks: I think most people would agree with what your contention that, as a general rule, mind-altering substances are best avoided.
Mr. Kent: Absolutely. I feel that is a fair comment, particularly as it relates to young people. Obviously, whether cannabis is ever legalized to any extent or not, we recognize that the effects of any kind of drug are negative, and we would certainly want to discourage young people from using alcohol and other drugs, such as cannabis. It is a growing concern with respect to our youth population. It seems that young people are experimenting with drugs, such as alcohol, at an earlier age than ever before. This causes great concern for those of us who are involved in leading the community.
I certainly would agree with your statement that there are obviously negative effects, as there are for alcohol and tobacco use. However, in my opinion, there is a need for further information and research to be made available to Canadians, so that people can be better informed when making decisions that affect their health, their well-being, and their safety in our society.
Senator Banks: Can you tell us what compelling reasons you have heard that would argue for the decriminalization, or legalization of cannabis? We have heard serious, first-hand arguments about the medicinal ethicality in certain circumstances of cannabis, in particular. However, that is also true, for example, of heroin. There are circumstances in which heroin is prescribed, and codeine, and all kinds of other mind-altering substances. However, those are controlled substances, and they are illegal. One cannot run around buying and selling cocaine or large quantities of pure codeine or heroin. What kind of compelling arguments have you heard that cannabis ought to be legalized or decriminalized?
Mr. Kent: My information has been gathered from general conversations with family, friends and others in the community. I do not claim to have solid or sufficient knowledge of the facts of the issue. Some of what I have heard, and some of the arguments that I think people seem to accept as evidence that would support legalization and decriminalization are based on myth. There does, however, seem to be some real support for decriminalizing cannabis for medical purposes. That is a sentiment I quite regularly hear expressed because of some of the perceived and understood benefits of using the drug for medical purposes.
I also hear discussion of the issue as it is related to enforcement. I referred to that in my earlier comments this morning. My understanding, which is based on very limited research, is that we are talking about hundreds of millions of dollars per year being spent on enforcement in this country. We know that policing is a growing concern for our municipality and for our neighbouring municipalities. We constantly voice our concern to the provincial government that we have inadequate policing resources to meet the needs of our community. We are not satisfied with the level of responsiveness and the response time. We know that our police officers are overworked. We know that we do not have enough police officers in this region to meet community needs. When very significant resources of our police departments in this country are tied up with cannabis enforcement, it seems to me the sense I get from people I talk to is that there is a need for further discussion of the issue. That is why I am so encouraged to see this Senate committee going to such lengths to seek the opinion of Canadians on the issue.
Senator Banks: Let me ask you about that rationalization. There are two ways to solve that problem. One is increase police funding, and the other is for us to acknowledge that a crime is occurring, but pay no attention to it. If we took that argument further, it would be easy to conclude that we could free up a lot of police resources and make them available to do more important things; just as me might choose to eliminate speed limits and allow people to drive however they like. Maybe these things are not less harmful than others, but if we adopted that response, we would free the police to do things that we think are more important. That is not a very good argument.
Mr. Kent: I agree with you, senator. That is certainly a fair comment. We need to look at the wisdom of what we are doing. For me, it is an issue of social acceptance. There seems to be increasing social acceptance of cannabis use. I guess we have changed a number of laws in our recent history, and I certainly am not advocating the legalization and decriminalization of cannabis. As a community leader, I do not feel that I would be in a position to do so, nor do I feel well enough informed of both sides of the debate.
However, laws have changed in recent history as a result of social acceptance and various views of the Canadian public being considered. Laws concerning health oriented and sexual preference behaviours, for instance, have been changed as a result of public opinion, public beliefs and public concern about various issues. The issue of social acceptance is very much related to the concern around enforcement.
I have also heard that, with so many Canadians being prosecuted each year for cannabis possession, there seems to be a real concern on the part of people who are convicted of minor possession offences about the long-term consequences. While they may receive conditional discharge or pay a small fine, they will carry a criminal record. We all know the impacts of that, especially for young people who are coming out of school and about to start a job, doing an apprenticeship, starting a career, family, or perhaps travelling. This burden is a great social, professional, and economic cost.
However, that does not mean that changes should be made on that basis alone. It is a weak argument to support legalization, but it is a reality that hundreds of thousands of Canadians each year are prosecuted for minor offences related to possession.
As to other comments I have heard that would support legalization, I have heard people say that cannabis is not physically addictive. I was a little confused by that, not being an expert on drug-related issues. I did a little research and talked to some people in the field who know more than the people I talked to on the street about the issue. While it may not be physically addictive, I understand that there are some real negative effects of the use of cannabis, particularly in the long term.
Another comment I heard that contradicts the addiction argument relates to the fact that cannabis is a gateway drug, and it could potentially lead to greater use of other illicit substances, particularly among young people. It is an experimental and gateway drug with which youth certainly do experiment. It impairs good judgment. The use of cannabis would obviously pose a concern for people who drive after smoking marijuana. I also understand from talking to some people who work in the field, that there are long-term effects on memory. I believe that it is a fat soluble drug, which means that the long-term effects on the brain are perhaps more harmful than what people seem to understand when they talk about the drug not being physically addictive.
Again, I do not claim to have done much research or study of the issue, but these are some of the things I have heard. I hope that I have answered your question to some extent, and I thank you for the question.
Senator Cochrane: Steve, I wish you had been here last evening when we heard from Dr. McKim of Memorial University. He has published a book that you might find useful to read.
I am please to read that you are affiliated with youth. In my view, not enough young people like yourself are affiliated with youth and youth groups and leaders.
Dr. McKim told our committee that marijuana or cannabis is not a gateway drug, that the use of marijuana does not lead to the use of other drugs such as cocaine or LSD. He has research to substantiate that view. You may want to contact him to get information on that. Perhaps then you could relay that fact to those people you meet in your day-to- day business.
Dr. McKim also told us that by the time kids reach Grade 8 or Grade 9 they just give up on using marijuana. It is more or less a social thing. Young people smoke marijuana because they are bored. That is what he told us last night. It would be a good idea for you to get in touch with him because he could give you some advice.
Mr. Kent: I appreciate your comments. I was just sharing some of the remarks that I hear.
My sense is that young people who experiment with alcohol may, at some point, choose to experiment with drugs, such as marijuana.
As to whether or not it is technically defined as a gateway drug, my perception is that a young person who has experimented with alcohol and marijuana is perhaps more likely to experiment with other illicit substances that are not as accessible to youth. However, I do not know have enough information to form a firm opinion about marijuana being a gateway drug. My concern is that experimentation with alcohol and marijuana, which are both readily accessible to youth, may have a significant impact on school performance and career opportunities, and the further development of young people.
I would predict that young people will be more likely to experiment with other drugs as a result of their involvement with alcohol and cannabis. As someone who works with young people, that is my concern. Growing social acceptance is a real concern. That is why in my opinion, and in the city's opinion, the more we can do in terms of education, awareness, and prevention, the better off we will be.
We had the first meeting of our Community Advisory Committee of our drug strategy just last week. In attendance were some experts from various health backgrounds and from our schools, as well as some young people. We posed the question: With a very short amount of time and limited resources, what is it we need to do in this community to prevent young people from getting involved with alcohol and drugs? The overwhelming response was: Start educating them as early as possible. As soon as they are in school, bring in messages about the impact, the threats and the dangers of drugs and alcohol, so that young people even at a very early age are involved in strong prevention programs.
I think our school system does a wonderful job right now of educating our youth on various issues facing them in society, but there is definitely a need for greater prevention programs starting at the earliest stage possible. It is not enough to start talking about drugs and alcohol in junior high school when young people may already be experimenting with such substances. We need to start prevention and education programs as early as possible. As a community leader, that is one of the main messages that I want to bring to you this morning.
Senator Banks: Of course. As far as schools are concerned, everybody in every province does this differently. It is done to a different degree, and in a different way. Thus far, nobody has come up with what could be reasonably said to be a working, practical, effective solution to convince young people not to smoke cigarettes. We have been trying to do that for decades and it has not worked. It does not work.
I think we would be hard pressed to find a young person in Grade 7 or Grade 8 who does not know that smoking is bad for you, who does not know that being a drug addict is a bad idea, and who does not know that, on balance, drugs are bad. Young people know that their parents think — never mind what their parents do — that drugs are bad. However, we have not been successful in encouraging them not to do those things, and part of the reason for that relates to the ``cookie jar'' principle. If you say to a kid, ``You musn't do that,'' and particularly if you say ``You musn't do that because that is an adult pleasure,'' as the tobacco companies have been saying, that is interpreted by young people as being the ``cookie jar.'' The first thing any kid wants to do is get into the cookie jar. Every kid knows that it is a bad idea to drive too fast. Every kid knows that it is a bad idea to smoke. Every kid knows that it is a bad idea to become a junkie. In spite of all of our education efforts, all of the public information that we have made available, and all of the postulating we have done, we have not been effective in stopping young people from starting those things.
What kind of program do you think we need to come up with to meet with success? That is a 30-second question that requires a four-day answer, but that is the nature of the problem. What we have done has not worked.
Mr. Kent: You are right, it is a very complex question, and I am not sure I am the best guy to provide the answer, but I will do my best from my perspective.
First, I think that it is a symptom of a larger problem when young people experiment with alcohol, tobacco, and other drugs. You are right, young people know that smoking is bad and that using alcohol is bad. There is a general understanding and awareness of the issues, but the use of such substances, to me, is a symptom of a larger problem. It may simply be that young people are curious, and they want to experiment to find out more.
Senator Banks: They think that they are indestructible.
Mr. Kent: Perhaps. It may be that they are having trouble at home or trouble with their peers. They may be facing enormous peer pressure. They may be having problems at school, and they may have low self-esteem. There are a whole host of reasons why young people may choose to experiment with alcohol and drugs. The problem is that those who experiment and end up getting caught in the trap or find themselves in trouble, need to know where to turn. In terms of education and awareness, there is a real need to ensure that young people understand what to do if they do find themselves in trouble. I am not sure that present educational and prevention programs do an effective job of that.
As to what approach I would recommend, I believe we need a much more holistic approach when it comes to young people because, whether they are experimenting with tobacco, alcohol, cannabis or other drugs, whether they are having problems with peer relationships, low self-esteem, staying in school, dealing with family problems or finding a job, all of those issues facing young people today are very much interconnected to some extent. I believe that a more holistic approach to dealing with young people would be appropriate, an approach where young people could access a whole host of services under one roof or through one central network within the community. I think that would be a meaningful solution.
By starting prevention and education programs as early as possible, the impact will be greater.
I would also argue that we do not have enough peer-led programs. Our experience in Mount Pearl has been that, when young people are involved in coming up with the solutions themselves, there have been remarkable results. Take a simplistic municipal issue, such as skateboarding in the streets. We allowed young people to get together in several public forums, and we helped to facilitate that. We allowed them to be involved in the design of the solutions, and as a result, we were able to come up with a solution that certainly is widely supported by young people in terms of the construction of skateboard facilities in the city. The same applies to social issues and other problems facing youth.
We had a problem with vandalism, and still do, to some extent, certainly in our parks, playgrounds and schools. The city funded and supported a peer-led program where young people themselves delivered the message to other youth. The impact was remarkable. In five years we have seen a remarkable reduction in vandalism.
There is no simplistic solution that will lead to overnight success when it comes to dealing with alcohol, tobacco, and cannabis use among young people. Supporting and empowering youth to be a part of the solution, allowing them to take leadership within the community, providing them with the support and resources to do so, and starting at an early age are some of the elements that will lead to success. I wish I could do a better job of answering your question.
Senator Banks: You are exactly right. That is precisely what we must do. Some guys sitting in an advertising agency do not know how — whatever they might think — to talk to young people. You have nailed it.
Mr. Kent: The ads have gotten a lot better, but they are just simply not enough, and they will not have a meaningful, long-term impact on addressing the problem. We must come up with truly integrated holistic, meaningful, community solutions if we are to succeed.
Senator Banks: Those should be peer led.
Mr. Kent: Absolutely, and we must start when the kids are young.
Senator Banks: That is the answer.
Senator Cochrane: I agree with you and Senator Banks that young people must be involved in any decisions that are being made on issues that affect them. Peers should take the lead. They are educated, they are knowledgeable, and they can make decisions for themselves. We often do not give them that opportunity, and that is too bad.
I think you are doing wonderful work for the community, and I hope you continue in that vein.
Have you seen people who are in an older age group using cannabis as well?
Mr. Kent: Yes. What surprises me — and I will admit to being a little naïve — is the prevalence of use among older people. I guess that there are certain stigmas attached to drug use. I was amazed at the various people from different types of backgrounds who casually use cannabis. These are professional people. They are upstanding citizens. I do not mean to say that it is widespread, but I can think of several examples of people I know who do casually use cannabis, and they are contributing, productive members of the community. That is part of the conflict and the real struggle that policy-makers, our government, is faced with.
To answer your question, yes, it is also prevalent among older people. I wanted to focus on youth because I believe that is important to our community. The reality is that cannabis is available, is used, and is accessible.
Senator Cochrane: Have you or the general public noticed any adverse effects from the use of cannabis by older people?
Mr. Kent: It is not something that is necessarily publicly or widely talked about, at least, in my circles of contacts, so I cannot say. From what I have heard about through the media or in various pieces of research that have been produced from other health sources, I sense that the long-term effects are well known and well documented. However, I think there is a lot of myths and a lot of confusion. In terms of a first-person perspective on that issue, I have not heard a whole lot to be able to comment effectively.
Senator Cochrane: Let me ask you about those people who have been convicted and who have a criminal record. Have you noticed any problems with regard to those people either obtaining employment or continuing with employment?
Mr. Kent: I can certainly speak to my experience in the voluntary sector. In even applying to becoming a volunteer with a number of youth serving agencies today, if you cannot obtain a clear certificate of conduct or police clearance, then that poses a major problem. It applies even to volunteering with your child's scout group or wolf cub pack. It also applies to volunteering in the organization that I work for. It does pose a major challenge, not necessarily specifically in terms of the cannabis issue, but also in terms of other minor offences that may have occurred very early in a person's life. Twenty years later, as a result of that minor offence that caused the person to have a criminal record, unless a pardon has been granted, a criminal record does have an impact.
It has an impact if you want to get involved in the community, and definitely so from an employment perspective. Many employers in our community would require people to provide a certificate of conduct or a police clearance. Yes, I believe it is a major concern.
Senator Cochrane: What about taking a blood test?
Mr. Kent: I do not believe that would be widespread or common. Of course, it may depend of what kind of profession is being pursued. For most general occupations, I would suggest that is probably not a requirement today, but obviously it does pose some concern.
Senator Cochrane: It is a concern if you are working in the oilfield.
Mr. Kent: Exactly.
The Chairman: When you talk about a police check, what do you mean?
Mr. Kent: I am referring to either a CPIC report, or a police record check — a background record check through your local police department. A CPIC check is done for everybody. No matter what police department you go to in the country to get police clearance, you can use the a national CPIC service.
The interesting thing about police records checks in this country is that there is no uniform, unified national system that is truly effective in checking criminal background. We are in the Royal Newfoundland Constabulary's jurisdiction here in the capital region. If I committed a crime in this region, that offence record would show up on a check done through the Royal Newfoundland Constabulary. However, if I drove an hour outside the St. John's region to Whitbourne, which comes under RCMP jurisdiction, some of the minor charges that would show up on my record through the St. John's police department will not show up on my record on an RCMP check. It is a real problem for employers and it is a real problem for voluntary organizations.
I know that is not directly related to the legalization issue, but it does speak to a larger issue that is a concern when we talk about the legal challenges facing our police departments, governments, community organizations, and employers.
The Chairman: We are concerned with the double standard, and differences in provinces where in two regions of the same province the consequences are totally different, for instance, Toronto and London. We will have to close that gap. We may want to write to you in order to explore further certain subjects.
Mr. Kent: Thank you very much for the opportunity to speak with you this morning, and I wish you the best of luck in the rest of your deliberations. Thanks for choosing Mount Pearl. Enjoy the rest of your day.
The Chairman: Senators, our next witness is Tracy Butler from the Salvation Army Harbour Light Addiction and Rehabilitation Treatment Centre.
Ms Tracy Butler, Program Director, Salvation Army Harbour Light Addiction and Rehabilitation Treatment Centre: Honourable senators, when I was asked to speak, I was more than happy to do so. I have worked for twelve years in the addictions field. Even though I manage the Salvation Army Addictions and Rehabilitation Treatment Centre program, I will be speaking more from my experience as a clinician. Some of my views are reflected in the Salvation Army program but, since I am a private practitioner and an addictions counsellor in private practice, I will be speaking from my experience. I am sure that the Salvation Army has a position statement, so I wanted to be clear that I would be speaking from personal experience.
When I looked at all the research that has been done and I read the information that is on the Internet, I realized that the research is out there, and it has been there for years. While I support research, I realize that you can put whatever slant you want on research. I have done research myself, and I have studied under Dr. McKim, although he probably does not remember me. There are pros and cons for all research. Therefore, I will speak from my experience in working with addictive clients.
We have looked at a shifting mountain of facts. Years ago cannabis was used in the treatment of PMS — not a bad thing — but it has gone from there. Over the course of time, people have used it for different purposes. Then it lost its popularity; and then it became popular again. We are now at the stage where there are lots of pros and cons about the use of cannabis.
One of the things that has not changed, however, is the fact that cannabis is a very complex drug. We know some things about it, and we do not know others.
The research is suggestive of a dose response relationship. When they looked at heavy users and occasional users versus non-users, it suggested that conclusion. Decriminalization would alter the variables for opportunity, frequency, and pattern of use. It would, in turn, increase the percentage of individuals exhibiting characteristic effects.
A major controversy surrounding the use of cannabis is whether it is a gateway drug. While there is no causal correlation, I think there are linkages. Marijuana users may have a pre-disposition to use other drugs. I was going to quote Dr. McKim, but I do think it is true when he says that a causal relationship cannot be proven. We cannot dismiss the correlation between the use of marijuana and other drugs. There must be an explanation, and it is likely a motivational syndrome. It probably has more to do with sociology than pharmacology. Heavy marijuana use does not predispose a person pharmacologically to use other drugs, but it provides the social setting, the motivation and the opportunity to use drugs. In addition, the personality traits of curiosity risk-taking behaviour that motivate a person to use marijuana are also likely to motive the use of other drugs.
In the treatment facility where I work, I notice that people who use marijuana will not necessarily go on to use other drugs, but it is surely the case that people who have used harder drugs have used marijuana as well. It is sort of the opposite that is true.
Other research at Columbia University indicates that marijuana activates the same pleasure centres in the brain that are targeted by heroin, cocaine, and alcohol, and that it can be perceived as a smoking gun because there could be a biological mechanism by which the gateway phenomenon could occur.
Horticultural development has increased the potency of marijuana, and added many other dangerous chemicals, which undoubtedly increases risk for negative health consequences. We have every reason to believe that horticultural development and advancements will develop and continue.
We may want to consider the development of best practices, a control strategy, and policies for therapeutic and medicinal uses of marijuana. We know to date, that marijuana for medicinal purposes and therapeutic purposes is not curative, but we know that it is helpful in treatments as an anti-emetic in cancer chemotherapy, glaucoma, and the various conditions that are listed. That is not necessarily a bad thing, but we definitely need to have controls around that as well as the development of guidelines for best practices.
The regulatory framework to facilitate cannabinoid research is important. Further research in the field will certainly uncover things as we become more technologically advanced. We can find out and tease out some of the therapeutic benefits of cannabis.
As to the issues as they relate to substance abuse by children, there are, again, a whole host of studies out there. However, in recent studies of children, marijuana-smoking mothers have been shown to be more impaired in the executive functions of the brain. These changes are not often visible to the naked eye, because they are the highest brain functions. We know that these functions are necessary in our ever-changing technological society. These disturbances of the executive functions make it difficult to plan, organize, sequence events, and apply past experiences to current situations.
Senator Banks: The study you have just referred to, which one is that? We would like to have the proper reference.
Ms Butler: I do have it here. I will have it copied for you.
As to impaired driving issue, it has been demonstrated that there is an inability to complete motor tasks, and that driving performance is impaired due to an altered perception of space and time. There is also a reduced ability to make quick decisions.
As was pointed out in the discussion paper, we cannot afford to make the same mistakes or have the same impacts that alcohol on impaired driving has had. I think the statistics on driving fatalities would be higher if we were testing for cannabis. We are not testing impaired drivers for cannabis use, especially not at roadside. There is no known roadside test for cannabis, but I know that cannabis can be easily detected in urine. We do qualitative testing for cannabis in the treatment centre where I work, and I think that it could be easily discerned if there were cannabis in a person's urine or blood. If impairment is a consideration, I do not think that it would be perceived as progress to encourage more people to use cannabis. I think many law-abiding citizens do not use cannabis because it is illegal, but if it were legalized, because of the perception of cannabis, say, in comparison to alcohol, they would probably use it. When it comes to impaired driving, I think we cannot take that risk. We know about the numbers of fatalities on the roads, and many innocent individuals are affected because of alcohol-impaired driving. The same situation would hold true with cannabis. I do not think that will be helpful in the long run.
We know that cannabis causes more psychological dependence than physical dependence, except in extremely high doses.
You state in the discussion paper that people do not need therapy for cannabis addiction. I sincerely question that because the individuals who present for treatment at my centre certainly do need treatment for cannabis addiction. For those individuals who identify marijuana abuse as problematic in their lives, quitting can be very complicated.
At Harbour Light where I work, 37 per cent of admissions in 2001 were attributable to abuses of THC. Many reported that as the drug of choice. Consistent with findings, many who abused THC, abused other drugs, but that is not inclusive of all THC users. Most heavier drug users were, undoubtedly, former lighter drug users, but it is still difficult to establish a causal connection. The individuals who presented for cannabis abuse alone, found it problematic and difficult to come off it because of the psychological dependence, and for other related treatment issues. If the people who are addicted to cannabis identify it as a problem, it certainly is a problem, and it does require treatment. I was not quite sure how ``therapy'' was defined in the discussion paper.
The Chairman: I just want to make sure we are talking on the same thing. Let me review the sentence in the discussion paper which is:
...addiction to cannabis usually does not require therapy and existing forms of therapy have demonstrated their effectiveness. For most dependent users, stopping use for a few days is usually sufficient to eliminate any symptoms of addiction.
Is that the area to which you were referring?
Ms Butler: Yes.
The Chairman: We are not saying there is no problem, and dependent users do not need treatment. However, most users do not need treatment. Most users do not develop dependency. For those who develop dependency, at the far end of the spectrum, we do not question the effectiveness of the actual treatment system.
Ms Butler: I am speaking of people who present for treatment. When they do that, it is certainly indicated. We know there is no psycho-active drug that does not have positive and negative effects. It is unlikely that health effects alone will be the final determinant of our choice for control strategies for cannabis. There is mention of the justice system being clogged.
I also work for the Department of Justice. I deliver addictions programs in provincial institutions, so I work with individuals who have substance abuse issues inside, and on the outside we work with Correctional Services Canada delivering addictions treatment to people on parole, and people on temporary absences from provincial institutions.
When you consider offenders, I do not know if the reason that the system is clogged is a good reason. If we take the burden from the justice system, physicians I have spoken with say that it will amount to a transfer to the health care system. That is important if there is a greater associated health risk with larger populations using and maybe misusing marijuana.
There has also been research about visits to hospital emergency rooms because of marijuana in the blood. There will probably be further psychiatric issues, addictions and substance abuse programs, and even impacts on our education system, if the cognitive deficits linked to cannabis abuse become identified down the road.
I have some concerns about where the monies are better spent. I know that monies are better spent on treatment sometimes, but we also know, and I would like to cite gambling, as an example, that the amount of treatment dollars in this province that goes from revenue generated from gambling into treatment is very small. Would the money be channelled into helping a small but important population of persons who do experience substance abuse problems? Would the money go to treatment if it were not being utilized in the justice system?
Speaking from an addictions perspective, by the time people get to me they have identified some sort of problem, whether it has been through the justice system, or they have had a marital breakdown or they have had problems with their families or jobs. Whatever the case, I still recognize it as a very real problem. In terms of therapeutic effects, that is a different issue. In recognition of the fact that people do experience problems and addictions problems with cannabis, I have some concerns if we do decriminalize. I am also concerned about how we might go about doing that.
Senator Banks: What percentage of people using your services use them only for cannabis addiction?
Ms Butler: Thirty-seven per cent identified THC as the drug of abuse. That could be coupled with others.
Senator Banks: Like what?
Ms Butler: It could be cocaine; it could be prescription medication; or it could be alcohol.
Senator Banks: Are there beneficiaries of your treatment centre who are only dependent on cannabis?
Ms Butler: I do not have the actual statistics, but, yes, we do have some people who present only for cannabis abuse.
Senator Banks: Even though you do not have the precise statistics, are we talking about 10 per cent or 5 per cent?
Ms Butler: I would not want to give an inaccurate figure. My guess would be somewhere around 10 per cent.
Senator Banks: What group age are they?
Ms Butler: Eighteen, and there is no upper limit.
Senator Banks: No upper limit, so the lowest is 18?
Ms Butler: The youngest we would see in our program would be 18, and they are males only, I might add.
Senator Banks: Is that for a legal reason, a systematic reason?
Ms Butler: That we have 18 and over?
Senator Banks: Yes.
Ms Butler: We find that those 18 and under do not integrate well in terms of the type of programming we deliver. There are other services in the province. You will hear from a speaker later on that.
Senator Banks: Your program would not accept someone who is 16.
Ms Butler: No.
The Chairman: In your presentation, you talked about better control mechanisms for the medical use of marijuana. What kind of control are you identifying?
Ms Butler: I know that we have developed policies around that. Some of the studies that I have read, and some of the people that have been interviewed certainly do find positive effects from cannabis use. If other routes have not been successful and this would be something that would help someone, while we know it does not cure, but it can help alleviate symptoms, I think that a person should not be penalized or have a criminal record or anything like that for using it.
In terms of how we distribute that, disseminate it to the public, and all those kind of things, I do not know if the best mechanisms are in place right now. Maybe they could be further developed so that would allow for those individuals to safely use without negative repercussions if they have bona fide medical conditions as sanctioned by a medical practitioner.
I say that the policies around that need to be developed because we know that people can present with some things like the benzodiazapens to get medications that really are not necessary. It would have to be ascertained that there is a bona fide medical condition.
Some of the psychiatric patients learn how to read the DSM and they present to medical practitioners in order to get the medications they want.
However, I know that with cannabis, it would normally be used to treat physical conditions which would be more easily substantiated in medical tests.
The Chairman: Are you familiar with the actual regulations on medical use?
Ms Butler: I know that there are regulations in place, but I am not familiar with the complete guidelines.
The Chairman: Are you aware of the involvement of the medical profession all along the process?
Ms Butler: Yes.
The Chairman: Are you aware that patients require three references or letters from three different physicians before they can be considered eligible to have access to medical marijuana? In your area of knowledge, geographically, are you aware of people who have gone through the process to access medical marijuana?
Ms Butler: No, I do not know of any individuals who have been treated with marijuana.
Senator Cochrane: How are patients referred to your centre for problems from the use of cannabis alone?
Ms Butler: They could either self-refer, or they could be referred by a doctor, social worker or psychologist. With regards to our Corrections referrals, a case management officer, parole officer, or a classification officer would identify, in an internal interview with an inmate, that he has a substance abuse or abuse issue. The person is then referred to the program. We screen them from there.
Senator Cochrane: What do these people do that make them stand out? What sort of behaviour do they exhibit?
Ms Butler: Are you referring to cannabis abusers as opposed to other drug abusers?
Senator Cochrane: Yes.
Ms Butler: That is a difficult question because usually in treatment, while we look at all the specific drugs and drug effects, we are referring to substance use, misuse, and abuse issues collectively. In individual counselling, we would tease out further the impacts of their particular drug of choice on their life areas. I do not know if there is anything that stands out that would make them any different from any other person addicted to a different drug, in that, if they experienced problems in their life, that is what we are trying to treat.
Senator Cochrane: Would you recommend a particular treatment for this? Is there something specific that stands out in your mind that has worked?
Ms Butler: I have found that people use substances for different reasons, and there is no standard profile of why people use. If people are using substances, it is effective to deal with, or not deal with, particular issues in their lives to successfully effect change. We need to look at what is going on inside the individual, and what motivates him or her to continue to use. Lifestyle changes are important.
We use a collective bunch of therapies. Obviously, working for the Salvation Army, we do have a strong spiritual component, as opposed to religion, but we do believe that what is not okay on the inside needs to be dealt with also. I am thinking of some of the cannabis abusers we have come to our centre. Some people were more recreational users. However, when people present for treatment it is usually related to other underlying problems, and that happens to be the drug of choice that they use in order to cope.
Senator Cochrane: Has the spiritual aspect enhanced the ability of certain people to cope?
Ms Butler: In my experience in working with individuals, I have found that there have been varying philosophies around that spiritual component. However, I do find that the people who have been very successful in averting relapse and maintaining recovery have addressed the spiritual component. We do allow the individual to define what is spiritual for him or her. It is not for us to define that. Getting in touch with that aspect, I have found helps.
Senator Cochrane: You have a component within your Salvation Army rehabilitation centre to deal with that.
Ms Butler: Our program is holistic, and we focus on physical, psychological behavioural, social, emotional, spiritual, and relapse prevention. It is all woven into the six-week program. Each aspect of recovery is addressed.
Senator Banks: Thank you, Ms Butler, for being here. I personally know several people whose recovery and capacity to maintain a productive lifestyle has, in their view, been directly attributable to the spiritual aspect of their treatment, particularly as they have been able to experience that through the Salvation Army. On behalf of some of my friends, I would express my gratitude to the Salvation Army.
I may be paraphrasing, but I understood you to say that marijuana is not addictive except in extremely high doses. Does that mean that in extremely high doses you have reason to believe that it is physically addictive?
Ms Butler: I think there is evidence out there to say that in extremely high doses it is.
Senator Banks: Is that in evidence that you can provide to us?
Ms Butler: I can get what I quoted from, yes.
Senator Banks: The reason I ask the question is because we have heard from many people that there might be a psychological addiction. We also heard from Dr. McKim that this distinction is one that ought not always to be made. We have heard from many people that there is no such a thing as a physical, physiological addiction, in a narcotic sense, to marijuana, and I would be very interested, and I think we all would, in hearing otherwise. Perhaps you could let us have that information at some point. You can send it to the clerk whenever it is convenient.
Ms Butler: I will do that.
Senator Banks: The answer to this question depends on the definition, but you said that health effects is not the only consideration in respect of whether or not somebody ought to abuse something. What are the other considerations?
Ms Butler: I think that people will take into consideration the impacts of what was mentioned earlier when you were talking to Steve Kent, that is, having a criminal record. There is also the consideration as to whether someone ought to be imprisoned for cannabis use or abuse. I spoke with our clients in a general discussion a week or two ago about their views o this. These are all users of cannabis, and some had been imprisoned for that. They seemed to think that it would drive the illegal drug trade further underground, because they are not going to stop selling illegally. That would be a consideration.
As to whether it will be helpful if we change the laws, the question they asked was: Are people going to find creative ways to carry the substances just to meet the legal requirements in different ways? They just expressed some of their thoughts.
Even though they were users who had used for many years, when I put the question to them as to whether it would be okay for their children or grandchildren to use cannabis on a regular basis, their answer was no. This reflects some of their underlying views.
I think there are considerations other than health considerations, although that may be one of the primary considerations. There are, legal considerations. We must look at all the aspects when making our decisions. Obviously you have done that in the course of your research.
Senator Banks: There is the stigma aspect of a criminal charge being laid, as we have had pointed out to us, whether or not there is a conviction. As soon as somebody is brought in to be charged, notwithstanding a conviction, there is fingerprinting and all sorts of things like that go on. You are at the pointy end of the stick.
You know from reading our research that we have heard from many people — leaving aside the medicinal aspect now — who have told us that, in comparison with liquor, for example, marijuana is relatively harmless. We have heard that the problem with people who drive after using marijuana is that they drive too slowly, and that it just is not a big problem. We have also been told that decriminalizing would remove one of the tools that organized crime uses.
As you said, if there is a gateway effect, it is probably a cultural issue as much as anything, or a social one as much as anything, because the same guy that sells you pot will sell you something else, and he has access to the community that does that.
We have heard many arguments in favour of relaxation of the laws, specifically as they apply to cannabis. As I said, you are at the pointy end of the stick dealing with the problem on an everyday basis. What is your candid view of that?
There are two sides to every ledger, and on the positive side of relaxation of some of the laws as they apply to simple possession of cannabis, there are some big advantages to be gained. There is also the other side of the ledger. You see both sides. If you were to make the decision today as to whether or not to relax the laws, what would you decide?
Ms Butler: Since I work with people on the front line who know it has been the cause of a very real problem in their lives, and also speaking as a parent, my perspective is that the only foolproof way to safeguard against those negative or unwanted effects is to abstain.
Senator Banks: I agree, but that does not have anything to do with the law.
Ms Butler: If the sanctions are not there, I think more people will use because, as I mentioned earlier, there are a number of law abiding citizens out there who will not use because it is against the law. Comparing it to alcohol is a different issue altogether. I think alcohol is a very dangerous drug when abused.
Senator Banks: Do you think there would be less use of alcohol if we made it against the law?
Ms Butler: I think a certain number of people would probably be respectful of the law. However, alcohol has been around for a long time now and it has been legal. It would be quite an undertaking, in and of itself to make it illegal.
No matter what restrictions put in place, a certain percentage of the population will use, no matter what the substance. Another certain percentage of the population will not because of laws that are in place.
I know that CSC is in the process of developing a policy not to test for THC. That will have impacts on us because we have a lot of parolees in our centre. A concern that they had was, if they had a drug restriction clause on their parole forms, as soon as a parolee tested positive for THC, the parole would be suspended. They are looking at other treatment options and other options.
From a treatment perspective, yes, I do not believe in punitive measures for people who relapse, but if their problem is alcohol, cannabis — and those are the two substances that they are not going to be tested for — then that would cause some concerns when you are looking at it from a treatment hinge. I know there are no really easy answers to this.
I just believe that, if we open the door on cannabis, I am fearful of what will come next. Will people start to seek out another drug and decriminalize that, and on we go. I know that it is difficult to know what to do. As you say, I am on the other end. I am coming from a perspective of seeing people have some real problems. I believe it impairs cognitive function. I believe that to be regularly smoking cannabis is not a good thing for young, developing adolescents. I would not want it for my children. I am speaking from the treatment side.
The Chairman: What is the overall population your centre works with?
Ms Butler: What does the population consists of?
The Chairman: Yes.
Ms Butler: I would say probably 40 per cent are community-based referrals; with about 60 per cent from Justice.
The Chairman: Are you talking about 100 people?
Ms Butler: We probably see about 120 people in treatment a year.
The Chairman: You are servicing a general population of how many thousands?
Ms Butler: We accept referrals island-wide.
The Chairman: I understand that. I am trying to correlate the general population that is 100,000.
Ms Butler: Normally it would be the St. John's-Mount Pearl region.
The Chairman: What is the population of St. John's?
Ms Butler: St. John's, I think, is around 130,000. I am not sure.
Senator Cochrane: Tracy, have the people that you have treated in your centre experienced difficulties in being able to find employment?
Ms Butler: We try to maintain statistics on employment, particularly gainful employment. The main reason some are not gainfully employed is because their lack of skills. Many of these people had a minimal job history, if any at all. That probably had to do with many other sociological issues as opposed to their substance abuse. Sometimes the converse is true, that is, it was their substance abuse that impaired their ability to work and got them out of the workforce,
Senator Cochrane: The skills issue is the main factor?
Ms Butler: Yes.
Dr. William A. McKim, Acting Head, Department of Psychology, Memorial University of Newfoundland: As I said last night, thank you for inviting me. I find myself in very illustrious company.
My background is as a teacher and as a researcher in the field of psychology, particularly as it applies to the use of drugs — not only the effects of drugs on behaviour, but how drugs interact with behaviour in various other ways, particularly with regard to addictions.
In the context of what you just heard, I do not want to present any false credentials. I am not involved in therapeutics. I am not a clinical psychologist, I do not treat addicted people, and I have great respect for those who do and who do so very well like the witness you just heard.
Apart from my research, I am, essentially, an ivory tower psychologist. I work in the University, I do research, and I teach. Keep that in context as well.
I have had an opportunity to look at the presentations that you have received on the Web. You have certainly been exposed to a great deal of information. Much of it seems to be contradictory. People use a lot of different language as well. They talk about ``addiction,'' they talk about ``dependence,'' and ``physical dependence,'' as well as ``psychological dependence.'' I just want to briefly review what we know about those fields.
Perhaps we can get a better understanding of the process of why people take drugs, and why some people take too many drugs. It is quite clear that some people can take a drug occasionally without any particular ill-effect, but other people continue to take the drugs in what would seem to be an irrational fashion ,to the detriment of the rest of their lives. In fact, they often go for treatment. They do not want to take the drug, but they feel compelled to continue taking it, and they try to get some understanding of what is involved in that particular process.
Traditionally, we have used physical dependence as an explanation of that. The term ``dependence'' derives from that particular assumption, and the assumption is that the reason the person continues to take a drug on an irrational basis when it does not make any sense is because they are afraid of withdrawal symptoms. Withdrawal occurs, and the symptoms are so uncomfortable, that they will do anything to avoid the withdrawal. For that reason they will do anything to obtain the drug. This is often to the detriment of everything else in their lives, their family, their marriage, their job, and so on.
We now know that that is not true, that physical dependence is not the motivation for people taking drugs in an irrational fashion, but that model was around for a long time. In the 1930s, 1940s and 1950s, it became apparent that people would take drugs that did not produce physical dependence. Rather than change the theory, theorists made up a modification of it. They invented something called ``psychological dependence.'' This, presumably, would explain, without losing that rationality, why people would compulsively consume drugs that did not produce any real, serious physical dependence.
I should point out that you find withdrawal symptoms from many things. People who take lots of aspirin and then stop can experience physiological changes resulting from that. The presence and absence of physical withdrawal symptoms is not really that important.
To get back to the story about psychological dependence, people perceived that there must be some kind of dependence and there must be some kind of withdrawal symptoms but that it was inside the brain because they could see it. They called that ``psychological dependence.'' They said that if you took a drug compulsively or irrationally, and it was not the kind of drug that produced severe uncomfortable withdrawal symptoms, then it had to be going on inside your brain where it could not be seen. Therefore, the brain became dependent and, when you stopped taking the drug, there were all kinds of things happened inside your head which did not show up in the rest of your body, but it still was very uncomfortable, and you would still do anything to give yourself the drug and relieve those withdrawal symptoms.
The trouble with the thinking on psychological withdrawal is that it is essentially circular. It does not explain anything. The reason you would give for somebody taking a drug is, you would say, ``Well, he is psychologically dependent because he compulsively uses the drug.'' Then you would say, ``Well, why does he use the drug? Because he is psychologically dependent.'' You are in a circle. You do not know for sure. It can describe a state of affairs, but it is not an explanation.
People have been using that as an explanation for why people take a drug — because their brain is somehow dependent, and they are going through these withdrawal symptoms that you cannot see. The term ``psychological dependence'' is used incorrectly that way, because it is a concept that does not make any kind of rational sense, at least from a scientific point of view.
People have often used the term ``psychological dependence'' in a different way as well. They have used the term to describe the motivation or to explain the compulsive drug use with the assumption that it is not the withdrawal that is important, it is the pleasure that is important. People somehow continue to use the drug because it produces euphoria; it produces pleasure. A number of different words have been used to describe it. They look at that as the motivation. I think that is probably closer to the truth.
It is very clear that when you take drugs — and all drugs of abuse have in this in common — they increase activity in a part of the brain that has a number of different names, but I refer to it as the mesolimbic dopamine system. That is a very important part of the brain that exists in the brains of most organisms. Some form of that evolved very early. It is a system that controls behaviour. When you do something that is adaptive, that is the part of your brain that makes you want to do it again. That is important. It is an adaptive mechanism that most organisms have. If they are looking for food and they find it in a certain place, then they will remember how to get food again, and they will be motivated to return and continue to get food from that place. It allows them to adapt to the environment.
We have a mechanism inside our head which, for want of a better phrase, we could refer to as a ``do-it-again system.'' Your brain is programmed so that, when you do something that is good for your body or good for the species, such as eat, drink, and have sex, you want to do it again. Your brain makes you want to repeat that activity. It is sometimes called ``a pleasure centre'', in fact, because the subjective experience of the active part of that brain is feeling good. It is pleasure. The pleasure part of it, I think, is perhaps what you might call an ``epiphenomenon.'' It is not necessary that you experience pleasure for this system to work. It can control your behaviour without you feeling pleasure.
Subjectively, when we try to understand why we have done something, we say ``I enjoyed that so I am going to do it again,'' but what is really happening is that part of our brain is saying, ``That was good for the species; you should do it again.'' When we think about it, and we look at our own behaviour, we say, ``I did it because I liked it.''
Interesting research has been done where people have been given very small doses of cocaine, so small that people cannot even detect it. They do not even know they have been given cocaine, but the way this research is often done is you give people a red pill, and blue pill, and then a red pill, and a blue pill, on successive days, and then you ask them which one they want. They will chose one or the other, and it is often used as a test for the reinforcing ability of drugs. You will often find, and researchers have shown, that if you have a placebo in the red pill, and a dose of cocaine in the blue pill, people will usually chose the blue pill. That even happens at such a low dose that they cannot tell that they have been given anything. Their brain knows that they have been given something, but they subjectively do not know.
I explain that to try to explain the role of pleasure in all of this. Pleasure is a subjective phenomenon. It may or may not be present. It is probably present about 99 per cent of the time, but it is not necessary. What is really important is the activation of that part of your brain that makes you want to repeat something.
Of course, the bottom line here is that all drugs of abuse stimulate that part of the brain, that mesolimbic dopamine system, that makes you want to repeat what you did. That is one thing they all have in common. Ultimately, they will increase dopamine activity in that system. They sort of short circuit this part of the brain that has evolved as an adaptive mechanism to control your behaviour so that your brain thinks you have done something good, but you have not. You have done something really quite bad, but your brain does not know that, and it makes you want to do it again. That is what all of these drugs of abuse, cocaine, alcohol, tobacco, and, in fact, marijuana do. THC and marijuana do have that particular effect on you.
That explains why people use drugs in the first place, and it is also an explanation for why people use drugs excessively.
Most other theories of addiction suggest that there are different mechanisms between the casual use of a drug and the compulsive use of a drug, which we would call addiction. This particular way of looking at it suggests that it is really qualitative, not quantitative. The same mechanism makes us use drugs occasionally as makes us use drugs compulsively. Why is it then that we all do not end up addicted as soon as we drink a beer or smoke a cigarette, or smoke a joint? The brain has also developed other mechanisms to prevent that from happening.
One of the things that we understand from studying behaviour is that we tend to distribute our behaviour among aspects of the environment that do this to our brain. There are lots of things that will do this to our brain. As I said, basic things like eating, drinking, and sex, will do it, but social interaction with people will also do it. Most of the things which you would describe as giving you pleasure do it because of what they do to that particular part of the brain.
Many things in our environment that can do that, and the brain is made so that it tends to distribute behaviour among all those different sources. I will use the term ``sources of reinforcement,'' because, in fact, from a behavioural point of view, people like Skinner and various other researchers have described something they call ``positive reinforcement.'' We now know that positive reinforcement is what is the behavioural correlate of stimulation of the mesolimbic dopamine system. The two lines of research were independent for a while, but we now understand that they both describe the same thing.
The mechanism involves the brain mechanism. The reason we use drugs is because it is a natural system. It is not a disease, for example. It is a natural system. Some people end up using drugs compulsively. As to why it happens to some people and not to others, there are a myriad of explanations. I suspect the environment has a lot to do with it. The availability of other sources of reinforcement is extremely important.
One of the things that tends to happen with drugs is that they have sort of a circular spiral. One of the side effects of a lot of drugs — and I say side effects because these are not directly arising from the stimulation of the mesolimbic dopamine system — like alcohol, for example, is that it is difficult to do anything else. If you are intoxicated, it is difficult to carry on your job,. It is very difficult to have a good family life if you are drunk all the time. What will then tend to happen is that the gratification you get from these other sources tends to diminish, and that pushes you more toward getting all your gratification from the alcohol. Your family leaves you; you lose your job; and you lose your health. You no longer exercise. All you have left is the alcohol. Many of these dugs will tend to undermine other sources of reinforcement, and control your behaviour and produce a compulsive kind of behaviour.
It is interesting to note, from the point of view of therapy, one component that leads to successful therapies is the re- establishment of normal family life, normal work life, and the re-establishment of health. There is a wonderful program in Toronto called COPA. It deals with alcohol and older people, people who experience addiction problems in their later years. Very few of them take marijuana, so that is not the problem. Most of them drink alcohol. If someone is referred to this program, they are not told, ``You are an addict,'' or ``You are an alcoholic,'' or ``You are a drunkard, and we are going to help you.'' Very often they do not even use those terms. They do not talk about alcohol.
What they will do is they will meet with these people and try to improve aspects of their lives. They will improve their housing; they will improve their health; they will help them to make contract with the health care system; they will give them some kind of social contact and supply transportation so that they can get to social clubs and the like. Very often, the alcohol problem disappears on its own. They do not even have to say, ``Look, you are a drunk,'' or ``You are an alcoholic and we are going to help you.'' As a matter of fact, those older people would not deal with them if they did that. There is a big stigma attached to being an alcoholic.
You try to improve everybody's life, and that will often, though not always, tend to cause the alcohol problem or the drug-use problem to disappear.
It is important to try to understand why people start using drugs in the first place, or why they develop into compulsive users. Often there is nothing else in their lives to compete with the alcohol.
An example I often use is the Davis Inlet gasoline sniffing situation. Solvent sniffing is an insidious problem, and it often shows up in isolated rural communities. Why some develop these problems and others do not, is a bit of a mystery. I was amazed that they would remove these Innu children, give them therapy, and then send them straight back into exactly the same position in the same community. Everything was exactly the same, and they just started up again. Everybody was surprised that we spent millions of dollars on therapy and it did not work. It is not surprising at all. It is exactly what you would expect under the circumstances.
In any case, I have probably said too much already. I will be glad to answer any questions you may have.
The Chairman: Last night you alluded to the extent of research that you have done on animals. I want you to explain to us how a researcher can, from findings made on research on animals, for example, rats, correlate, transfer and extrapolate those findings to determine what the consequence would be on human beings.
Dr. McKim: It is not terribly difficult. You are dealing with the brain of a rat. When we are dealing with the kind of brain mechanisms that I have been describing, and you try to understand drug use in that context, it is not terribly difficult. Rats are mammals not terribly distant from us, all descended from an ancestor way back that had the same type of brain mechanism. The brain of a rat works very much the same as the brain of a human brain when it comes to controlling behaviour. We have consciousness, awareness, language, symbolic abilities, and executive function in many areas that rats do not have, but they still have a mesolimbic dopamine system that works in a way that is very similar to ours. You can put a catheter in a rat's circulatory system and allow it to push a lever to give itself an infusion of a drug, and virtually every drug that human beings take, rats also take. Incidentally, marijuana is the exception; and it is an interesting exception.
The Chairman: I was alluding to that exception. Why is that an exception?
Dr. McKim: I do not understand, and a lot of people do not understand, but I can speculate that it might have a lot to do with the delivery system. Human beings do not inject THC. They inhale it. The route of administration is important in determining the control a drug will have over behaviour. People have tried, in fact, to get rats to inhale marijuana smoke and they have not had much luck. The whole area of getting rats to consume drugs by inhalation is a real problem. I suspect it is a route-of-administration problem. If we could figure out some way of delivering the THC to rats that would be equivalent to human inhalation, I suspect we probably would see them self-administering it. However, this is an interesting question, but a technical one rather than a practical one.
The Chairman: Research done in the U.S. which is frequently referred to by the National Institute on Drug Abuse in the U.S. deals with the effects of marijuana on the brain, and that research was conducted using rats, and they concluded that marijuana can or could damage brain cells. When looking further into that research, we found out that an enormous amount of marijuana was injected to those rats daily. Are you familiar with that research?
Dr. McKim: I am familiar with a number of different studies that have looked at continuous exposure to fairly high doses, and at permanent changes. Some studies were done at the Addiction Research Foundation in Toronto a number of years ago. Studies have been done with monkeys in the U.S.
The Chairman: What are the conclusions of those studies?
Dr. McKim: The study that I am thinking of that was done at the Addiction Research Foundation was done by Kevin Fehr. That was a classic study. It was one of the first to be done. She used massive doses for an extended period of time.
The Chairman: Extended doses of what substance?
Dr. McKim: I can find out for you, but I cannot tell you off the top of my head. The doses were much higher, in fact, than a human user would ever take.
The Chairman: Just to make sure that we understand, if a regular user were to take two or three grams a day, he or she would be considered to be a heavy user. Are we talking about more than three grams a day?
Dr. McKim: The study was conducted by Fehr, Kalant and others, and you have already heard from Dr. Kalant. THC was administered to rats in large daily doses for six months. I will have to go back and look at the study to find out how large the dose was. The findings of the study tell us that THC caused an impairment of maze learning that still existed two months after the drug was discontinued. Researchers concluded that it was likely that the drug caused some sort of permanent brain damage. In fact, other studies have shown that there are alterations in rat brain structure and function, especially in the hippocampus after chronic exposure to THC. It was also reported that high levels of THC — and once again it is not specific — are toxic to cultured hippocampus cells in rats. That is where you take the brain cells out and expose them to THC.
However, there is another more definitive study. In a study with rhesus monkeys, William Slikker and his colleagues at the National Centre for Toxicological Research in Jefferson, Arkansas, trained monkeys to perform behavioural tasks, including progressive ratio schedules in order to obtain a banana flavoured food pellet. One group was exposed to the human equivalent of smoking four to five low- to medium-potency cigarettes through a mask that covered the nose and mouth, and they did that every day for a year. The monkeys got the human equivalent of four to five joints a day every day for a year.
A second group was exposed to the same, only on weekends, and there were appropriate control animals that received the smoke without the THC. During the exposure, there were effects on behaviour in some hormone levels probably resulting from stress, but seven months after the exposure, there were no detectable differences in behaviour, hippocampal volume, neuron size, or synaptic and dendritic activity. That is a more recent study, and I think it is more definitive, and the dosage level seems to be more appropriate.
The Chairman: Massive use is the difference.
Dr. McKim: The final paragraph of the study states that it had been pointed out that comparisons between culture cells in rats, monkeys, and humans, should take into account the duration of exposure relative the organisms life span. It states that three months exposure is normally required to cause neurotoxic effects in rats, and that that is about 8 to 10 per cent of a rat's life span. The monkey equivalent would be three years, and the equivalent exposure in humans would be seven to ten years.
The Chairman: To what page in your book are you referring?
Dr. McKim: Page 316. I have recently read some other epidemiological studies done with humans who are long-term chronic users. Some studies claim to show some sort of a permanent dementia, at least effects lasting as long as a year, after people stopped. Other studies do not reach that conclusion. In epidemiological studies it is difficult to find people who use only marijuana. If there is a finding, it is not clear that it is due to marijuana.
Senator Cochrane: Dr. McKim, I would like your reaction to something we heard this morning from Mr. Steve Kent, City of Mount Pearl. He said:
Using a model of overall community development and health community, we would advocate for the enhancement of programs that can be accessed through a one-stop-shop model so that youth can access supports from health providers, and through recreational activities, employment opportunities and youth advocacy initiatives.
What do you think of a model like that? Do you think that would help solve the problem of youth starting to use cannabis?
Dr. McKim: I think the community development approach is terrific, because it pays attention to the entire environment of the individual. It is not an approach that isolates one individual and encourages him or her to stop. It treats the whole community, which I think is really important. That is definitely the way to go.
However, I do not think it will stop people from experimenting, and it may not stop them from using it, to some extent. That type of approach is quite likely to prevent excessive use insofar as it provides a great many other things for the person to do.
As I explained, it is not so much a matter of what the drug does in your brain, it is a matter of what else is available in your environment to try to distract you away from that. It is a competition. If I could paraphrase, Nancy Reagan said, ``Just say ``no'' to drugs.'' That is only half the picture. It is much easier to say ``no'' to drugs, if you are saying ``yes'' to something else. You have to provide the something else for people to say ``yes'' to.
Senator Cochrane: I shudder when I think of the situation in Davis Inlet. As a doctor of psychology from Memorial University, do have a suggested solution to that problem? I notice that another $25 million is going to Davis Inlet to try to counter this problem. However, I do not think money alone will solve our problem. As you said, taking these children out of that environment, bringing them to Alberta or Manitoba, and then returning them to that environment has not solved the problem. It has been proven not to solve the problem. What can we do?
Dr. McKim: As Steve Kent points out, it is a community problem. You must fix the community, not the person. You must ``fix'' where they live. The people of Davis Inlet are being moved to a completely new town site. That may do it. It depends on whether recreational facilities are available there.
However, that is only part of it. The traditional lifestyle of the Innu is important to them, and that involves spending time with the elders and hunting in the woods. That has to be part of it as well.
There are lots of things to do in Labrador besides sniffing gas, and these young people have to be given the opportunity to do those things as well as be encouraged to do them. Building a recreational complex would help. Having basketball coaches and swimming pools will help.
However, in an ethnic community like that, there are many things that you and I do not understand well enough to be able to advise them on what to do. A lot of it has to do with their traditional lifestyle. Basically, I think that they know what needs to be done. The elders probably know what needs to be done. We just have to be able to give them the opportunity to do it. I am not sure how easy that is. I am not on the scene. I have no idea what will work. Maybe having camps in the wilderness would help. I just do not know. I do know that, in principle, we need to provide something that young people can do to compete with gasoline sniffing. That is the easiest, most available, cheapest source of stimulation of their mesolimbic dopamine system. Unless we provide alternatives, that is what they will do.
Senator Banks: I am going to be argumentative just to get some information. You told us last night and again today that the perception that we have had for a long time about the fear of withdrawal from physiological dependency is not what we always thought it was — the main motivation for people to keep on being junkies. I think I understood you correctly.
Dr. McKim: Yes.
Senator Banks: I have been through the process of withdrawal from heroine with certain people. Heroine is physiologically addictive, and the process of withdrawal is horrible. It was worse than anything I had ever imagined. To simply stop ``cold turkey,'' as it is called, is a horrible process for everyone involved. It was so horrible that I have a tough time believing that the fear of that is not a factor in people continuing to take drugs because it is takes from them, physiologically, something that they equate almost with food. It is something that their systems need. Whether it is a psychological or a physiological addiction is beside the point. That urgent necessity leads, in their case, to such horrible consequences when they suddenly stop and do not get a fix, that I have a hard time understanding what you said about physiological addiction and the fear of withdrawal not being a factor in continued addiction. Why they started is almost beside the point. Could you enlighten me a little bit in that respect? I know this does not have anything to do with cannabis, but what you said is intriguing to me.
Dr. McKim: Your perception and assessment of the situation is accurate. Withdrawal from heroine is not a pleasant experience. When people first tried to come to grips with understanding why people would compulsively use substances like morphine, heroine, and alcohol, those were the substances — the opiate in the form of morphine and alcohol — that seemed to be the big problems at the time, and they both produced those kinds of withdrawal symptoms. Withdrawal from alcohol is even worse than withdrawal from heroine. It was logical for them to say that fear of withdrawal was the motivation, and it seemed apparent.
However, the difficulty that arises is twofold. Why do people relapse if this is so awful? Somebody will go through heroin withdrawal and then start using heroin again. You would think that would be the last thing that they would want to do — setting themselves up to go through it a second time. The same thing is true, of course, with alcohol. It does not really provide any kind of an explanation for why people would relapse, and relapse rates are extremely high for lots of drugs, those two included. As well, it does not explain why people use drugs that do not produce terribly severe withdrawal symptoms, and use them just as destructively and just as compulsively. It is a factor, and if I led you to believe it has nothing to do with drug use, then I made a mistake. It does. It can, in fact, increase the motivation.
If I may refer to the rats studies again. One way of testing the abuse liability of drugs is to see how hard a rat will work in order to give itself an injection of the drug. They make the rats work pretty hard. For a drug like cocaine, you can get animals pushing levers 7,000 to 8,000 times just to receive a single infusion. With rats that are physically dependent and undergoing withdrawal symptoms and with rats that are not undergoing withdrawal, you will not see a big difference in how hard they will work to get heroine. Rats will work harder if they are undergoing withdrawal for heroine, but not that much.
It has no major effect on alcohol withdrawal. Rats will work just as hard for alcohol whether they are undergoing withdrawal or whether they are not. I think I have got that the right way around. It is a factor, and it does make a difference, but it is not the crucial factor, and it is not sufficiently strong a factor to be the explanation for why people will take drugs in that kind of a compulsive destructive fashion.
By way of a footnote here, you are familiar, of course, with methadone maintenance. Methadone is a synthetic opiate that postpones withdrawal symptoms. People who are heroine addicts will very often go into a methadone maintenance program and they will take their methadone every day for years, in fact, just to prevent withdrawal symptoms.
That program was based on the whole idea that the reason people take drugs is to prevent withdrawal. The point that I want to make is that, in order to get on methadone maintenance, you must be tested to make sure you, in fact, are physically dependent on heroine. In order to do that, a person will be given an injection of maloxone which is an antagonist, and that brings on instant withdrawal symptoms if the person is physically dependent. Very often people will come in looking for methadone maintenance. When given this test it is discovered that the person is not physically dependent upon heroine at all although they think they are. They are living the heroine lifestyle. They are injecting themselves with heroine, but they do not do it enough and in high enough doses to produce a physical dependence, but they believe that they are physically dependent. It is not just a matter of their trying to dupe the system and get the methadone free. They actually think they are physically dependent, and think that they are going to go through withdrawal symptoms if they stop, but, in fact, they are not.
It is a consideration and it is important, but I do not believe that it is the explanation for why people behave in such a compulsive irrational fashion just to avoid the withdrawal symptoms, as horrible as they may be.
The Chairman: Thank you very much, Dr. McKim. I know the researchers are anxious to read the various chapters of your book. I shall leave it with the secretary.
Dr. McKim: I should mention that I was involved in a research project a number of years ago. It was referred to last night. Jim Power, if you remember, had a youth drug use report that was part of a series of studies conducted by Dr. Christiane Poulin, who is an epidemiologist at Dalhousie Medical School. She conducted, throughout the Maritime provinces, large scale surveys in high schools every two or three years. Jim Power had the 1966 report and I believe there was one in 1968. There was one done two years previous. I do not think anything has been done since then. It is extremely good work.
These studies involved very large samples of high school students throughout the entire Maritime region, Newfoundland included, and it asked the same question under exactly the same circumstances, so you can pick up trends, you can see what drugs are being used. I note that Senator Cochrane asked questions about the age of the people who are using. The studies would give you those kinds of breakdowns.
You may want to contact her and get copies of her reports. She looked at Grades 7, 9, and 12. That left Grades 8 and 11. We piggybacked on her survey and did another survey. We did a path analysis, a structural equation modelling, which is almost unbearable to try to describe in its mathematical complexity, and I must admit I do not really understand it. It gives you that kind of an output, and it looks at all the factors. It is complex social research, and it looks at the amounts of drug particular people use. It looks at things like their values, whether their parents use it, and other issues. It puts it all together in a mathematical fashion and shows you the influence of all these other variables. I brought the marijuana-hashish-solvent use reports, which you can digest at your leisure. I will leave that with your secretary as well.
Honourable senators, we now welcome Mr. Robert Pike from the Penitentiary Addictions Group.
Mr. Robert Pike, Classification Officer, Penitentiary Addictions Group: My remarks are based on my working experience and are not the opinion of my department or its affiliates. As a classification officer, I work with offenders who present with addictions problems. Part of my work involves assessing the severity of that addition and making appropriate referrals to our addictions programs. I also co-facilitate an addictions program for provincial and federal male offenders at Her Majesty's Penitentiary. My point of view, as it relates to the decriminalization of marijuana, is based on my interviews and work with the male offenders who have substance abuse problems. Through my work, I have gained some basic knowledge of the negative impact of marijuana use and the major problems it causes for these individuals and their families.
I oppose the decriminalization of marijuana on moral, legal and health issues. Our fundamental beliefs and values are traditionally sound with respect to marijuana use. There are basic goals that we must maintain in our society. For example, we must provide an opportunity to achieve our goals, encourage physical activity and overall promote a health lifestyle. Criminal behaviour has always been discouraged, but it now seems we are considering a change based on public pressure.
Marijuana users today, unlike the 1960s, are from all walks of life, and this push for decriminalization is being influenced by other cultural values and lifestyles. This exposure has weakened our values and beliefs around marijuana use and how we respect our laws. Do we, as a society, consider lowering our standards of living by introducing another psychoactive drug to our communities? Are we prepared to decriminalize a psychoactive drug because of people's attitudes around committing an offence and then minimize their actions by considering their behaviour as insignificant, a simple possession? Will we in the future consider a simple theft as being okay?
We all have some understanding of the psychological and physical effects of marijuana. Individuals choose to smoke dope for various reasons. For example, there are those who look forward to the psychological effect, as an escape from reality. Therefore, are we giving people another opportunity to avoid responsibility and enabling them to seek a drug to influence how they think and feel? The government of today has a moral obligation to stay the course against decriminalization of marijuana use.
From a legal perspective, the law is there to protect society. I believe that decriminalizing marijuana will lead over time to other drug-related crimes. Look at alcohol abuse. Do two wrongs make a right? According to the research, a minority of marijuana users develop problems as result of their drug abuse. The same has been said about alcohol abuse. A small percentage of drinkers have problems related to alcohol abuse. We know the various costs of alcohol abuse, the legal costs, the health costs and the cost to families. Are we now setting up our pre-teens, adolescents and young adults for addictions problem that may lead to criminal behaviour to support their habit? Young offenders today report using marijuana prior to using other illegal and illicit drugs. Some youth even report combining drugs to get different feelings or highs. The addiction to a psychoactive drug is powerful, and for some the need to use is greater than the need to avoid criminal behaviour.
Let me quote from your news release: ``Scientific evidence seems to indicate that cannabis is not a gateway drug. It may be appropriate to treat it more like alcohol or tobacco than like the harder drugs.'' In respect of alcohol, think of all the victims of impaired driving as a result of their drinking alcohol prior to driving and the number of property crimes committed while under the influence of alcohol. Alcohol is a legal drug. Will we be putting more impaired drivers on our streets if we decriminalize marijuana? There is a significant distortion around using marijuana and driving. Marijuana users think they drive better after smoking dope. This perception is frightening and very dangerous. Although people decide to disobey the law by using marijuana, this disobedience should not facilitate the decriminalization of marijuana.
The significant expenditure of public funds in the area of law enforcement is put forward in the argument to decriminalize marijuana. Decriminalization will only shift this expenditure to another agency or department. I do not support the point that less information and prevention action is undertaken if we stay the course. Public awareness and education is always a positive alternative.
For the majority of citizens, the law is a deterrent. By lowering the consequences of having marijuana in your possession, we are encouraging a higher rate of marijuana usage. Eliminating the negative effect of marijuana possession, for example, a criminal record, may increase the availability of marijuana. People who support decriminalization of marijuana may be users themselves and believe that the risk of getting caught is low compared to the drug-induced high. These people seem to be more interested in the psychological effects of the drug than the legal consequences. One may question why they would prefer to change laws rather than obey the law. If it feels good, people want to use it.
Generally speaking, the health issue around the debate of decriminalization of marijuana is founded in research. Both the psychological and physical effects of marijuana are well researched and documented. As it relates to addiction issues, whatever theory of addiction a person supports may have a bearing on the point of view around marijuana use and the development of that addiction.
In any event, there are health risks associated with marijuana use. Marijuana is the second most widely smoked substance in our society after tobacco. We fully understand the health problems associated with smoking tobacco. Marijuana, for the majority of users, is smoked. A health threat to marijuana use is irritation to the lungs and the respiratory airway. The user inhales deeply and holds smoke longer. As well, pot smoke does contain cancer-causing chemicals.
In respect to the impact on a persons' brain, we know that pot changes more than just the way people feel. It also triggers a number of changes in the brain function and behaviour. Marijuana smoke affects the mood, energy, appetite, attention, learning and memory processes. It may also cause forgetfulness and reduce concentration. Marijuana can impair a users ability to perform complex tasks, including driving a car. Information seems to be endless with respect to the health costs of marijuana use. The cost of law enforcement may shift to the cost of health care if decriminalization of marijuana is passed.
Yes, some people may sing the praises of marijuana use as a recreational drug, but as a society are we prepared to put up with the significant negative effects of marijuana on our children, grandchildren, and others generations to come? I believe we can ``think smart'' and work with our educators and youth to assist in the fight against drug abuse. There has been success in the fight against tobacco smoke. Let us work together to promote a healthy lifestyle and oppose the decriminalization of marijuana.
In closing, I would like to thank the committee for this opportunity to speak against decriminalization of marijuana. I look forward to reading your recommendations. Thank you.
The Chairman: What you are telling us is that prohibition works fine, that we should stay the course and maintain the status quo.
Mr. Pike: Yes, that is my position.
The Chairman: You have looked at the prevalence of use of marijuana and cannabis in the general population. Do you maintain that prohibition in the way we are operating prohibition, that is, investing massively in policing?
Mr. Pike: The population, of course, is the penitentiary, the correctional population.
The Chairman: I am talking about the general prevalence in the general population. Ten per cent of the Canadian population use marijuana. Even though 10 per cent of the Canadian population use marijuana, you believe that prohibition is the way to go; correct?
Mr. Pike: Yes.
The Chairman: You have talked about the role of the penal law as being the tool to protect society. Let us expand on that. Professors and experts are calling it the harm principle: If an attitude is causing harm to others, we should penalize that attitude. What degree of harm should we tolerate?
Mr. Pike: There needs to be a balance with respect to using a prison as a deterrent. We have to look at the combination of justice, for the protection of society, and intervention, to assist individuals in identifying why they are using marijuana and assist them in correcting their behaviour. The programs at Her Majesty's Penitentiary address the need of the individual. An individual who is returned to the community has a better focus on where he or she wants to go in life, versus going back to the drug community, back into using marijuana.
Research has identified that regular use of marijuana may cause an individual to become disinterested in doing anything, not motivated to learn. Some of the people I have worked with in assessment have told me that they were drop-outs at school, that they had no interest, and that they just hung around with the guys and smoked dope.
The prisons provide an opportunity to assist a person in getting back into their community. They provide harm reduction, get the person off the street and provide him with appropriate intervention so he can probably correct his ways.
The Chairman: In your remarks, you said something to the effect that the majority of users end up having problems. Are you referring to the clientele that you are working with, or the general population?
Mr. Pike: The people I work with in corrections, of course, committed an offence or decided to behave in a way that influenced the courts to intervene and take them off the street. Of the 10 per cent of the population that uses marijuana, a portion, maybe 10 per cent, actually have problems. Granted, there are people who use marijuana who have not become involved with the law, but many of them may still have problems.
The Chairman: Statistically, roughly 1 per cent of the users are caught. The numbers are not telling us whether they are the 90 per cent who are using it regularly recreationally or the 10 per cent who are using it more regularly, more chronically. Do you maintain that the majority of users are creating harm to themselves?
Mr. Pike: For every joint smoked, there are health consequences. There are physical and psychological consequences. With regular use, a person will develop some psychological dependency to the drug. In fact, as I mentioned in my presentation, there is a big outcry from all walks of life opposing tobacco. Governments and people are suing tobacco companies.
In the future, we may find ourselves in the same predicament with respect to health problems associated with marijuana use, vis-à-vis a financial strain on society. There are costs associated with law enforcement, yes, but the costs of health care down the road need to be taken into consideration — and we all know where we are with respect to health care costs.
Senator Banks: Mr. Pike, if you were here earlier, you would have heard that I, at least, think the best way to get information and to become informed is to ask devil's advocate questions, regardless of who is sitting in your chair. So I am going to do that and ask you to comment on these things.
In your presentation, you said that we have had some success in reducing tobacco use. I am wondering where you see that success and what program, in your opinion, has been successful in reducing tobacco use. I have to tell you that I do not know whether that is true; in fact, I believe that it is not true. I think that we have not succeeded in any Canadian jurisdiction in reducing tobacco use. There are jurisdictions in which that has been done, but none that I know of in Canada. Do you know of some success that we have had?
Mr. Pike: I am basing my remarks on what I read in the papers around the whole issue of tobacco smoke.
Senator Banks: We are making lots of efforts to try to convince young people not to smoke.
Mr. Pike: I think that effort is paying off, sir.
Senator Banks: It is paying off?
Mr. Pike: I would like to think it is. Locally, teens are doing TV commercials against tobacco smoke. I think that is having some impact. Do I have research to back my statements up? No, sir; I am using observation only. There was not sufficient time to do a lot of research.
The reference in my presentation related to the problems associated with tobacco smoke — health care costs, cancer, lung damage, heart damage, et cetera. Those things have been well documented. There are similar problems associated with marijuana use.
Senator Banks: Well, are there? We know that 45,000 deaths each year are attributable to smoking cigarettes. That is statistically demonstrable. Do we know anybody who has ever died from marijuana?
Mr. Pike: No.
Senator Banks: I do not think that anyone does.
Mr. Pike: I do not know. Because it is a criminal offence, people do not readily admit use. As such, perhaps the medical profession is unable to correlate a person's death to marijuana use. If there were a way to research that and to track statistics on it, I am sure we could correlate marijuana use and death.
Senator Banks: If we were to outlaw liquor, do you think there would be any less use of liquor by the general population?
Mr. Pike: I think so, yes.
Senator Banks: We have to work hard, everyone would agree, by whatever means, in treating abuse of any substance. We have to stop people, to the extent that can, from abusing any substance, including every drug we know, liquor, marijuana, heroine, chemical pills, and God knows what. We often hear the argument that prohibition is not the way to do that, that teaching people how to properly deal with these things is the way to do it.
I want you to understand where I am coming from here. The church to which I, at least putatively, belong, prescribes, rather than proscribes, the use of alcohol in its sacrament of Holy Communion — prescribes it. It is alcohol because if it were not alcohol there would be a huge health problem from all those people drinking out of the same cup. Hence, the church literally prescribes that you must use alcohol in one of its most important rites, and there are other churches that do the same thing.
We do not say that, since it is possible for individuals to harm themselves by drinking too much alcohol, we are going to outlaw alcohol. What we say is that people must be taught to use alcohol prudently in social situations. If I drink enough vanilla, I can become completely inebriated. Nevertheless, no one is suggesting that we outlaw vanilla. No one is suggesting that we outlaw those substances that come out of spray cans that people use to get high; no one is suggesting that we outlaw gasoline, which can be used to get high. My point here is that there are many substances out there. Some of them are on the narcotic list, some of them are on the controlled substances list, and some of them, like vanilla, are not on any list.
It does not make sense to me to outlaw one thing where we do not outlaw another. Our job is to teach people to deal responsibly with these things. It becomes a matter of eventual individual choice, as opposed to prohibition. I would suggest that the general experience with respect to prohibiting liquor, for example, in the U.S. is that it did not work, even with the expenditure of huge efforts.
I am wondering if you would respond to the contention that I will put to you just for the sake of response that what we ought to concentrate on is teaching people to deal with substances, including coffee, responsibly, as opposed to outlawing them because outlawing substances does not seem to have worked. I would invite your response to that point of view.
Mr. Pike: My first response would be, where do we stop then?
Senator Banks: That is the question. Is it best to draw circles around some things, to use the ``cookie jar principle'' and tell people that they cannot have a particular thing? You have nailed it. Is that the best point of view? Or is the best point of view to educate people about the many different things in the world, some of which are made by people who do not have your best interests at heart in chemical factories?
Should we expend our efforts, our thinking, our money and everything else on teaching people how to deal with those things responsibly, or ought our strategy be to say that of all the hundreds of things available there are only six or seven of them that you simply cannot have?
Mr. Pike: You referred to the lack of success with liquor prohibition back in the 1920s and 1930s. We know the problems associated with alcohol and alcohol abuse. We know the problems associated with tobacco smoke. You talked about alcohol use in church services. Maybe we should add peanut butter to our discussion, because many people are allergic to peanut butter. Should we take peanut butter off the shelves for everyone?
With respect to marijuana use, we know, based on research, the direct effects of it on a person's health, and indirectly to other people, say, in respect of driving under the influence.
Over the last six months, there have been a couple of people come to my attention who totally feel that their driving skills are great when they are smoking marijuana. That is frightening. Those people are not only a risk to themselves but a risk to other people. It is very dangerous to drive under the influence.
I think the whole point of what you were just saying, sir, was relevant to the issue, and I respect that, but I think we can discuss the matter from both perspectives. In my opinion, moving in this direction with marijuana use over time will create bigger problems for society at large. What would be the ramifications of banning alcohol, and tobacco, which we are trying to ban? I know we are not talking about legalizing marijuana, but we are talking about decriminalisation. In my opinion, if people can be punished for possession of marijuana, it will provide a greater deterrence for those who are ambivalent about using it. If we decriminalize it, it might cause more people to use it.
There are more than 400 known chemicals in a joint of marijuana. What else is there?
Senator Banks: Well, we do not know, and we need to find out more.
You deal with people who are already in the penal system.
Mr. Pike: Yes, I do.
Senator Banks: I am going to refer to the question of harm to others as opposed to harm to oneself. I am a smoker, and I am harming myself, but I am no longer able because of enlightened laws to harm others by smoking in places that they do not want me to smoke.
In terms of harm being done to others, I am going to assume that you have probably come into contact with lots of people who have committed assault when they were drunk on liquor. After all, liquor sometimes causes people to be aggressive. I know that people who are addicted, whether it is physiologically or psychologically to the harder opiates, if I can characterize them that way, commit robberies and break into people's cars or steal their cars in order to feed their habit.
However, I am going to put to you that I suspect, and I am eliciting your response, that you have not run across anybody who committed assault because they were high on marijuana — because it usually has, if anything, the exact opposite result. The same thing is true of speeding. People who smoke marijuana generally drive too slowly, whatever else they might do. As a general rule, the cost of getting enough marijuana to satisfy even a constant user does not usually exceed one's means. An individual is not going to steal a car to buy some pot or break into a drug store to get enough money to buy some pot, generally. Have I got a correct understanding of the people with whom you deal every day?
Mr. Pike: Pretty well. I think it is a fair understanding. When it comes to violence, one of the main contributors to that type of aggressive behaviour is alcohol. I acknowledge that. As a matter of fact, some of the guys I deal with use the argument that they are only smoking dope, not drinking, and thus are not violent.
You are correct. Generally speaking, marijuana users do not commit a serious offence to support their habit. However, I think a portion of that population, through their contact to purchase drugs, may be influenced to purchase another type of drug. Hence, I am looking at marijuana as a gateway drug.
A marijuana user in purchasing marijuana might be offered a harder drug, for free, in the hopes that he or she may come back for more of that harder drug.
Senator Banks: The corollary argument might be, in the circumstance that you just mentioned, that if someone is able to go into his backyard and get marijuana he will be less likely to come in contact with a pusher; correct?
Mr. Pike: I do not know.
Senator Cochrane: Mr. Pike, would you tell us about the programs you are using to help people, as you say, who have become addicted to cannabis.
Mr. Pike: The programs that we offer at Her Majesty's Penitentiary are twofold. First, there is the psycho- educational program, where we bring in the individuals who voluntarily come looking for help with an addictions problem. During group sessions, we give them information and educate them around the negative effects of their drug of choice, which could range from alcohol to prescribed medication, or something else. We talk about the effect of the particular drug on the person physically, psychologically, legally, and on families. We speak about relapse. We help them to make informed decisions about what they want to do on release.
Our level-two program is more therapeutic. We spend time looking at some of the issues around what is influencing them, what is going on in their lives to influence them or why they look to abuse drugs to deal with those personal issues. We do some work around that. It is broader based than level one. We help the person develop a release plan, a relapse plan, regardless of what community they may be returning to. The guys in level two may have been back and forth to jail on a number of occasions for possession, property offences or other offences, and are now acknowledging that they have abused drugs over a number of years. They want help in dealing with their drug problem. For some of them, our program is the first they have ever been involved in. Some of them continue with some other level of intervention after their release. Although they may return to us for another jail term, sometimes the drug use has deteriorated, and for us this is a measure of success.
Senator Cochrane: Would you recommend, for example, that they continue to see, say, a psychologist? What is your recommendation after they leave you?
Mr. Pike: For a lot of these guys — and I am talking about 19 and 20 year olds also — it is a lifestyle issue. Some of them have admitted to marijuana use as early as 9 and 10 years old. Hence, they have a long-term lifestyle of drug abuse. They have a large void to fill in terms of changing their lifestyle. As to reintegration, often we use the Harbour Light Program as a stepping stone, to give them some structure in their release but also to continue with the intervention. There are other agencies, fee for services, or whatever, within the community that we can make referrals to.
Senator Cochrane: What age group do you deal with mostly?
Mr. Pike: Eighteen and older.
Senator Cochrane: How older?
Mr. Pike: Seventy and eighty.
Senator Cochrane: Those are the ones you say have become addicted; correct?
Mr. Pike: For some reason — maybe for legal reasons they have decided to give up drugs — as they get older the prevalence is more with alcohol abuse than drug abuse.
Senator Cochrane: At what age do you see this drug abuse waning?
Mr. Pike: I would say around 30. Without any data to support this, I would say that between 25 and 30 there is a decline in drug use.
Senator Cochrane: Let me go to something else. You disagree with decriminalizing marijuana. What about using marijuana to eliminate pain? I have just heard about a women who uses it for the sole purpose of eliminating the pain related to Crohn's disease. What is your position on marijuana use for medical purposes?
Mr. Pike: I am not familiar with Crohn's disease. However, the medical use of marijuana is a concern for many. If a person has a terminal illness, there is not much we can do for him or her. Take multiple sclerosis and AIDS, for example. My brother died of MS. In his remaining days, weeks or months, if marijuana could have helped him, I would probably have said, yes, give it to him.
However, do we have to provide it for everyone? That is the dilemma I would face in respect to the medical use of marijuana to alleviate pain in terminally ill people. With respect to Crohn's and colitis, there are other forms of treatment. Marijuana may assist at some point, and I am not going to dispute that. However, should be looking at other means of alleviating some of the distress of that illness without using marijuana? I do not know the answer to that.
Senator Cochrane: Although the person I was told about is taking prescribed medicine, the medicine is not as effective as marijuana, is what I was told last night.
The Chairman: Who prepares the material you use in the course of your profession? Who is gathering all the information that you are using?
Mr. Pike: There are contractors who work in the area of addiction in the community who come in and develop some of the programs based on their knowledge and their expertise in the area of addictions. We also use literature that we receive from different publishers that centre on substance abuse, as well as other agencies. That is how we put together our programs.
The Chairman: It has been suggested that inmates who use drugs may switch from marijuana to cocaine, or even heroine, because detection of marijuana in their blood system is much easier long term than cocaine and heroine. They would switch their drug of choice, if available, and they have the resource to pay for it. Do you agree with that?
Mr. Pike: Yes, I would agree with that. We do not have any instance of that at our institution, keeping in mind that we are a provincial institution with a maximum of probably 170 inmates, mostly provincial inmates. However, I would think that in the federal institutions, where there is an ongoing drug problem, that would be the case. Traces of marijuana can found in urine up to 30 days after use. With cocaine, I think it is three to five days or less.
The Chairman: What is the consequence at your institution for an inmate if you detect drugs in his or her system?
Mr. Pike: The consequences would be time served in segregation, loss of remuneration, confinement to the range, and depending on how the person may have received the drugs, there may be some loss of privileges, visits and phone calls and things like this. We take it very seriously.
The Chairman: Are the consequences different for marijuana over heroine?
Mr. Pike: We have not come to that. We have only started in the last six to eight months to do drug testing. We are still learning. We have never tested for a harder drug, cocaine or heroine. I would be surprised if there were a need to do that, given our population. I would suggest that the consequences, to be fair and consistent, would be the same. Of course, that is my own observation, not the opinion of the department.
Senator Cochrane: Am I then reading you to say that there are less hard drugs, like, cocaine, here in the province?
Mr. Pike: I said less of that within the institution. I cannot speak about the community, of course, because I am not privy to that type of information or that knowledge.
Senator Cochrane: You are saying that there is less of that in your institution, that there is more marijuana than anything else; correct?
Mr. Pike: Yes.
Senator Banks: You mentioned that a lot of the people with whom you come in contact have switched as they get older from marijuana and other things to alcohol, for whatever reason. Did I understand that correctly?
Mr. Pike: The drug of choice at one time may have been drug use, but for whatever reason once they stopped using drugs continued with alcohol use. In some cases, of course, it was just a matter of substituting one drug for the other. Alcohol is a legal drug. An individual can sit on his or her front steps and drink a few beers, without consequence. That is not the case with drugs.
Senator Banks: You said the guys you come into contact with are all males; correct?
Mr. Pike: Yes.
Senator Banks: Just off the top of your head, do you that their bad behaviour, if that is the way to put it, has been caused by drugs? I am not a tree hugger, nor a bleeding heart liberal; nor am I am looking for anybody else to blame except the individuals for their behaviour. However, do you think those individuals with whom you come into contact are having a tough time in society because of drugs or because of the social situations they came from, whatever they are? They might have a lot of money, but they might have a bad moral upbringing, if there is such a thing.
Mr. Pike: It would be all of the above. I always refer to the guys as good people. It is just that they have some poor decision-making skills. Those poor decision-making skills may have been influenced by their upbringing. A number of them come from dysfunctional family backgrounds, where there is drug and alcohol abuse openly within the family. Some come into contact with alcohol and marijuana early and continue to enjoy the effect. There are numerous reasons why a person may decide to use drugs and/alcohol.
The Chairman: Thank you, Mr. Pike, for attending here today.
We will now hear Ms Diane Power-Jeans, from the Janeway Community Mental Health Division.
Ms Diane Power-Jeans, Social Worker, Janeway Community Mental Health Division, Health Care Corporation, St. John's: I am here representing the adolescent team. Our team of professionals works with the 12- to 21-year-old age group. The adolescent team offers a coordinated and comprehensive service to adolescents and their families. The team uses a combination of individual, family, and group interventions to address any emotional, social, and/or behavioural difficulties teens may be experiencing.
While the team usually has a waiting list of up to eight months, teens with problems related to drugs and alcohol are serviced through an addictions protocol established five years ago. This protocol is as follows: ``Any teen with issues related to substance abuse will be seen within two weeks of the initial referral date for assessment and/or treatment.'' This protocol was instituted to address any substance abuse issues before the problem further progressed through the stages of adolescent addiction. Upon examination of the data collected through the addictions protocol, several trends are noted.
Over the last five years, males have consistently outnumbered the females who are referred through the addictions protocol. The average age for both sexes at the time of referral is 15.5 years, with males being slightly older. While adolescents are notorious for being poly-drug users, meaning they will use whatever is available to them, they are able to identify a drug of choice most times. Alcohol and marijuana run a close first and second, while abuse of prescription drugs, Ritalin and Valium place third and fourth.
Reasons for use are many, but they include boredom, peer pressure, curiosity, self-medication of psychological problems, as well as escape from emotional and family problems. While many teens misuse alcohol and drugs on occasion, the adolescents we meet through our program have often progressed to the third and fourth stages of adolescent drug use, dependence and addiction, respectively. This means that the teens we assess have lost most of the choice and control over their drug use; the drugs now control them. Using drugs and alcohol leads to many problems for the teens. Educational, legal, monetary, as well as family and physical problems are most often cited as a consequence of their use.
Indeed, I see the criminalization of our youth as one of the most devastating effects of our present system. To support their habit, youth may turn to crime. It is our philosophy that teens should be held accountable for their actions, be that criminal charges and court appearances or not. However, it is the continued criminalization of the addicted youth that we see as a disservice to our adolescents. We need to offer these youth services that can address the addiction as well as the underlying cause or causes for the drug use. Without resources to aid in the rehabilitation of teens, with the emphasis on developmental lags caused by their drug addictions, I feel these youth will be lost.
With the costs of open and closed custody arrangements under the Young Offenders Act, the cost that school dropouts place on our school system, the medical costs of addressing the health problems created by drug addiction and the cost of family breakdown on our society, it is evident that our monies will be better spent on treatment.
As to the question of whether marijuana should be decriminalized, the impact this would have on adolescent youth is unclear. The fact that it is illegal for teens to drink alcohol does not seem to provide a strong deterrent to the adolescents we meet. It may or may not have a significant impact on the amount of marijuana teens use, but it may help teens access more services geared towards helping or kicking their addiction, as opposed to punishing them.
I thank you for the time to speak on behalf of the teens in this region, and welcome any questions for comments.
Senator Banks: Tell me what you think about the concept that every individual, including young people, sooner or later, but in the case of young people growing up, have to be entirely personally responsible for themselves, that they cannot shovel that responsibility, for whatever it is that they are doing, off on somebody else, and that society cannot do that either.
Comment on that, please, in respect to people that you come into contact with.
Ms Power-Jeans: While I am here representing the adolescent team, the Community Mental Health Program works with any child, birth to 21. In our parenting groups, and in therapies with families and individuals, we very much want children and teenagers to be held accountable, as far as they can be, for their actions. Hence, if a child has a temper tantrum, he or she should be timed out.
Let me explain what I am trying to say in my presentation. A lot of the teens I meet may have criminal charges; in fact, some may be on probation. A lot of times, in fact, we get to know these teens because the court has ordered them into treatment. Many of them, when they appeared before the court, said that part of the reason they shoplifted or assaulted was drug use. Hence, they are ordered into addictions treatment. I see it as a good thing that they are held accountable for their addiction. However, what I do see more and more of, and which I think is not helpful, and, in fact, is very hurtful, is the breach of probation due to alcohol or drug use. These children, whose crimes may have been relatively minor like shoplifting, are now incarcerated because they smoked a joint.
In this regard, teens are often very easily institutionalized, especially if they come from a family where it is not so nice to live. A teen that ends up in a closed custody facility, where everything is laid out, where there is a nice warm bed, three meals a day, recreational programs and where school is easy to get to, often ends up in a revolving-door situation. Teens express to us that they, in fact, try to get caught so they can be put back in a closed custody facility. The saddest thing I can hear as a therapist from a teen is this: ``I am better off locked up.'' That says a lot about our society.
We better serve these adolescents by asking them what it is they get out of drug use, what it does for them and how can we do it better for them.
Once a week we run a group for adolescents with addictions. People do not talk about the benefits of drug use, and for adolescents there are many. How can you get those benefits in a different way? How can you learn to cope better? How can you get that adrenalin rush from doing something that you are not supposed to be doing?
We do things like take them rock climbing and kayaking. We try to show them that they can get a rush in a socially acceptable way, one that is not as harmful as alcohol or drug use. Again, though, they should still be held accountable.
Senator Banks: We are concentrating on marijuana, although that keeps bumping into other things, of course, as you know better than I. You said a moment ago that a teenager will often use drug use to explain a particular behaviour.
Just anecdotally, do you think that they ever say that they have shoplifted or assaulted somebody because of marijuana?
Ms Power-Jeans: I did not mean that a teen would use marijuana use as an excuse to a judge for some behaviour. What I meant is that it often comes out in court that a teen also use drugs and therefore the judge assumes that because the teen smokes a joint he or she needs addictions treatment, which often is not true. Do they assault because of marijuana use? Rarely. If anything, marijuana probably lowers the incidents of violence, because it is very amotivational. More often, it takes energy away from things like that.
Adolescents are very good at articulating how marijuana mellows them out, how they may be really hyper and how smoking a joint calms them down. Therefore, they articulate that, in fact, it deters them from further crimes.
Senator Banks: Is the potential of a criminal record hanging over somebody's head a good practical deterrent to keep them from doing something? Do you think that works?
Ms Power-Jeans: No, not when it comes to marijuana use.
Senator Banks: Why?
Ms Power-Jeans: While an individual may be hauled into court, he or she negates that that is serious, even if the individual reappears, reappears and reappears before the same judge. Often, that belief is reinforced by the court system, because the individual just gets continued probation, until the judge decides to lock up the individual. Often, that is exactly what adolescents are looking for, to be locked up.
The other big problem we have here in Newfoundland is that there are no inpatient addiction treatment facilities for adolescents. I send adolescents either to a long-term treatment program in New Brunswick or to a short-term treatment program in Nova Scotia. A lot of our adolescents know that the only way to stay off drugs is to get locked up, so they do it purposely to get away from the drugs.
Senator Cochrane: What percentage of the adolescents that you are treating want that?
Ms Power-Jeans: Want to get treatment, be that in another province or at Whitbourne; is that what you are asking?
Senator Cochrane: Yes.
Ms Power-Jeans: Twenty-five per cent, I would say. The population that I am talking about under this protocol are the addicted and dependent adolescents. There are, however, obviously, many adolescents on our caseloads who flirt with alcohol and drugs, who misuse it, but who, in fact, are not dependent or addicted. My population are the ones who are dependent or addicted. Often, it is a final cry for help.
Senator Cochrane: How many people do you deal with?
Ms Power-Jeans: Last year, we had 35. The average is about three a month.
Senator Cochrane: Is that just for the Avalon Region?
Ms Power-Jeans: That is for the St. John's region alone.
Senator Cochrane: And Mount Pearl?
Ms Power-Jeans: That takes in Mount Pearl, Kilbride, and The Goulds.
Senator Cochrane: That population is about 200,000; correct?
Ms Power-Jeans: I am not sure.
Senator Cochrane: How long do these kids stay with you? How long are they within your supervision?
Ms Power-Jeans: One of the things that we have to recognize with adolescents is that, as opposed to rehabilitating adults, we have to habilitate adolescents. When they start using drugs, they miss out on skills they were supposed to learn at 13, 14, 15 and 16. As soon as they start using drugs, their development stops. How long they are with us depends on when they first used, how long they have been using and when we meet them. We teach coping skills, communication skills, conflict resolution, all the skills a young person does not realize he or she is learning in growing up.
Another variable is the family of origin. If there is a lot of stuff going on in the adolescent's family, it takes longer. It takes family work, as well as group and individual work. Obviously, very seldom do we see the drug use as the only problem. There are most often underlying problems.
Generally speaking, though, I would say that adolescents stay in treatment upwards of a year. I have clients who I have been seeing for four or five years. I have clients who came into the addictions protocol in the first year, five years ago, that I am still seeing. Abstinence is not a requirement. Because we are trying to help them, empower them, we do not kick them out if they relapse or if they continue to use, but we try to do risk reduction.
Senator Cochrane: Your cut-off age is 21, is it not?
Ms Power-Jeans: Twenty-one at initial intake. However, I would not kick out someone I had been seeing since 18 who turns 21. I have a 24 year old who still comes to group, but, developmentally, she is very much a 19 year old.
Senator Cochrane: How do you decide when someone is ready to leave?
Ms Power-Jeans: It is usually a joint decision — pardon the pun.
Senator Cochrane: What happens after 21? Let us use the example of an adolescent who came into you at 19 who at 21 has made a lot of advancement and so is let go.
Ms Power-Jeans: He is not let go. At about age 20, we begin to provide services with continuation of care. A client would continue to come to our group, yet launch into a more adult-focused group. The individual would attend both groups for about six months. Once the individual is comfortable, he or she basically graduates into the adult program. We also depend a lot on self-help groups like Narcotics Anonymous.
Senator Cochrane: What you are telling me then is that there is some follow-up; correct?
Ms Power-Jeans: Definitely.
Senator Banks: Comparing the two things, drug use on the one hand and the inability to cope and function properly in society on the other, is drug use a cause or an effect?
Ms Power-Jeans: It is different for different adolescents, but some are self-medicating. In other words, they have enough problems in their life that the drug use is a solution, and then of course that creates problems. However, the percentage of those who use drugs as a solution is lower. Most often, in that category, educational problems surface, in that drug use interferes with their ability to learn and retain what they have learned. Most often, for the clients I meet, it is very easily understood why they would use.
We talk about a tool bag. For the clients I see, when we open their tool bag, their coping and communication skills, it is empty when they come to us, most often, except for the drug. The drug is the only thing they have in their tool bag. It is the only thing they have been taught, the only thing they have seen in their home and the only thing they have seen in the schoolyard. Once they start to learn, and they really do want to learn different ways, the drug use decreases. The need for it is not as prevalent.
There are those who continue to flirt with it throughout their lifetime, but they have reduced the risk to the point that it is no longer a dependency. We explain dependency to adolescents in this way. We ask them: Do you do anything that brings you joy any more where the marijuana use is not involved? Is there any joy in your life at all, or do you use the marijuana to stop the pain? And we usually mean emotional pain, because most often there is not a physical withdrawal from marijuana. Generally, there is a psychological dependence, which they interpret as: ``I need it, I need it, I need it. Nothing brings me joy any more without it.''
The committee adjourned.