CANNABIS :
OUR POSITION FOR A CANADIAN PUBLIC POLICY
REPORT OF THE SENATE SPECIAL COMMITTEE ON ILLEGAL DRUGS
VOLUME I : PARTS I and II
Chapter
6
Users
and uses: form,
practice, context
Who
uses cannabis? How do the patterns of use in Canada compare to those in other
countries? In what context is cannabis used? Why? What populations are most
vulnerable? What are the social consequences of cannabis, specifically on
delinquency and criminal behaviour? Most important, what trajectories do
cannabis users follow, specifically with respect to consumption of other drugs?
Partial
answers to these questions, at the very least, are prerequisite to establishing
policy on a substance. If the aim is to deter, one needs to know what is to be
deterred and within what target group. If the aim is to help people for whom
consumption poses a problem, one must have at least an idea of the composition
and size of the group in question. And if one is looking for indications that a
public policy reduces all use or at-risk use, then knowing the evolution of
patterns of use within a population is a requisite.
In
Canada, knowledge of patterns and contexts of cannabis use verges on the
abysmal. In the early 1980s, the USA, the United Kingdom, and Australia
introduced monitoring systems for the general population and the student
population and use them as the basis of annual (USA) or biannual (United Kingdom
and Australia) reports on trends. In the last five years, a number of European
countries have introduced data collection systems as part of the European
Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Canada, by contrast,
has carried out only two epidemiological general population surveys specific to
drugs (1989 and 1994), and only some provinces conduct surveys of the student
population, using different methods and instruments that preclude data
comparison. Furthermore, everything suggests that few sociological or
anthropological studies are conducted on the circumstances or context of illegal
drug use (specifically for cannabis). At any rate, very little has been brought
to our attention. The result is that our pool of knowledge on users and
characteristics of use is lacking.
We have
no explanation for this situation, at least no satisfactory explanation. In the
1970s, following up on the work done by the Le Dain Commission, Canada
could have set up a trend monitoring system. In the 1980s, when Canada’s
Anti-Drug Strategy–to which the federal government allocated $210M over five
years–was adopted, a data collection system could have been created. The fact
that it wasn’t could be due to an absence of leadership or vision; a fear of
knowing; the division of powers among levels of government; or the absence of a
socio-legal research tradition within the departments responsible for justice
and health. In fact, all of the above are probable factors. Whatever the case,
it is our contention that the situation, unacceptable by definition, requires
timely remedial action. We must resign ourselves to working with the scarce
available data, and more significantly the virtually non-existent comparable
data. We will also look at studies and data from other countries.
The
chapter is divided into four sections. The first covers consumption patterns in
the population as a whole and specifically in the 12-18 year age group and
compares the patterns in various countries. The second section looks at what we
know about reasons for and details on use, including origins and cultural
differences. The third section deals specifically with cannabis user
trajectories, including escalation. The fourth and last section covers the
relationship between cannabis use and delinquency and crime.
Patterns
of use
Epidemiological
surveys are the main method of measuring consumption patterns. These surveys
cover the general population (usually 15 years of age and over) and specific
populations, usually students. Most epidemiological surveys of the general
population are done by telephone and based on a validated questionnaire.
Personal interviews are involved in some cases. Some surveys of students are
based on a questionnaire distributed in class.
Due to
the low consumption of illegal drugs by the population as a whole, samples must
necessarily be large (in Canada over 12,000 respondents). Whatever the sample
size, these surveys inevitably underestimate consumption. Respondents tend to
under-report, either because individuals simply refuse to respond because of the
legal implications, or because some at-risk persons are not included in a
telephone survey. Then there is the matter of memory: the more time elapsed
between consumption and the survey, the less reliable one’s memory of
occasions, circumstances, and quantities.
Furthermore,
some reports, including the report by the French National Institute for Health
and Medical Research (INSERM) and the Canadian
Profile of the Canadian Centre on Substance Abuse (CCSA), use data on police
and customs seizure as indirect indicators of use. We have opted to discuss data
on seizures and other police and customs activities in Chapter 14. In our
opinion, these data, rather than accurately reflecting use, are indicators of
police drug-related activities and to some extent, market conditions.
Not all
surveys measure phenomena in the same way, although, in the past two years,
significant strides have been made toward improving data comparability.
Generally speaking, lifetime prevalence (minimum one time consumption) is
measured. This episodic or experimental consumption is distinguished from
consumption within the previous year. Frequent consumption (e.g., within the
past month) is less frequently measured. Heavy users are even more rarely
studied. Furthermore, regular consumption tends to be measured in terms of
dependency criteria - described in detail in the following chapter - rather than
quantity-related indicators. As described in greater detail later in this
chapter, this makes it difficult to distinguish among categories of users,
specifically at-risk users and heavy users. Such information is essential to
identifying target groups for preventive measures.
Consumption
by the population as a whole
In
Canada, five national surveys are the sources of data on consumption of
psychoactive substances, alcohol, tobacco, and illegal drugs. The Health
Promotion Survey (HPS) was conducted in 1985 and 1990; the Alcohol and Other
Drugs Survey (AODS) in 1989 and 1994. The 1993 General Social Survey (GSS), a
survey conducted on a regular basis, includes drug-related data. These are the
data referred to in the following paragraphs.
In the
1994 survey, 23% of respondents reported consuming cannabis at least once in
their lifetime. As shown in the bar graph below, men are more likely than women
to have consumed cannabis, as are persons under 35 years of age.
Consumption
varies by province. According to the AODS, consumption is highest in British
Columbia (35.4%), followed by Alberta (29.4%), Manitoba (25.2%), Nova Scotia
(25.1%) and Quebec (24.7%); and lowest in Newfoundland (16.3%), Ontario (16.6%)
and Prince Edward Island (18.6%).
Lifetime
prevalence was unchanged from the 1989 study. At the time of the Le Dain
Commission, in 1970, the figure stood at 3.4%; by 1978 it was up to 17%, showing
a steady increase in cannabis consumption.
Prevalence
over the previous twelve months is a more sensitive indicator of current
consumption as reporting is less dependant on long-term memory. The following
table shows the evolution of this indicator beginning with the 1985 study.
Cannabis consumption in the last 12 months, 15 years and
over[1]
|
Year |
Survey |
Sex
Men
Women
Total |
|
1985 1989 1990 1993 1994 |
Health
Promotion Survey National Alcohol and Other Drugs Survey Health Promotion
Survey General Social
Survey National Alcohol and Other Drugs Survey |
6.9%
4.3%
5.6% 8.9%
4.1%
6.5% 7.0%
3.0%
5.0% 5.9%
2.5%
4.2% 10.1%
5.1%
7.4% |
By
comparison, the percentage of users in the last year was 1% in 1970 and 9.7% in
1979.
The rate
of use reported in these surveys is twice as high for men as for women. It is
important to note the variations among studies. Because the AODS deals
specifically with psychoactive substances, rather than being part of a broader
survey of health or living conditions, it would appear to be more reliable.
We have
no detailed data on incidence (i.e., new consumers) or rate of discontinuation.
As will be seen further on, rising prevalence among young people would indicate
increased incidence. With respect to discontinuation, it is generally believed
that the vast majority of users do not continue using, although we are lacking
specific information in Canada on this issue.
We are
aware that there are limitations to comparing the various psychoactive
substances. As properly pointed out by Dr. Zoccolillo in his testimony, each has
its own characteristics and effects.
There
is little point in comparing the levels of harm from cocaine, marijuana and
alcohol. Each drug has specific kinds of harm. If you were to compare the
effects of tobacco and cocaine in young people, you would conclude that cocaine
is terrible but tobacco is not worth worrying about, because the harm from
tobacco takes 30 years to appear. The point is that there are different patterns
of harm and making comparisons among them is not a useful exercise. [2]
Nonetheless, to place the phenomenon in context, we believe it is valid
to compare Canada’s consumption of cannabis in the general population to
consumption of other substances. The 1994 Alcohol and Other Drugs Survey shows
that, of total illegal drug consumption, cocaine accounts for less than 1%, and
heroin, LSD, and amphetamines together for approximately 1%. In the case of
legal drugs, alcohol consumption is about 75%, tobacco approximately 30%. The
accompanying graph compares consumption of cannabis and alcohol among those over
15 years of age.
General
population studies have been conducted in Ontario since 1977, giving the
province the most extensive database in Canada. Of even greater interest, is the
fact that Ontario (again since 1977) has conducted studies in schools. This
practice provides for a better tracking of trends.
According
to the 2000 report of the Centre for Addiction and Mental Health (CAMH)[3],
more than one third (35%) of Ontarians over 18 years of age have consumed
cannabis at least once in their lifetime and 10.8% within the last 12 months.
The figure for users within the past year has changed little since 1984 (11.2%),
although it is up slightly from the 1977 figure (8%). The 18-29 age group shows
the steadiest increase, from 18.3% in 1996 to 28.2% in 2000; the 1984 figure for
the cohort is 28.5%. In the long term, we also see an increase in consumption
within the last 12 months in the 30-49 age group (from 6.5% in 1977 to 18.7% in
2000). The following table sets out selected data from the report.
Proportion
of Ontarians 18 years old and over
using cannabis users in the previous 12 months
|
(N =) |
1977 (1059) |
1982 (1026) |
1984 (1043) |
1987 (1075) |
1989 (1098) |
1991 (1047) |
1992 (1058) |
1994 (2022) |
1996 (2721) |
1997 (2776) |
1998 (2509) |
1999 (2346) |
2000 (2406) |
|
Total M W 18-29 30-39 40-49 50-64 65+ |
8.1 11.2 4.5 22.6 3.9 2.3 1.2 |
8.2 12.3 4.1 22.7 4.2 1.3 |
11.2 15.6 7.1 28.5 9.5 2.2 1.8 |
9.5 12.3 6.8 20 11.6 5.4 |
10.5 13.0 8.2 24.6 11.8 3.9 1.4 |
8.7 11.5 6.0 19.9 9.1 3.0 |
6.2 9.1 3.6 13.3 6.6 2.4 1.3 |
9.0 11.4 7.0 19.6 10.2 4.3 |
8.7 12.6 5.3 18.3 11.3 6.1 |
9.1 11.4 7.0 21.4 9.8 4.3 1.7 |
8.6 12.1 5.4 25.2 8.2 4. 1.4 |
10.4 13.2 7.8 27.1 10.3 6.8 4.1 |
10.8 14.3 7.7 28.2 12.3 6.4 2.9 |
Of those
who consumed cannabis at least once in their lifetime, 68% did not consume
within the last 12 months, 15% consumed less than once a month, and 17% more
than once a month. Of users within the last year, 47% consumed less than once a
month and 53% at least once a month.
In
Quebec, general population studies were done in 1987, 1992, and 1998. L’enquête
sociale et de santé (ESS)[4]
reports that 31.3% of people 15 and over used cannabis or another illegal drug
at least once in their lifetime, and 13.5% had consumed cannabis at least once
in the past few months. As elsewhere, consumption is a function of age: in the
15-24 age group, consumption of illegal drugs is 39.7%; it is 18.4% in the 25-44
age group, 8% in the 45-64 age group, and 5.5% in the 65 plus age group.
Although 83.7% of the 45-64 age group and 93.8% of the 65 plus age group report
never having used a prohibited drug, over 40% of the 25-44 age group and half
(50.3%) of the 15-24 age group report current or past consumption.
Consumption
among young people
A number
of witnesses have reported “worrying” increases in cannabis consumption
among young people (under 18).
Given
the existing research on the escalating rates of cannabis use in the general
population of young people, our street youth and our youth at risk, coupled with
knowledge about the harms associated with drug use, we know that our problem is
growing. [5]
Special
consideration needs to be given to minors when developing drug policy. A policy
created only with adults in mind may have strong, unintended negative
consequences for adolescents. We have a parental obligation to adolescents. They
are not adults. [6]
The
Ontario students survey is equally disconcerting. A dramatic upswing is noted in
the use of all drugs since 1993.(…) The use of cannabis has more than doubled
to 29 per cent.(…) Unfortunately, the only statistic that has decreased is the
one that records the students who do not use drugs. That figure has decreased
from 36 per cent to 27 per cent. From almost one-third of the students not using
drugs, we now have almost a one-quarter of the students not using drugs. We are
clearly in a time where young people are turning to drugs as an answer to life's
problems. [7]
It is a
fact that consumption of psychoactive substances by young students has increased
significantly in the past several years. Nationally, the survey conducted among
Grade 6, 8, and 10 students (approximately 2,000 young people in each grade) in
1990, 1994, and 1998[8],
reports the following with regard to marijuana use:
Proportion
of Grade 8 and 10 students who have consumed cannabis at least once
|
|
1990
1994
1998 |
|
Grade 8
girls
boys Grade 10
girls
boys |
10%
11%
18%
11%
13%
21%
24%
27%
41%
26%
30%
44% |
Surveys
on consumption of psychoactive substances, including cannabis, among young
people have been conducted in some provinces. These give a clearer and more
detailed picture of the evolution of cannabis consumption among young people in
those provinces, although the results cannot be compared from province to
province.
Atlantic
In the
Atlantic provinces (Newfoundland and Labrador, Prince Edward Island, Nova
Scotia, and New Brunswick) identical comprehensive surveys on cannabis
consumption by high school students were first conducted in 1996.[9]
The process was repeated in 1998. The 1996 survey covered 14,908 students and
the 1998 survey, 13,539 in grades 7, 9, 10, and 12.[10]
The following graph illustrates the data from the two surveys and the 1992
reference year for New Brunswick.
Cannabis
consumption among students in the Atlantic provinces rose from 28% in 1996 to
almost 33% in 1998. The provincial trends follow.
v
In Nova Scotia,
between 1991 and 1998:
·
The percentage
of students using illegal drugs nearly doubled;
·
The percentage
of students reporting consumption of cannabis within the last year was close to
38% in 1998, compared to 32% in 1996;
·
Distribution by
school grade: 11.4% in Grade 7, 41% in Grade 9, 47.6% in Grade 10 and 51.7%
in grade 12;
·
The percentage
of students using cannabis more than once a month tripled, from 4.4% to 13.5%;
more men (17.5%) than women (9.3%) consumed cannabis once a month.
v
In New
Brunswick:
·
The proportion
of students reporting cannabis consumption climbed from 17.4% in 1992 to 29% in
1996 and 31% in 1998;
·
Among cannabis
users, 5.5% experimented during the year and 11% were frequent users (more than
once a month);
·
As in the other
provinces, more men (33.4%) than women (28.3%) consumed cannabis.
By
comparison, in 1996 56% of students in the Atlantic provinces reported consuming
alcohol at least once during the last year; the corresponding figure for 1998 is
59%.
Manitoba
In
Manitoba, a 2001 non-random survey of schools in the province was conducted
among 4,680 students in 32 schools.[11]
Although the sample is not completely representative of all students in
Manitoba, it is sufficiently large to give a satisfactory representation of the
situation in the province.
Virtually
all students reporting consumption of illegal drugs in the course of the
preceding year used marijuana (96%). 47.7% of students consumed it at least once
in their lifetime, 39.7% in the course of the preceding year (compared to 37.4%
in 1995 and 38.8% in 1997). The mean age of initial use is 14.1 years. More boys
(40.4%) than girls (35.4%) consumed cannabis in the course of the preceding
year. Of the users, 8.5% consumed it approximately once a month and 15.8% more
than once a month (20.5% of boys and 11.2% of girls).
By
comparison, 87.4% of students consumed alcohol at least once in their lifetime,
and 80.4% at least once in the course of the preceding year. The mean age of
first consumption is 13.3 years. Of those who consumed alcohol in the course of
the preceding year, 26% reported consumption once or more weekly, 46.5% at least
once a month. Weekly consumption rises with school grade, from 17% in the 1st
year of high school to 33% in the 4th. Finally, 27.7% of students
consumed cannabis, alcohol, and tobacco in the course of the preceding year.
Ontario
In
Ontario, in the 2001 Ontario Student Drug Use Survey (OSDUS)[12]
an average of 33.6% of young people in Grade 7 to Grade 13 report using cannabis
at least once, and 29.8% in the past several months (the corresponding figures
for tobacco are 33.8% and 23.6%; for alcohol 70.6% and 65.6%). Rate of use is
significantly higher for boys than girls. Examination of changes in trends shows
that, following a dip in the early 1990s, the results in the two most recent
surveys are similar to those in the late ‘70s and early ‘80s.
Proportion
of Ontarians in grades 7 to 13 using cannabis in the previous 12 months,
Grades 7 to 13
|
(N =) |
1977 (4687) |
1979 (4794) |
1981 (3270) |
1983 (4737) |
1985 (4154) |
1987 (4267) |
1989 (3915) |
1991 (3945) |
1993 (3571) |
1995 (3870) |
1997 (3990) |
1999 (2868) |
2001 (2326) |
|
Total M. W. 7th 8th 9th 10th 11th 12th 13th |
25.1 29.4 21.1 5.6 - 23.2 - 39.4 - 42.4 |
31.7 36.4 26. 10.4 29.2 50.2 43.6 |
29.9 33.2 26.3 5.7 27.1 44.2 37.4 |
23.7 28.0 19.4 5.2 25.1 42.1 36.5 |
21.2 24.4 17.9 4.7 18.3 35.1 30.8 |
15.9 18.7 13.2 3.8 12.1 24.3 30.5 |
14.1 14.7 13.5 0.9 12.9 22.5 28 |
11.7 13.2 9.9 0.7 8.1 20.2 20.5 |
12.7 14.8 10.7 1.7 8.7 22.3 21.6 |
22.7 25.7 19.8 2.8 19.6 40.7 27.5
|
24.9 25.7 24.1 3.4 23.9 42.0 31.9 |
29.2 32.5 25.8 3.6 25.5 48.1 43.3 |
28.6 32.1 25.1 5.1 28.8 45.7 43.9 |
Comparison
of cannabis use trends to trends for other substances shows that:
·
In the past 12
months, tobacco consumption fell from 30.4% to 22.3% of students;
·
In the past 12
months, alcohol consumption fell from 76.3% to 62.6% of students;
·
Heroin [heroine
being a female hero] consumption slipped from 2.0% to 1.2%;
·
Cocaine
consumption remained steady at 3.8%;
·
Amphetamine
consumption edged up from 2.7% to 3.1%; and
·
Ecstasy
consumption shot up from 0.6% in 1993 (first inclusion) to 6.0% in 2001.
The
Ontario survey examines frequency of consumption. Of those who used cannabis in
2001, 25% did so once or twice, 30% from 3 to 9 times, and 45% more than 10
times. Overall, 16.9% of students consumed cannabis at least 6 times in the
course of the past 12 months. The following table illustrates the evolution of
consumption frequency in the preceding 12 months (1981 base year).
Frequency
of consumption in the preceding 12 months among users in Ontario[13]
|
|
1981 (1002) |
1983 (1304) |
1985 (907) |
1987 (701) |
1989 (570) |
1991 (515) |
1993 (455) |
1995 (873) |
1997 (1019) |
1999 (778) |
2001 (636) |
|
Freq. 1-2 3-5 6-9 10-19 20-39 40 + |
28.2
12.4
14.0
13.0
10.7
21.7 |
32.4
15.1
12.5
11.4
9.0
19.5 |
33.7
18.3
11.3
11.3
8.3
17.1 |
39.8
16.2
9.0
14.1
6.2
14.8 |
42.6
17.2
10.5
11.8
8.3
17.1 |
37.1
17.7
12.2
9.8
8.9
14.3 |
41.1
17.5
10.1
9.0
8.8
13.6 |
31.7
17.1
10.4
12.5
9.0
19.4 |
29.5
16.3
12.4
12.3
9.8
19.7 |
28.8
14.7
13.9
11.9
9.5
21.2 |
25.6
17.1
11.4
14.9
10.2
20.9 |
On
a smaller time scale, the study looks at consumption over the past four weeks.
Overall, 8.4% of students consumed cannabis weekly, and 3.1%, daily. The
proportion of students who did not consume cannabis in the past month fell from
90.2% in 1987 to 66.6% in 2001.
The
following table illustrates the evolution of monthly consumption among users
over the preceding 12 months for the 1987-2001 time period. There is a marked
reduction in the percentage of students who had used no cannabis in the past
month (from 41% in 1987 to 30% in 2001) and, conversely, an increase in the
number of students who used it daily (from 3.5% in 1987 to 9.1% in 2001).
Frequency
of monthly usage among users in the preceding 12 months, OSDUS[14]
|
|
1987 (701) |
1989 (570) |
1991 (515) |
1993 (455) |
1995 (873) |
1997 (1019) |
1999 (778) |
2001 (636) |
|
Never Total
Men Women 1-2 times a month Total
Men Women 1-2 times a week
Total Men 3-4 times a week Total Men Women 5-6 times a week Total Men Women Daily Total Men Women |
41.1
38.1
45.3
36.6
36.7
36.4
9.7
9.8
9.5
4.9
4.6
5.5
4.1
5.3
2.5
3.5
5.6
0.8 |
46.0
44.8
47.2
38.3
33.8
42.9
9.6
10.6
8.5
2.6
4.8
0.4
1.0
1.9
2.6
4.1
1.1 |
44.1
38.6
51.8
34.5
33.4
36.0
7.9
8.7
6.7
5.8
8.5
2.0
2.4
3.2
1.2
2.6
4.1
1.1 |
37.2
29.7
47.5
36.9
35.8
38.1
9.9
12.7
6.1
5.9
7.4
3.8
5.1
7.5
2.0
5.0
6.9
2.4 |
30.9
28.4
33.8
35.7
33.8
37.9
14.4
15.5
13.2
9.2
9.4
9.0
3.6
4.4
2.5
6.3
8.6
3.6 |
33.0
28.9
36.9
34.2
30.4
37.9
13.7
14.6
12.8
7.6
10.2
5.1
3.9
4.5
3.4
7.6
11.4
3.9 |
30.5
28.5
33.0
34.8
31.1
39.4
12.5
12.9
12.0
8.5
10.2
6.3
4.4
5.9
2.6
9.3
11.3
6.6 |
30.6
23.2
39.8
33.2
32.9
33.6
11.3
12.
10.1
8.3
9.9
6.4
7.4
7.5
7.3
9.1
14.3
2.8 |
OSDUS
also provides information on quantity consumed. Among 2001 users over the past
12 months, 15% smoked less than one joint, 21% approximately one, 22% two or
three, and 15% more than four. The study also looks at the question of age at
the time of first consumption. Again in 2001, 10.2% of students used cannabis
for the first time, including 31.7% of cannabis users over the past 12 months.
The age of initial use does not vary with sex or region, but is significantly
linked to educational level: between Grade 8 and Grade 9 (14-15 years of age),
the proportion of those who have smoked cannabis shoots up from 6% to 14.9%.
Early initiation (Grade 7, approximately 12 years of age) to cannabis has fallen
over the years: in 2001, 2% of Grade 7 students said they had used cannabis at
least once in the preceding year (at about 11 years of age), a figure below
those for 1997 (5%) and 1991 (8%).
Quebec
In
Quebec, some observers report a “disturbing” increase in regular consumption
of cannabis by young people. According to Michel Germain, Director of the CPLT,
increased use is closely related to social values, specifically messages
relating to a relaxed attitude to drug use, as opposed to socio-demographic
factors such as family income or composition.
The data
available are not directly comparable to those collected in Ontario. They come
from three general population surveys conducted by Santé Québec in 1987, 1992, and 1998 and cover the 15-24 year age
group. Respondents numbered 3,136, 3,912, and 3,587 respectively, and were
divided into three age groups (15-17, 18-19, and 20-24).[15]
At first
glance, the study reveals a statistically significant drop between 1987 and 1998
in the number of young people who report no drug consumption (71.3% in 1987,
57.4% in 1992, and 50.3% in 1998). The figures for “current” consumers (last
12 months) are 39.7% for 1998 and 27% for 1992. By age group, the increase
in illegal drug consumption (significant in each case to p<
.001) is as follows:
·
15 – 17
years: 26.2% to 37.6%
·
18 – 19
years: 28.1% to 41.6%
·
20 – 24
years: 26.2% to 40.3%
Among
drug users, the percentage of those who use marijuana exclusively climbed from
15% in 1992 to almost 26% in 1998, whereas the proportion of those who use other
drugs remained steady at approximately 13%.
Use
patterns in other countries
Obviously,
use patterns are not immediately comparable from one country to another, not
only because of cultural differences but because the systems for collecting data
on use patterns do not all measure the same things in the same way, or even for
the same time period. In Europe, the European Monitoring Centre for Drugs and
Drug Addiction (EMCDDA) is gradually working toward uniformization of data
collection in the various countries of the Union with a view to improving
comparability. Nonetheless, significant differences among countries remain.
In spite
of these reservations, it is interesting to compare use patterns among the
various countries. We will begin by looking at the situation in the United
States, the United Kingdom, France, and the Netherlands, and then attempt to
compare some of the indicators selected.
United
States
In the
United States, two major surveys have been conducted for a number of years: a
general population survey conducted by the Department of Health and Social
Services, and the University of Michigan
Monitoring the Future study of cohorts of graduates conducted for the National
Institute on Drug Abuse (NIDA).
The
2000 general population survey[16]
shows that 6.3% of Americans 12 years and over used illegal drugs during
the past month, and 4.8% (4.7% in 1999) consumed cannabis. Overall, 14 million
Americans are considered current users
of illegal drugs, i.e., consumers in the past month. Among this group of users,
76% are consumers of marijuana and 59% of marijuana only.
The
estimated number of new users in 1999 was 2 million, compared to 2.6 million in
1996 and 1.4 million in 1990. Two thirds of the new consumers were between 12
and 17 years of age, the others in the 18-25 age group. Average age at the first
experiment with cannabis was 17 in 1999, compared to about 19-20 at the end
of the 1960s.
Frequency
of consumption among current users increased between 1999 and 2000: in 1999,
31.6% consumed cannabis 100 days or more during the preceding year, compared to
34.7% in 2000. Finally, the distribution by age group follows the expected
trends, as shown in the following chart.
The Monitoring the Future 2000[17]
survey gives use patterns beginning in 1986 for cohorts of young graduates
between 19 and 32 years of age. The following figure summarizes the data.
In 2000,
lifetime prevalence in the 31-32 age group was 73% for all illegal drugs, 68%
for marijuana.
United
Kingdom
In the
United Kingdom, the British Crime Survey[18]
has measured illegal drug use patterns every two years since the early 1980s.
Since establishment of the EMCDDA, Drugscope,[19]
the United Kingdom correspondent, annually reports use patterns and related
indicators.
The
percentage of respondents between the ages of 16 and 59 who consumed an illegal
drug during the last year in the United Kingdom rose from 9.9% in 1994 to 10.7%
in 2000. The figures for cannabis are 8.4% and 9.4% respectively. Lifetime
prevalence of cannabis use in the 16-29 age group climbed from 34% in 1994 to
44% in 2000. As a function of age, the use patterns over the last year are as
follows:
·
16-19 years of
age: from 29% in 1994 to 25% in 2000;
·
20-24 years of
age: from 23% in 1994 to 27% in 2000;
·
25-29 years of
age: from 12% in 1994 to 17% in 2000.
In all
instances, consumption by men is greater than consumption by women.
The
report notes that the most significant change is in consumption of cocaine by
young men in the 16-29 age group (up from 1.2% to 4.9%).
France
The work
of the Observatoire français des drogues
et de toxicomanies (OFDT) [French monitoring centre for drugs and drug
addiction] has greatly improved monitoring and understanding of trends in
France. The OFDT publishes a bi-annual report on use patterns and related
indicators (e.g., seizures, enquiries, applications for treatment) and a series
of studies and technical reports on specific issues. In its 2002 report, the
OFDT[20]
gives the following figures on cannabis consumption:
·
Lifetime
prevalence: 21.6% of adult population (18-75)
·
Occasional use (at
least once in the past year): 6.5%
·
Repeated use
(at least ten times within the past year): 3.6%
·
Regular use
(ten times per month and over): 1.4 %
More
than twice as many men as women experiment with marijuana; in the 18‑34 age
group, 40.5% of men have tried it. The proportion of experimenters drops with
age. Repeated consumption is reported by 14.6% in the 18-25 age group, compared
to 1.6% in the 26 and over age group. The OFDT reports that the percentage of
the adult population (18-34 age group) who have experimented with cannabis
continues to rise due to increased “trivialization” of cannabis. Among
adolescents, consumption has risen significantly. In 1993, 34% of boys and 17%
of girls reported having consumed cannabis by the age of 18, compared to 59% and
43% respectively in 1999. The OFDT report goes on to say that experimentation
with cannabis has become standard behaviour for young people in late
adolescence.
Interestingly
enough, the OFDT report allows for construction of a user typology and, without
too great a stretch, identification of the warning signs of possible at-risk
behaviour.
The
following table shows frequency of consumption among young people in late
adolescence.[21] In addition to the
differences according to sex found in other epidemiological surveys, this table
shows that fewer than one quarter of 17 year-old boys report occasional use,
compared to one third of 19 year-olds. At the same time, the figure for boys,
between the ages of 17 and 19, who abstain drops by 10 points.
Frequency of cannabis consumption by young people in
late adolescence in 2000, by age, sex and type of consumption
|
Type of
consumption |
Boys, 18 yrs |
Boys, 19 yrs |
|||
|
Experimental Occasional Repeated Regular Intensive |
Never Past consumption, but not in the last year Between 1 and 9 times a year More than 9 times a year, less than 10 times a month Between 10 and 19 times a month 20 times or more a month |
59.2 5.0 23.3 7.4 2.6 2. |
49.9 5.4 20.9 9.3 6.4 8.0 |
45.1 6.5 19.9 9.9 6.2 12.4 |
39.8 8.2 19.4 10.1 6.8 15.8 |
The
other interesting breakdown in the OFDT study–one that points to potential
problems (and could be useful for preventive purposes) even though the report
makes it clear that no equivalence was made between these profiles and
risk–concerns circumstances of use. A separate category is created for those
who smoke alone or in the morning or at noon. A near-perfect linear relationship
can be seen between type and circumstances of use, as shown in the table below.[22]
Frequency of cannabis use, in the morning or alone, by
young people in late adolescence, in 2000, by type of consumption
|
Type of use |
Morning or noon |
Alone |
|
Occasional Repeated Regular Heavy |
Never
Occasionally
Often 57.2
40.4 2.4 17.9
69.8
12.3
4.7
58.9
36.4
1.1
22.7
76.1 |
Never
Occasionally
Often
81.9
16.2
1.9
46.4
46.6
7.0
19.9
60.2
19.8
4.5
38.2
57.3 |
The
situation was explained by Jean-Michel Coste, Director of the Monitoring Centre
in his testimony to the Committee:
I
think it is extremely important to answer the concerns of authorities when, in
matters of prevention, those authorities are looking for something whose
objective is not only to prevent first use, but also to prevent going from
regular use to use that turns into a problem. From the investigation point of
view, it is important to define this idea of problematic use and grade the
users. It is possible to do this by trying to find occasional users, those who
use repeatedly or regularly and those who constitute a problem.
Right
now, we are trying to define three user criteria. We are trying to see if the
young person uses cannabis on an intensive or daily basis, if he often uses
alone or uses often in the morning. If we get a combining of those three
criteria, I think we can define something covering the notion of problematic use
of cannabis. [23]
The
Netherlands
The
Netherlands is a country of particular interest because of the unique approach
it adopted in 1976.[24]
An epidemiological survey of use patterns of the general population was
conducted in 1997; the results of a second (2001) survey are expected soon. For
individuals between the ages of 15 and 64, the data show a lifetime prevalence
of 19.1%, consumption in the preceding year of 5.5%, and consumption within the
past month of 2.5%. First-time users in the preceding year account for 1% of the
population, and average user age is 28. In the 15-34 age group, lifetime
prevalence is 31.8% and use within the last year, 14.2%.
Among
recent users (within the past month), frequency is distributed as follows:
·
Consumption on
1 to 4 days during the course of the month – 45%
·
Between 5 and 8
days – 14%
·
Between 9 and
20 days – 15%
·
Over 20 days
– 26%
In
addition, since 1984, the Netherlands has conducted surveys of students between
the ages of 10 and 18. The data produced show a significant increase in lifetime
use and current use (past month) as in the following charts (data for 12-18 age
group only). [25]
As in
the other studies, more boys than girls are consumers and prevalence increases
with age: in the 16-17 age group, lifetime prevalence for boys is 43%, for girls
31%, with current use figures 22% and 11% respectively.
Use
patterns in Europe, ages 15-64
EMCDDA
publications covering Europe and Norway reveal an interesting gradation in the
nature of illegal drug use. Although the table shown here covers all illegal
drugs, we know that cannabis is the drug of choice for at least 90% of users in
all countries. The table is relevant here because we will be attempting to
estimate proportions of users in Canada by cannabis use.
In other words, of the approximately 50 million people who have
experimented with an illegal drug at least once in their lifetime, approximately
17.5 million have used drugs in the preceding 12 months, 10 million, in the
past month, and 0.5% are considered at-risk users.
International
comparisons
In spite
of significant differences in survey methods (type of questionnaire and form of
entry), indicators, years and age range covered, the following tables provide
valuable indications of prevalence in a group of countries.
The
first table sets out information on year of survey, age of respondents, and
proportions reporting prevalence of cannabis consumption in their lifetime and
in the last year. For purposes of comparison, we have added the most recent
Ontario data on the general population.
Lifetime prevalence and consumption in the last year,
general population [26]
|
Year |
Form of entry |
Sample |
Age |
Lifetime
prevalence |
Last year |
|
|
Australia USA U.K. Denmark France Belgium Germany Ireland Spain Netherlands Switzerland Greece Sweden Germany (East) Finland Ontario |
1998 1999 2000 2000 2000 1999 1998-1999 2000 1998 1999 1997 1997 1998 2000 2000 1998 2000 |
Mixed Mixed Mixed Mixed In person Telephone Telephone Mail Mail In person In person Telephone In person In person Mail Mail Telephone |
10,000 66,706 71,764 13,021 14,228 11,526 3,311 6,332 10,415 12,488 22,000 13,004 3,752 2,000 1,430 2,568 2,406 |
14+ 12+ 12+ 16-60 16-65 15-65 18-50 18-60 15-65 15-65 15-65 15-60 15-65 15-65 18-60 15-70 18 + |
39% 35% 34% 27% 24% 23% 21% 21% 20% 20% 19% 19% 13% 13% 11% 10% 35% |
18% 9% 8% 9% 4% 8% ? 6% 9% 7% 6% 5% 4% 1% 5% 3% 10.8% |
Lifetime
consumption prevalence is 10% in Finland compared to 39% in Australia;
consumption in the preceding year in Sweden is only 1%, in Australia, it is 18%.
The Ontario figures of 35% and 11% respectively are among the highest cannabis
consumption figures reported.
The
second table is specifically about young people.
Prevalence of consumption by young people, 15-16 years
old, 1995 and 1999 [27]
|
Lifetime
prevalence |
Last month
|
> 6 times in the
last month |
||||
|
USA Russia France Ireland Netherlands Italy Denmark Norway Finland Greece Portugal Sweden |
1995 34% 41% - 37% 29% 19% 17% 6% 5% 2% 7% 6% |
1999 41% 35% 35% 32% 28% 25% 24% 12% 10% 9% 8% 8% |
1995 16% 24% - 19% 15% 13% 6% 3% 1% 1% 4% 1% |
1999 19% 16% 22% 15% 14% 14% 8% 4% 2% 4% 5% 2% |
1995 7% 9% - 7% 6% 5% 1% 1% 0% 0% 1% 0% |
1999 9% 6% 9% 5% 5% 4% 1% 1% 1% 2% 2% 0% |
We
lack readily-comparable data for Canada. Returning to the Ontario data, we see
that, in 1995, 40.7% of Grade 10 students had consumed cannabis at least once in
the preceding year; the figure for 2001 is 45%. Similarly, in 1995, 19% of all
high school students consumed cannabis more than six times monthly; the figure
for 2001 is 25%. This means that, consumption levels in Canada appear to be
among the highest in the world for this age group.
To
summarize
In the
absence of recent reliable data on a national scale, we can only
hypothesize. For the population over age 16, there is reason to believe that
cannabis use is as follows:
Based on
the last census, there are approximately 20 million Canadians between the ages
of 18 and 64. If we accept the values used in this graph, there are then
approximately 2 million Canadians over age 18 who have used cannabis during the
preceding 12 months, approximately 600,000 who have used it during the past
month, and approximately 100,000 who use it daily.
In young
people aged 12 to 17, the situation could be as follows:
According
to the latest census, there are approximately 2.5 millions young persons aged 12
– 17 in Canada. If 40% have used cannabis in the preceding year and 30% in the
past month, this means 1 million and 750,000 young users in each category
respectively. Approximately 225,000 would make daily use of cannabis.
Overall,
these epidemiological trends indicate a number of things. At the simplest level,
they clearly show division by generation and gender: people under the age of 35
consume more than those over 35; and men are more frequent consumers than women.
Furthermore, users are more likely to be single. The data appear constant both
over time and among countries.
At the
same time, there have been changes to the user profile. Rates for the
30‑49 age group have tended to increase, supporting to some extent the
hypothesis that these are the first cohorts of ’70s users. Although the
tendency in the ’60s was to identify users as working-class or unemployed,
there has been an increase in employed individuals with post-secondary or
university education.
Some
authors link usage to living in an urban area–for example, in the Netherlands,
use is far more widespread in metropolitan than in rural areas. This factor does
not apply in Canada. In Ontario for example, students outside Toronto consume
more cannabis than do those in Metro Toronto. Cannabis use is also related to
non-practice of religion, families in which at least one parent has a
post-secondary education, and single parent families.[28]
According
to the Ontario studies, age of initial use seems to be lower than it was in the
1970s (close to 16 years of age); it now stands at between 13 and 15 years of
age (a mean of approximately 14). On the other hand, as we have said, early
initial experience is down (currently 2% compared to 8% in the early 1980s). If
age of first experience appears related to regular consumption in late
adolescence and early adulthood (18-25 years) as suggested by the American
studies, it is clear that consumption is inversely proportional to age and the
rate of cessation is high. For those who continue to consume in the long term,
the age of cessation is delayed until the late 30s.
On a
more complex level, these trends would lend support the OFDT hypothesis
concerning “trivialization” of cannabis consumption. The following section
shows that a number of researchers–including persons who have testified before
the Committee–impute this “trivialization” to a reduction in the
perception of cannabis-related risks (health and legal consequences) and greater
availability. Aside from “trivialization”, there is also an acculturation
aspect, the idea that cannabis will eventually be considered a psychoactive
substance akin to alcohol or tobacco, whose risks we learn to recognize and
manage.
Furthermore,
cannabis consumption rates vary widely from one country to another with no
apparent relation to public policy. This is one of the strong hypotheses that we
will revisit in greater detail in our Chapter 21 examination of public policy.
Patterns
and circumstances of use
Why do
people use cannabis? In fact, why have people felt the desire or the need to use
all manner of psychoactive substances since time immemorial? We suspect that
these questions are highly charged with symbolic and political meaning: when it
is a question of cannabis, sometimes the focus is on its “soft drug” nature,
its festive and sociable side, and sometimes the focus is more on its role as
part of a marginal, if not pre-delinquent, trajectory and the risks associated
with moving on to other drugs. When it comes right down to it, and rather
surprisingly, we know very little about users’ motivations and experiences.
We
can distinguish two large groups of studies: socio-anthropological studies that
try to identify users’ practices and certain environmental factors that put
these practices in context, and psychological studies that try to relate
personality and family-related factors to cannabis use. Although both types of
studies are just as relevant to understanding the nature of the phenomenon,
their approaches and their results are often difficult to reconcile. But, first,
a few historical notes on the uses of cannabis.
Cannabis
in history
[29]
Although
the historical routes of cannabis still remain obscure, archaeologists
discovered a Chinese village where they uncovered the oldest use of the cannabis
plant, dating back approximately 10,000 years. It was primarily used for
clothing, ropes and fishing nets, paper and other decorative purposes. It was
also considered one of China’s five cereals. Around 2000 B.C. the Chinese
became aware of the psychotropic and medicinal properties of cannabis oil
(resin) and used it in particular for the treatment of menstrual fatigue, gout,
rheumatism, malaria, constipation and absentmindedness, and as an anaesthetic.
Religious uses were also identified, and the Chinese noted that its use allowed
communication with spirits and lightened the body. In the first century B.C.,
Taoists used cannabis seeds in their incense burners to induce hallucinations
that they considered a way to achieve immortality.
Several
historians attribute the origins of cannabis to the Scythians around Siberia and
North Central Asia towards the 7th century B.C. According to
Herodotus, a Greek historian who lived in the 5th century B.C.
marijuana was an integral part of the cult of the dead that the Scythians
followed to honour the memory and spirit of their departed leaders. Indications
of cannabis use, often for religious purposes, have also been found with the
Sumerians and, according to some, in certain passages of the Bible.
The
first ethnographic description of ancient people inhaling marijuana as a
psychotropic stimulant was confirmed by a Russian anthropologist, Rudenko, in
1929. Not only did he find the embalmed body of a man and a bronze cauldron
filled with burnt marijuana seeds, but he also found shirts woven from hemp
fibre and metal censors designed for inhaling marijuana smoke. Apparently this
activity was not religious in nature but was a daily activity in which both men
and women participated, as confirmed by the discovery of the frozen body of a
2,000-year-old woman in the same cemetery where Rudenko made his first
discovery. Archaeologists found some of her possessions, including a small
container of cannabis that would have been smoked for pleasure and used in pagan
rituals, buried in a hollow tree trunk.
In
India, cannabis has been closely associated with magical, medical, religious and
social customs for thousands of years. According to legend found in the Vedas,
Siva is described as “The Lord of Bhang”, a drink made of cannabis leaves,
milk, sugar and spices. This drink is still part of the traditions of certain
castes. Cannabis is also renowned for its use in Tantric sexual practices.
Approximately one hour before the yoga ritual, the devotee drinks a bowl of
bhang after reciting a mantra to the goddess Kali. Similarly, “charas” holds
a special place in the prayer ceremony called Puja. Lastly, cannabis was used
for medical purposes.
Although
not indigenous to Africa, the cannabis plant is part of religious, medical and
cultural traditions across almost the entire continent. In Egypt, it has been
grown for over a 1,000 years, while the first evidence of its presence in
central and southern Africa dates back to 14th century Ethiopia where
ceramic smoking-pipes containing traces of cannabis were discovered. In North
Africa, cannabis influenced music, literature and even certain aspects of
architecture since in some homes, a room was set aside for kif where family
members gathered to sing, dance and tell stories. The plant was also used as a
remedy for snake bite (Hottentots), to facilitate childbirth (Sotho) and as a
remedy for anthrax, malaria, blackwater fever and blood poisoning (former
Rhodesia).
In South
America, it would have been primarily slaves imported from Africa who brought
cannabis. East Indian labourers brought cannabis to the Antilles, and Jamaica in
particular, where it is not only used recreationally but is integrated in many
aspects of Jamaican, and particularly Rastafarian, culture.
As
for North America, it is not known exactly when the psychotropic properties of
cannabis were discovered. Some think that it played a role in several native
cultures; others doubt that it ever played a significant role. The oldest
evidence of the existence of cannabis in North America dates back to Louis Hébert,
Champlain’s apothecary, who introduced cannabis to white settlers in 1606,
essentially as a fibre to be used to make clothing, cordage, sails and rigging
for ships. However its psychotropic properties were not discovered until the 19th
century. Between 1840 and 1900, it was used in medicinal practice across almost
all of North America. It was prescribed for various conditions such as rabies,
rheumatism, epilepsy and tetanus, and as a muscle relaxant. Moreover, its use
became so widespread that cannabis preparations were sold freely in drug stores.
The
first study of cannabis was conducted in 1860 by the American Governmental Commission. When presenting the findings of
the Commission to the Ohio State Medical
Society, Dr. Meens said:
Cannabis
effects are less intense than opium, and the secretions are not so much
suppressed by it. Digestion is not disturbed; the appetite rather increases; the
whole effect of hemp being less violent, and producing a more natural sleep,
without interfering with the actions of the internal organs, it is certainly
often preferable to opium, although it is not equal to that drug in strength and
reliability. [30]
At the
same time, other doctors criticized its use because of the variability and
uncertainty of its effects. As for its recreational uses, they seem to have been
noted for the first time at the beginning of the 20th century and
quickly became the subject of social concern, especially because of the
association of cannabis with Mexican and then black American workers,
strengthening fears about its criminogenic and aphrodisiac effects. In 1915,
California became the first state to prohibit possession of cannabis. Canada
followed suit in 1923, while the United States outlawed possession in 1937.
However, in 1944, the La Guardia report, from the State of New York, emphasized
the harmless effects of cannabis. It was followed by reports from the Le Dain
Commission in Canada and the Schafer Commission in the United States at the
beginning of the 1970s. On the international scene, cannabis was prohibited by
the Single Convention of 1961 (which will be discussed more fully in
Chapter 19).
In
Canada, mass use of cannabis came with the 1960s. Prior to that, the phenomenon
was almost invisible and there were only 25 convictions for cannabis possession
between 1930 and 1946. In 1962, the RCMP reported 20 cannabis-related cases.
Then came the explosion: 2,300 cases in 1968 and 12,000 cannabis convictions in 1972.
According to the Le Dain Commission, the sudden growth in cannabis use
could be attributed to the hippies, the Vietnam War, underground newspapers and
the influence of the mass medias. On top of these major counterculture
movements, Canada became more open to the world: more and more young Canadians
were travelling and Canada itself received more and more visitors and
immigrants. Since then, except for a few years, cannabis use for non-medicinal
purposes has increased as we saw in the previous section.
Trajectories of use
Most
studies identify quantity and frequency of use. Thus as we saw in the previous
section, the OFDT report, for example, identifies experimentation, occasional,
repeated, regular and heavy use, with frequency of use (number of times a month)
and circumstances (alone or in a group, morning or evening) as the preferred
indicators of at-risk use. However, this knowledge of certain characteristics of
use by young people in particular tells us very little about what will follow.
If we could stop time at a given moment in a user’s history, the knowledge
would not help us determine what would happen next. For example, with this
knowledge we could not answer the question of whether or not cannabis use begun
during adolescence is part of a trajectory leading to increased use. Now, a
certain number of those who testified before the Committee told us that they had
observed dependence in cannabis users. Also, certain government documents, in
the US in particular, do not hesitate to point in this direction by measuring
requests for treatment and by reporting that requests for treatment of cannabis
dependence are on the rise. For example, documents given to us by American drug
authorities indicate that 40% of people who meet the DSM IV diagnostic criteria
for dependence (which will be dealt with in the following chapter) have a
primary diagnosis of cannabis dependence.[31]
Unless we believe that a few occasional uses lead to dependence, we must accept
that a relatively significant number of young people who try cannabis during
adolescence will embark on a trajectory of use that will lead to dependence.
But what
is the situation exactly? What are these trajectories of use? What are the
stages? Is there a progression?
First of
all, like Professor Mercier, we must point out that the idea of a trajectory is
itself slightly inaccurate.
The
concept of trajectory is based first of all on the basic principle whereby
individuals will go through a number of stages or successive phases. It is true
that the concept of trajectory is somewhat incorrect. A trajectory is somewhat
of a metaphor for the trajectory of the planets and the stars, that is something
very focused and in continuous motion. The word "journey"
("trajet") would be more accurate. A journey includes detours, round
trips, et cetera. So we must bear in mind that this concept of trajectory is not
necessarily linear, but that there will be different situations and different
paths. The word "journey" is a more accurate way of describing the
relationship an individual will have with psychotropic substances during his or
her life. There is another important concept as well. In addition to
trajectories, phases and stages, there are also transitions and passages, when
individuals move from one stage to another.[32]
Some,
like the INSERM report, speak of contact, experimentation and commitment phases.
Contact is seeing cannabis or knowing people who use it. Experimentation, of
course, is trying it, and may be limited to a single time. Lastly, commitment
refers to the various ways of managing use, from relative commitment where there
are significant changes in use to true commitment where there are fewer changes.
The report specifies that these three stages are not in all trajectories and do
not always follow one another in a coherent fashion. Furthermore, there will
often be periods of cessation, followed by resumption or a definitive cessation.
Nevertheless, according to INSERM, “commitment
probably constitutes the most important stage if we want to understand what
cannabis use corresponds to. However, the data on this commitment phase seems
the most inconsistent as most works deal with initiation.”[33]
[translation]
In fact,
the data on committed use is still very sketchy, such that beyond a few
generalities, we really know very little about the circumstances and
trajectories of cannabis use. It is as if we were first worried about
classifying users according to their risk of becoming dependent, or were trying
to make them fit into a ready-made model. While testifying before the committee,
Professor Mercier recalled the five stages in the classic pattern of addiction:
initiation, gradual start of abuse, dependency, treatment and reintegration.
However, as she pointed out, this is only one of the possible trajectories, the
one that has been studied most frequently with regard to drugs (alcohol, heroin
and cocaine in particular), and yet it hardly applies to cannabis. In any event,
it is clear that with cannabis users, there is great variability in use.
The
epidemiological data presented in the previous section indicate fairly clearly
that cannabis use decreases significantly with age. More specifically, the rate
of cessation is significant, as the following table shows.
Rate of Cessation (percentage of lifetime users who did
not use cannabis in the previous year), USA, 1996 [34]
|
Age Group |
Women |
Men |
|
12-17 18-25 26-34 35 + |
26% 54% 82% 91% |
20% 39% 74% 82% |
Consequently,
the rate of continuation is relatively low. It was 24% in the US in 2000, 17% in
Denmark, 29% in France and Germany (West), 24% in Switzerland and 8% in Sweden.
The only exception is Australia with a rate of continuation of 46%.
That
being said, these data says nothing about the period during which cannabis use
is continued, the frequency of use or the quantities used. Epidemiological
studies tend to establish that most users stop consumption during their
thirties, but only ethnographic studies can provide more information.
Unfortunately they are few.
The
INSERM report describes studies conducted in Australia, France and the United
States. Most show progress towards regulated cannabis use, that is, use both
stabilized–fewer variations in use–and use more integrated into social
living conditions, that is, more integrated into personal and professional life.
A significant proportion of long-term regular users are men, and are more likely
to be single and have creative occupations. Most say they use cannabis to relax
and relieve stress, to help them sleep, or to alter their state of
consciousness.[35]
In
Canada, Hathaway studied regular users[36],
using open-ended interviews from October 1994 to June 1995. The study involved a
sample of 30 regular users (15 men and 15 women), aged 22 to 47 (average age
32). Participants had used cannabis for 3 to 31 years with the average being 17
years; 40% had used it daily for 20 years or more. This data is in complete
agreement with what INSERM suggested. Long-term users integrate their regular
cannabis use into their daily lives and social activities while remaining aware
of the symbolic value of this “tolerable deviance”. While most started after
coming into contact with a small group of users who served as more or less
long-term support, the users who were most at peace with their drug use were
those who regulated their use independently.
In
this study, I found that moving from a pattern of use that is dependent on
one’s level of participation with other users to one that is independently
regulated marks a crucial transition in the marijuana user’s relationship to
the drug. (…) their continuing use of the drug does not necessarily suggest an
inability to commit to conventional adult roles. Instead, adapting one’s
marijuana use to suit an otherwise conventional way of life appears to make the
practice significant on a more personal level than that previously fostered
through affiliation with marijuana-using groups. [37]
For
a certain number of users, this acculturation of the drug occurs after a more or
less prolonged period of abstinence during which they distance themselves from
the group of users. This makes it possible for them to determine for themselves
the role cannabis will play in their lives. Moreover, every participant in the
study had managed to integrate their use into their personal or professional
life. Users associate their drug use primarily with free time and relaxation
after a day at work; some even compare its role with that played by alcohol.
Although 97% used cannabis at least weekly and 37% used it daily, only 7% (2
people) defined their use as problematic. Most went through periods of
abstinence or of decreased use without experiencing difficulties.
Another
study, reported by Rigter and von Laar,[38]
was conducted in the State of New York on a cohort of users who were followed
for a period of twenty years. This study identified four types of users:
·
Early-onset
heavy-use: start around age 15 and become regular users around age 17.5; daily
use for a duration of 131 months on average; 49% still use around age
34-35;
·
Early-onset
light-use: start around age 15 but fewer (44%) go on to daily use (for an
average duration of 28 months); only 10% still use at age 34‑35;
·
Mid-onset
heavy-use: start around age 16; two-thirds become daily users (average duration
42 months) and still use at age 34-35;
·
Late-onset
light-use: start at age 19.5 and a minority become daily users (21%). Almost all
discontinue use around age 34-35.
In all,
this study shows that there were clearly more light users than heavy users. The
latter had less education, went to church less often, were more likely to have a
history of delinquency, and changed jobs more often. Early-onset users showed a
greater tendency towards episodes of delinquency and mental disorders, started
to drink and smoke tobacco sooner, had a greater tendency to experiment with
other drugs, and tended to identify positive reasons for using marijuana.
But it
is risky to propose typologies, because boundaries are fluid and users switch
from one type of use to another fairly easily. This was shown in particular by
the comparative study conducted by Cohen and Kaal in Amsterdam, San Francisco
and Bremen.[39]
The
study involved a sample of experienced users consisting of 216 people in
Amsterdam, 265 in San Francisco and 55 in Bremen. The sophisticated method of
selecting candidates from epidemiological studies conducted in the general
population of these cities is important because it reveals the prevalence of
use. The following chart shows this data.
The
average age of participants varied between 33 and 37; most had a spouse and a
stable job. The average age for initiation into cannabis use in the three cities
was 16, that is, at a younger age than people who had only occasional exposure
to cannabis (21.2 in Amsterdam and 19.5 in Bremen). Most were introduced by
friends and their first experience was as part of a group. At age 19, they were
regular users (at least once a month) and their heaviest use was around age
21.5. Trajectories of use were determined using six patterns:
1)
More to less: after an initial period of heavy use, the individual
gradually decreased his use
2)
Gradually more: the individual gradually increased his use
3)
Stable: amount and frequency did not change
4)
Up-top-down: use increased, reached a peak, and then decreased
5)
Intermittent: frequent discontinuation after initiation
6)
Varying: use rises and falls
As the
following table shows, no less than 75% of respondents in the three cities
correspond to patterns 4 (48.7%) and 6 (25%).
Patterns of Use in Regular Users [40]
|
|
Amsterdam
Number
% |
San Francisco
Number
% |
Bremen
Number % |
|
Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 |
17
8 13
6 24
11
104
48
7
3
51
24 |
18
7
17
6
5
2
133 50
25
9
66
25 |
6
11
5
9
24
44
2
4
18
33 |
During
their period of heaviest use, approximately 45% of those studied used cannabis
regularly. However, during the preceding year, approximately 35% used it less
than once a week and more than 35% did not use it all. During the past three
months, more than 50% did not use cannabis at all, and less than 10% used it on
a daily basis. As for amounts, the authors of the study concluded that they are
low. During their period of heavy use, less than 18% of those studied smoked
more than one ounce per month, whereas during the preceding year, approximately
60% had smoked less than 4 grams (1/7 of an ounce) per month. Users were divided
fairly equally between those who preferred medium or mild cannabis and those who
preferred a stronger variety (with a more marked preference for the mild
varieties in Amsterdam). Users have a certain number of rules regarding use: no
smoking at work or school (more than 35%), during the day, or in the morning.
Most
long-term users had had periods of abstinence that varied from one month to a
year or longer, most often because they no longer felt the need or the desire to
smoke. Moreover, between one-third and one-half had decided to decrease their
use at various times.
Thus we
can see that trajectories of use do not follow a linear progression, and are
marked by key periods when the user integrates cannabis use into his social and
personal life, distances himself from groups of users, stabilizes the role
marijuana plays in his personal life, with periods of heavy use, especially at
the beginning of the trajectory, followed by periods of either decreased use or
of ups and downs in terms of frequency and amount.
Factors
related to use
Following
logically from what we saw in the previous section, studies on factors that
could explain the use of drugs, and cannabis in particular, deal primarily with
initiation or experimentation.
The
INSERM report examines a set of studies on factors that could explain cannabis
use: the influence of the family environment (use by parents, socialization,
parental teaching methods, quality of the parent-child relationship, parental
models), peers (symbolic values of use, norms) and educational and social
environments.[41]
There is no clear conclusion, but the report notes that the studies manage
either poorly or not at all to take into account the user’s role in social
situations and consequently the incremental impact on use arising from the
variability of social stresses as well as the methods of integration. We would
also add that these studies do not reflect trajectories of use.
First of
all, along with DrugScope, we note
that the epidemiological approach to analysis of drug use, cannabis in
particular, is based on a medical model of analysis of the prevalence of
disease, whereas the reasons (which are not necessarily the causes) for drug use
can very easily lie outside the medical field and, in a broader sense, outside
the psychosocial model. Attributing dependence – understood here in terms of a
disease – to factors pertaining to the relationship between the locus of
control and the environment has consequences for the understanding of the
phenomenon as well as for public policy. The report by this British body
contains a table of the explanations of drug use we feel it useful to reprint
here.
Attribution Explanations of Drug Use [42]
|
Attribution |
Common Sense Meaning |
Resulting Public Policy |
|
Internal x stable Internal x unstable External x stable External x unstable |
Drug
use is a disease (dependence model) Drug use is the periodic seeking of pleasure Shortcomings in the environment explain drug use Availability of drugs explains their use |
Treatment model Reduced demand model (replace drugs with something else) Change the environment Reduced supply model |
In fact,
we must not forget that, with regard to psychoactive substances, the medical
model of disease is still a dominant model for comprehension and forms the other
part of the public response along with the penal model.[43]
As we were told several times, drugs, and cannabis in particular, are not
dangerous because they are illegal, they are illegal because they are dangerous.
We will have occasion to comment on this statement in greater detail in the
following chapters.
For now
it is enough to remember that attempts to explain drug use most often involve
looking for defects in personality or the environment rather than trying to
understand the choices made by users.
Among
the factors related to the locus of control, studies identify primarily:
·
Peer
influences: the first uses depend on the influence of other young people in the
group;
·
Family
influences: a family environment where parental supervision is lacking, where
drug use is tolerated, where siblings or parents have criminal backgrounds, and
where parents themselves are users;
Among
the factors related to the environment, studies mention:
·
The
availability and accessibility of drugs: the more drugs are available, the
greater their use will be;
·
Social
tolerance: the more drug use is accepted, the higher levels of use will be;
·
Perception of
risk: the less the risk of social disapproval or the perceived risk to health,
or the risk of legal action, the greater the use there will be.
According
to the report Monitoring the Future,
there is no doubt that young people’s perceptions of drugs and their attitudes
towards them determine the levels of use, which in return must determine public
policy:
Early
in the decade of the 1990s we noted an increase in the use of a number of
illicit drugs among secondary students and some important changes among the
students in terms of certain key attitudes and beliefs related to drug use.
(…) Specifically, the proportions seeing great risk in using drugs began to
decline, as did the proportions saying they disapproved of use. As we predicted,
those reversals indeed presaged “an end to the improvements in the drug
situation that the nation may be taking for granted.” The use of illicit drugs
rose sharply in all three grade levels after 1992, as negative attitudes and
beliefs about drugs continued to erode. This pattern continued for some years. [44]
And
further on:
We
can summarize the findings on trends as follows: over more than a decade –
from late 1970s to the early 1990s – there were very appreciable declines in
use of several illicit drugs among twelfth-grade students, and even larger
declines in their use among college students and young adults. These substantial
improvements – which seem largely explainable in terms of changes in attitudes
about drug use, beliefs about the risks of drug use, and peer norms against drug
use – have some extremely important policy implications. One is that these
various substance-using behaviours among American young people are malleable –
they can
be changed. It has been done before. The second is that demand-side factors
appear to have been pivotal in bringing about those changes. The reported levels
of availability of marijuana, as reported by high school seniors, has held
fairly steady throughout the life of the study. (Moreover, both abstainers and
quitters rank availability and price very low on their list of reasons for not
using.). And in fact the perceived availability of cocaine actually was rising
during the beginning of the sharp decline in cocaine and crack use, which
occurred when the risks associated with that drug suddenly rose sharply. (…)
Over the years, this study has demonstrated that changes in perceived risk and
disapproval have been important causes of change in the use of several drugs.
These beliefs and attitudes surely are influenced by the amount and nature of
public attention paid to the drug issue in the historical period during which
young people are growing up. A substantial decline in attention to this issue in
the early 1990s very likely helps to explain why the increases in perceived risk
and disapproval among students ceased and began to backslide. [45]
In
other words, social disapproval – through government information campaigns,
for example – can generate attitudes that reject drug use and will be
reinforced by actions likely to increase the risks associated with use (the risk
of arrest, for example).
A study
conducted in Newfoundland and Labrador involving a sample of 3,293 people is an
example of this approach applied in Canada.[46]
The questionnaire included questions about activities (family activities,
housework, extracurricular activities, school work, sports, work, religious
life), the availability of cannabis, use by parents, peers and the individual,
parental and peer norms regarding cannabis, personal preferences and norms
regarding cannabis. Analysis of variance dealt with the interaction of these
various variables to explain personal use of cannabis. Overall, the model
explains only 57% of use in the provincial sample, 65% for boys and 54% for
girls. The results show that peer use is the main factor related to personal use
(29% of variance), followed by personal preferences (themselves influenced by
peer norms), personal norms and having to do chores around the home.
Availability is not directly related to use and works through peer norms and
use. Parental use is strongly linked to perceived availability. The authors
conclude that this model has clear implications for interventions to prevent
cannabis use:
In
the province wide sample, Peer Use, Peer Norms, Availability, Own Preferences
and Own Norms together account for 56% of the 57% of Own Use predicted by the
model. Peer Norms and Availability work though Peer Use, so important targets
for intervention should be Own Norms, Own Preferences and Peer Use. Of these
variables, Own Preferences and Peer Use contribute the most to prediction of Own
Use, together accounting for 48.8% of the variance. It is of interest that a
large part of availability is predicted by Parental Use, suggesting Peer Use
arises from possible supplies of the marijuana/hashish from parental sources.
This ought to be a target for intervention strategies as well. The model
suggests sources of influence on target variables that ought to be considered in
any intervention strategies. [47]
Taking
into consideration the limits of the model as well as the differentiation
between the sexes and provincial health districts with respect to the relative
weight of the independent variables, we have to wonder if this type of analysis
is a true reflection of use, including initial use. Furthermore, in the light of
international trends in use on the one hand, and studies on users on the other,
we wonder about the postulates of this type of mechanical model based on the
rationality of the actors.
Finally,
Aquatias et al., conducted a study on cannabis use among youth in the suburbs of
Paris.[48] The authors make a
particularly interesting distinction between forms of use based on user
characteristics and the ideological representations of cannabis use. They
demonstrate in particular (1) that there exist “hard” uses of soft drugs and
(2) that the traditional distinction between the festive, socially integrated
and group-regulated forms of use among middle class youth, and the excessive and
socially unregulated uses of disadvantaged youth does not hold. Depending on
factors related to their environment, both groups can have regulated and
unregulated forms of use.
Factors
traditionally associated with unregulated use such as social disenfranchisement,
poor living conditions in the suburbs and the lack of professional integration,
are only part of the picture. Other factors related to tensions arising in the
environment (for example family-related problems or being in conflict with the
law) and the capacity to remain autonomous from their social milieu also play an
important role in the trajectories of these cannabis users.
[Translation] In trying to understand what factors determined these different forms of
cannabis use among these youths, we have obviously noted the importance of
factors related to social dislocation: difficulties in social integration and a
lack of financial resources capable of fostering their autonomy from the living
environment.
However,
facing similar difficulties to get a job and socio-economic resources, some
smoke cannabis without any excess, some not at all and others smoke
considerably. Even within the group of youth who have a job, some smoke high
potency cannabis intensively while others have more regulated forms of use and
consume less.
Social
dislocation is obviously a factor explaining the different forms of use just as
integration in the job market serves to regulate these practices. But these
complementary factors only constitute the more general context to these
behaviours of intensive and prolonged use of cannabis.
(…)
Among
those who experience social dislocation the most, those who smoke cannabis in an
intensive and prolonged manner also experience the strongest social tensions
such as problems with their local reputation, being in conflict with the law or
family related problems… (…).
Conversely,
those who have a more regulated use are both better integrated in their
environment and at the same time more autonomous with respect to local social
life. [49]
The
authors propose a classification of forms of use which we reproduce since it
has, in part, inspired our own classification.[50].
|
|
Regulated
solitary uses |
Regulated group
uses |
Unregulated
solitary uses |
Unregulated
group uses |
|
Intensive use |
After work |
Boredom |
Personal problems |
Holidays, parties |
|
Medium or low level of use |
Before and after
work |
Generally in the
evening Boredom |
|
|
Finally,
the authors distinguish between four levels of use:
·
Occasional:
from experimentation to use in parties;
·
Moderate daily
use: 3 to 5 joints per day or about one gram;
·
Strong daily
use: 5 or 6 joints per day or between 0.9 and 1.2 grams;
·
Intensive daily
use: over 1.2 gram per day.
To summarize
From an
analysis of the life stories of users and their “trajectories”, we have
learned primarily that, for a proportion of experimenters, which varies between
15% and 20% of the population, who will become regular users, the circumstances
and patterns of their “career” as a user vary considerably but that for a
significant proportion of these long-term users, use is integrated into their
social and personal life.
Further,
contrary to some studies, uses of cannabis are not determined only by a series
of psychological or environmental factors. In all cases, it seems that specific
events, elements of one’s particular life story, can trigger unregulated forms
of uses, characterized in particular by intensive and solitary use. While such
unregulated uses appear to be temporary, we did not come across any study that
examined the trajectories of these users.
We also
note that negative social attitudes and the characteristic of the cannabis
market appear to have little impact on patterns of use.
Finally,
we note that regular use does not necessarily mean problem use. At the same
time, we have learned that early onset and rapid progression towards regular use
are factors in problem use. In other words, and this will be important for
choosing public policy and interventions, initiation at a young age (under age
16) and rapid progression towards regular use (under age 20) are markers that
should be used to identify and prevent heavy use. Chapter 7 will discuss
this issue in greater detail.
Stepping
stone to other drugs?
The
stepping stone theory holds considerable sway in debates on marijuana. In fact,
the concern is that cannabis use leads to the use of other drugs, in particular,
the so-called hard drugs, such as heroin and cocaine.
It
logically follows that more people using drugs will increase the number of
people being harmed by them. Cannabis is believed to be the foundation upon
which most young people begin experimenting with illicit drugs. (…) The
“gateway” concept has been around for a long time, and again, although there
is no definitive evidence, the National Institute on Drug Abuse has reported
that neuro-toxicological research suggests that marijuana “may alter the brain
in ways that increase the susceptibility to other drugs.”
Many
believe that cannabis use provides the impetus for those people looking to
increase the psychotropic effect a drug has on them. [51]
We
should first define our terms. The “stepping stone” theory holds that
cannabis use inevitably leads to use of other drugs. In this theory, cannabis
use would lead to neurophysiological changes, affecting in particular the
dopaminergic system (also called the reward system), thus creating the need to
move on to the use of other drugs. This theory has been completely dismissed by
research. We share this conclusion with several international bodies doing drug
research, including the British organization DrugScope:
The
Stepping-Stone theory has proved unsustainable and lacking any real evidence
base. The “evidence” that most heroin users started with cannabis is hardly
surprising and demonstrably fails to account for the overwhelmingly vast
majority of cannabis users who do not progress to drugs like crack and heroin.
The Stepping-Stone theory (often confused among the general public for the
Gateway theory) has been dismissed by scientific inquiry. The notion that
cannabis use “causes” further harmful drug use has been, and should be,
comprehensively rejected. [52]
The
“gateway” theory suggests that users’ trajectories offer them choices as
they start their trajectory of use and that one of these choices is to use other
drugs. According to this theory, certain factors, such as early initiation and
more regular and heavier use, reinforce this possibility. However, these factors
themselves, and early initiation to cannabis in particular, are related to
earlier factors, arising from the family environment and social living
conditions, that predispose the more vulnerable young people to this early
initiation and more rapid progress towards regular and heavy use.
The
link between cannabis and other drug use, according to this explanation, is thus
a reflection that there are a number of risk factors and life pathways that
predispose young people to use cannabis and that they overlap with the life
pathways that predispose young people to use other illicit drugs. [53]
In
addition to these factors that predispose some young people to heavier use of
psychoactive substances – including alcohol and tobacco first of all – the
sociological conditions under which users can obtain cannabis are such that they
are in contact with an environment that is at least marginal if not criminal.
Dealers are often the same people who also sell heroin, crack, amphetamines,
cocaine and ecstasy such that the probability that a young cannabis user,
already more vulnerable due to the factors of his personal trajectory, would
come into contact with these other substances more easily. We would also add
that wholesalers and dealers “cut” or even mix their products; we were told
at times that ecstasy, for example, could contain many things other than MDMA.
Furthermore,
if it is true that use of substances such as heroin and cocaine develops almost
necessarily out of prior use of marijuana, then it also develops out of the use
of other substances, nicotine and alcohol in particular, which are more gateways
to a trajectory of use than cannabis.
If we
come back to trends in drug use in the population, while more than 30% have used
cannabis, less than 4% have used cocaine and less than 1% heroin.
However,
it is true that regular and heavy users are more likely than occasional users to
use other substances. The study by Cohen and Kaal[54]
discussed in the previous section shows for example that more than 90% of
long-term cannabis users have also used tobacco and alcohol during their
lifetime. Above all, it also shows that 48% in Amsterdam and 73% in San
Francisco have used cocaine at least once in their life, and 37% in Amsterdam,
77% in San Francisco and 47% in Bremen have used hallucinogens at least once.
Nevertheless, no regular cannabis users were regular users of other substances.
The authors also show that the most common sequence is alcohol (around age 14),
tobacco (around age 15), cannabis (around age 17), followed by other drugs in
the early 20s.
We feel
that the available data show that it is
not cannabis itself that leads to other drug use but the combination of the
following factors:
·
Factors related
to personal and family history that predispose to early entry on a trajectory of
use of psychoactive substances starting with alcohol;
·
Early
introduction to cannabis, earlier than the average for experimenters, and more
rapid progress towards a trajectory of regular use;
·
Frequenting of
a marginal or deviant environment;
·
Availability of
various substances from the same dealers.
Cannabis,
violence and crime
It is
clear that there is some association between psychoactive substances and crime.
It is just as clear that this link is much more complex than is sometimes
thought, as Professor Brochu pointed out during his testimony before the
Committee.
Just
in my office at the Université de Montréal, I have 2,973 studies that attempt
to show a link between psycho-active substances and crime. Most of these studies
come from the United States or from English-speaking countries, which tends to
colour their perspective somewhat, since we know that our neighbours to the
south have very clearly opted for a punitive approach to illegal drugs. What
comes out of all these studies is that the link between drugs and crime is very
complex. [55]
Since
his testimony, Professor Brochu has released the study he mentioned to the
Committee.[56]
We can
examine the drug-crime relationship from at least three angles: the effects of
the substance itself, the effects of the cost of the substance, and the drug’s
position in the criminal world.
A
significant proportion of offenders have psychoactive substance abuse problems,
predominantly with alcohol. In fact, the study concludes that alcohol is the
substance most frequently associated with violent crime; in the case of crimes
against property, illegal drugs predominate. Cannabis ranked third (3% to 6%
according to the study), far behind alcohol (24%) and cocaine (8% to 11%).
With
respect to the second approach, the authors establish that between 17% and 24%
of inmates committed a crime to obtain the money needed to buy their substance
of choice, most often cocaine.
Lastly,
regarding the third approach, because illegal drugs are marginalized, users are
exposed to a deviant environment. In the previous section we noted that, with
regard to cannabis, the fact that dealers can offer heroin or crack as well as
cannabis could promote a gateway trajectory towards these other drugs.
Similarly, the fact that these substances are illegal could contribute to
leading people to a trajectory of delinquency. Furthermore, the drug trafficking
environment is a relatively violent environment where a whole series of crimes
are committed. Lastly, the simple fact of selling cannabis is itself a criminal
offence, and we know that a certain number of people are imprisoned for doing
so.
All in
all, cannabis itself does not lead to a trajectory of delinquency and it is more
likely to be the other way around: someone who embarks on a trajectory of
delinquency when young is exposed to illegal drugs more quickly and can
experiment at a younger age and begin a career as a user when younger.
Furthermore,
simply because of its relaxing and euphoristic psychoactive effects and its
effect of relaxing muscle tone, cannabis is hardly likely to lead to acts of
violence.
Data
from studies on long-term users confirm this global picture of the relationship
between cannabis and crime. Thus, Cohen and Kaal noted that less than 5% of
their respondents had committed offences to obtain cannabis (pilfering,
shoplifting, theft). The offence committed most frequently in order to obtain
cannabis was selling it.
In
short, the Committee has learned that cannabis is not a cause of violence or
crime except in rare cases, and of course excluding driving while under the
influence, which will be dealt with in Chapter 8.
Conclusions
We have
learned the following from all the information on trends, patterns,
circumstances, trajectories and social consequences of cannabis use:
|
Conclusions of Chapter 6 |
|
|
On trends in use On trajectories On the gateway
effect On violence and
crime |
Ø The infrastructure of national knowledge about the trends and circumstances of cannabis use is fundamentally weak and desperately needs strengthening. Ø The epidemiological data available indicates that close to 30% of the population (12 to 64 years old) has used cannabis at least once. Ø Approximately 10% used cannabis during the previous year. Ø Up to 30% of those who used cannabis in the last year are current users (have used cannabis this month). Ø Approximately 15% of current users would be daily users Ø Use is highest between the ages of 16 and 24. Ø The prevalence of use during the current year is highest, approximately 40%, in young people of high school age. Ø The prevalence of monthly use in young people is approximately 30%. Ø The prevalence of daily use in young people is approximately 9%. Ø The average age of introduction to cannabis is 15. Ø Most experimenters stop using cannabis. Ø Regular users were generally introduced to cannabis at a younger age. Ø Long-term users most often have a trajectory in which use rises and falls. Ø Long-term regular users experience a period of heavy use in their early 20s. Ø Most long-term users integrate their use into their family, social and occupational activities. Ø Cannabis itself is not a cause of other drug use. Ø Cannabis use can be a gateway because it is illegal, which puts users in contact with other substances. Ø Cannabis itself is not a cause of delinquency and crime. Ø Young people with a trajectory of regular and heavy use are often already on a deviant if not delinquent trajectory. Ø Cannabis is not a cause of violence. |
[1]
Table reproduced from CCSA-CAMH (1999), Canadian Profile. Alcohol, tobacco and other drugs. Ottawa: author, page
142.
[2]
Testimony by Dr. Mark Zoccolillo, Professor of Psychiatry and
Pediatrics, McGill University and Montreal Children’s Hospital, Special
Senate Committee on Illegal Drugs, second session of the thirty-sixth
Parliament, October 16, 2000, Issue 1, page 80.
[3]
Adlaf, E.M. and A. Ialomiteanu (2000) CAMH Monitor Report: Addiction and Mental Health Indicators among
Ontario Adults, 1977-2000. Toronto: Centre for Addiction and Mental
Health, pages 61-67.
[4] Chevalier, S., et O. Lemoine (2000) « Consommation de drogues et autres substances psychoactives. » in Enquête sociale et de santé 1998, Québec : Institut de la Statistique du Québec, chapter 5, page 137.
[5]
Testimony of M.J. Boyd, Chair of the Drug Abuse Committee and Deputy
Chief of the Toronto
Police
Service, Canadian Association of Chiefs of Police, Special Committee on
Illegal Drugs, Senate of Canada, first session of the thirty-seventh
Parliament, March 1, 2002, Issue 14, page 77.
[6]
Testimony of Dr. Mark Zoccolillo, op.
cit., page 77.
[7] Testimony
of R.G. Lesser, Chief Superintendent, Royal Canadian Mounted Police, Special
Committee on Illegal Drugs, Senate of Canada, first session of the
thirty-seventh Parliament, October 29, 2001, Issue 8, page 9.
[8]
King, A.J.C. et al., (1999) Trends
in the Health of Canadian Youth. Health Behaviours in School-Age Children.
Ottawa: Health Canada.
[9]
New Brunswick conducted student population studies in 1986, 1989, and
1992.
[10]
See http://www.gov.ns.ca/health/student-drug-use/contents.htm
for Nova Scotia and http://www.gnb.ca/0378/en/sdus1998/index.htm
for New Brunswick. A summary is also available on the CCSA’s website at: http://www.ccsa.ca/Reports/STUDENT.HTM
[11] Patton,
D., et al., (2001) Substance use among
Manitoba high school students. Winnipeg: Addictions Foundation of
Manitoba. Available at www.afm.mb.ca
[12]
Adlaf, E.M. and A. Paglia (2001) Drug
Use among Ontario Students 1977-2001. Findings from the OSDUS. Toronto:
Centre for Addiction and Mental Health.
[13]
Table reproduced from Adlaf and Paglia, op. cit., page 57.
[14] Ibid., page 58.
[15] Vitaro, F, Gosselin C. and A. Girard (2002) Évolution de la consommation d’alcool et de drogues chez les jeunes au Québec de 1987 à 1998: constatations, comparaisons et pistes d’explication. Montréal: Comité permanent de lutte à la toxicomanie.
[16]
Substance Abuse and Mental Health Services Administration (2001) Summary
of findings from the 2000 national household survey on drug abuse.
Washington, DC: Department of Health and Social Services
[17]
Johnston, L.D., et al., (2001) Monitoring
the future. National Survey Results of Drug Use, 1975-2000. Volume II
College Students and Young Adults Ages 19-40. Bethseda,
Michigan: NIDA.
[18]
The 1998 and 2000 reports are available on-line at the Home Office
website: http://www.homeoffice.gov.uk/rds/pdfs/hors224.pdf
[19]
The 2000 report is available on-line at the following website: http://www.drugscope.org.uk/wip/11/3/pdf/UK%20DRUG%20SITUATION%202001.pdf
[20]
Observatoire français des drogues et de toxicomanies (2002) Drugs
and Drug Addiction: Indicators and Trends 2000. Paris:
author, pages 98-99.
[21]
Ibid., page 100.
[22]
Ibid., page 101.
[23] Mr.
Jean-Michel Coste, Director, Observatoire
français des drogues et des toxicomanies, testimony given before the
Special Senate Committee on Illegal Drugs, Senate of Canada, first session
of the thirty‑seventh Parliament, October 1, 2001, Issue 7, pages
31-32.
[24]
Chapter 20 discusses public policy approaches in various countries in
greater detail.
[25]
Trimbos-Instituut (2000) The
Netherlands Drug Situation 2000. Report to the EMCDDA. Available on line
at: http://www.emcdda.org/multimedia/publications/national_reports/NRnetherlands_2000.PDF
[26]
Table adapted from Rigter, H. and M. von Laar (2002) “The
Epidemiology of cannabis use.” in Pelc, I. (ed.), International
Scientific Conference on Cannabis. Brussels.
[27]
Table adapted from Rigter and von Laar, op. cit., page 20.
[28]
See for example Rigter, H. and M von Laar (2002) “Epidemiological
aspects of cannabis use.” in Pelc, I. (ed.) International
Scientific Conference on Cannabis. Brussels.
[29]
This section is based extensively on Spicer, L. (2002) Historical
and Cultural Uses of Cannabis and the Canadian “Marijuana Clash”,
Ottawa: Library of Parliament, report commissioned by the Committee from the
Library of Parliament.
[30]
Quoted in Spicer, op. cit.,
page 29.
[31]
Office of National Drug Control Policy (2002) National Drug Control Strategy. Washington, DC: The White House.
[32]
Professor Céline Mercier, testimony before the Special Senate
Committee on Illegal Drugs, Canadian Senate, first session of the
thirty-seventh Parliament, December 10, 2001, Issue No. 12, Page 6.
[33]
INSERM (2001), op. cit., page
28.
[34]
Rigter, H. and M. von Laar, op.
cit., page 27.
[35]
INSERM (2001), op. cit., pages
55-58.
[36]
Hathaway A. D. (1997a) “Marijuana and lifestyle: exploring
tolerable deviance.” Deviant
Behaviour: An Interdisciplinary Journal, 18, pages 213-232; and (1997b)
“Marijuana and tolerance: revisiting Becker’s sources of control.” ibid, pages 103-124.
[37]
Hathaway, A.D. (1997a), op.
cit., page 219.
[38]
Rigter, H. and M. von Laar, op.
cit., pages 28-29.
[39]
Cohen, P.D.A. and H.L. Kaal, The
irrelevance of drug policy. Patterns
and careers of experienced cannabis use in the population of Amsterdam, San
Francisco and Bremen. Amsterdam: University of Amsterdam, CEDRO.
[40]
Ibid., page 48.
[41]
INSERM (2001) op. cit., pages 28-50.
[42]
DrugScope (2001) United
Kingdom. Drug Situation 2000. Report to the EMCDDA, page: 19.
[43]
On this subject, see for example the work of Bergeron, H. (1996) Soigner
la toxicomanie. Les
dispositifs de soin entre idéologie et action.
Paris: L’Harmattan; and Barré, M.D., M.L. Pottier et S. Delaître (2001) Toxicomaie,
police, justice: trajectoires pénales. Paris:
OFDT.
[44]
Johnston, L.D., et al., (2001) op.
cit., page: 6.
[45]
Ibid., page 30.
[46] Wasmeier,
M., et al., (2000) Path analysis
survey of substance use among Newfoundland and Labrador Adolescents.
Marijuana/haschish and Solvent use. Memorial University of Newfoundland.
[47]
Ibid., page 15.
[48] Aquatias, S., (1999) « Usages du cannabis et situations sociales. Réflexion sur les conditions sociales des différentes consommations possibles de cannabis. » in Faugeron, C. (éd.) Les drogues en France. Paris: Georg. Pour l’étude originale: Aquatias. S. et coll. (1997) L’usage dur des drogues douces, recherche sur la consommation de cannabis dans la banlieue parisienne. Paris: OFDT.
[49] Aquatias, S. (1999) op. cit., pages 48-49.
[50]
Ibid., page 45.
[51]
M. J. Boyd, Chair of the Drug Abuse Committee and Deputy Chief of the
Toronto Police Service, Canadian Association of Chiefs of Police, testimony
before the Special Senate Committee on Illegal Drugs, Canadian Senate, first
session of the thirty-seventh Parliament, Issue 14, page 75.
[52]
DrugScope (2001) Evidence to
Home Affairs Committee Inquiry into Drug Policy. Available on-line at: http://www.drugscope.org.uk/druginfo/evidence-select/evidence.htm
[53]
Ibid.
[54]
Cohen and Kaal, op. cit.,
page 92-93.
[55]
Professor Serge Brochu, Université de Montréal, testimony before
the Special Senate Committee on Illegal Drugs, Canadian Senate, First
Session of the Thirty-Seventh Parliament, December 10, 2001, Issue 12, page
18.
[56] Pernanen, K. et al., (2002) Proportions of crimes associated with alcohol and other drugs in Canada. Ottawa: Canadian Centre on Substance Abuse.