Bulletins (CISUR)

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    Youth Experiences Project: How police interactions impact youth who use drugs
    (Canadian Institute for Substance Use Research, University of Victoria, 2020-03-31) Selfridge, Marion; Card, Kiffer G.; Healey, Patricia
    In 2017/2018, the Youth Experiences Project (YEP) surveyed 449 and interviewed 38 youth aged 16-30 in Victoria, Chilliwack, and Prince George. • This report provides findings from YEP that illustrate the impact of police interactions on youth who use drugs (YWUD) • We also provide recommendations from youth about how police can improve the quality of their work among young people.
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    CISUR Bulletin 20: Scale up of Managed Alcohol Programs
    (Canadian Institute for Substance Use Research, University of Victoria, 2020-06-30) Pauly, Bernie; Graham, Brittany; Vallance, Kate; Brown, Meaghan; Stockwell, Tim
    In the landscape of illicit drug harm reduction and alcohol policy, there are few options for those impacted by the harms of high risk or illicit drinking (unsafe settings, unsafe sources such as nonbeverage alcohol and unsafe patterns of consumption) and/or severe alcohol dependence. These harms are not new but are being escalated during the response to COVID-19, creating a surge of unmet need and propelling interests in the development of Managed Alcohol Programs (MAPs) across Canada and elsewhere. In this bulletin, we provide some beginning guidance and suggestions for organizations looking to initiate or scale up a MAP. There is substantial and growing evidence that MAPs are a unique intervention to reduce harms related to high risk drinking, severe alcohol dependence, homelessness and poverty. Please see www.cmaps.ca for more detailed information on the Canadian Managed Alcohol Program Study (CMAPS). This guidance is based on six common elements of MAPs, CMAPS research on implementation and outcomes as well as extensive experience and wisdom of the CMAPS community of practice. This bulletin focuses on frequently asked questions received by the CMAPS team.
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    Community Empowerment & Transformative Learning among Sex Workers
    (Canadian Institute for Substance Use Research, 2017-11) Benoit, Cecilia; Belle-Isle, Lynne; Michaela, Smith; Phillips, Rachel; Shumka, Leah; Atchison, Chris; Jansson, Mikael; Loppie, Charlotte
    This bulletin offers findings from a pilot Peer Health Advocates training program, designed with and for sex workers. It aimed to enhance community empowerment to enable sex workers to shape their practices around health promotion and prevention strategies, and to contribute to improving access to health and social services within their communities. Participants enhanced self-esteem and reduced internalized stigma, increased their critical consciousness, acquired new knowledge from participation and control over the training program, strengthened solidarity with other sex workers, and contributed to increased resource mobilisation in the community. This pilot study, the first of its kind in Canada, was a successful proof of concept and built the foundation for a long-term initiative. Other jurisdictions in Canada could adapt similar programs in their area.
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    Drug use trends in Victoria and Vancouver, and changes in injection drug use after the closure of Victoria’s fixed site needle exchange
    (Centre for Addictions Research of BC, 2010) Ivsins, Andrew; Chow, Clifton; Marsh, David; Macdonald, Scott; Stockwell, Tim; Vallance, Kate
    Overview This 6th CARBC statistical bulletin reports trends in injection drug use in Victoria and Vancouver from the BC Alcohol and Other Drug Monitoring Project (www.AODmonitoring.ca). As well, changes before and after the closure of Victoria’s fixed site needle exchange in June 2008 are examined. Results are reported from 464 interviews (226 in Vancouver, 238 in Victoria) with adult injection drug users conducted in 5 waves using a standardised sampling strategy, every 6 months from July 2007 to December 2009. Around the time of the closure of the fixed site needle exchange in Victoria, there were shifts in the types of drugs injected and an increase in unsafe injecting practices. At the same time, numbers of clean needles distributed in Victoria since the closure fell by over 15,000 per month. Across both cities and all time periods, crack cocaine was the most commonly used substance, after tobacco, in the past 30 days (86%), followed by powdered cocaine (70%). When the needle exchange ceased operation on May 31, 2008, the data shows a brief decrease in daily injection among the sample, followed by a steady rise to higher levels than pre-closure over the next year. Trends show a decline in Vancouver during the same period. By the second half of 2009, there was a substantially higher proportion of frequent drug injectors in Victoria than Vancouver (89% vs. 29%). Needle sharing was significantly more common in Victoria than Vancouver (see Figure 1). Rates increased to 23% in Victoria, up from 10% before the fixed site needle exchange closure, compared with 8% in Vancouver - a concern highlighted by qualitative data suggesting this increase was directly linked to the closure. It is recommended that measures be taken to increase ease of access to both clean needles and crack- using paraphernalia to limit the spread of blood-borne viruses in the community.
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    The price of getting high, stoned and drunk in BC: A comparison of minimum prices for alcohol and other psychoactive substances
    (Centre for Addictions Research of BC, 2010-12) Stockwell, Tim; Vallance, Kate; Martin, Gina; Macdonald, Scott; Ivsins, Andrew; Chow, Clifton; Greer, Alissa; Zhao, Jinhui; Duff, Cameron; Lucas, Philippe; Marsh, David; Michelow, Warren; Treno, Andrew
    Overview ••This bulletin compares the price of alcohol in British Columbia with “standard doses” of six widely used illicit drugs. ••Street prices for illicit drugs were estimated by 1606 recreational and street drug users interviewed in Victoria and Vancouver over the past three years (www.AODmonitoring.ca). ••BC government prices were provided by the BC Liquor Distribution Branch for October 2010 ••CARBC surveyed prices in 150 BC private liquor stores between July and October 2010. ••Minimum prices in both government and private liquor stores were lower for some products than official minimum prices. ••Alcohol had the lowest minimum price at 58 cents for a standard drink, though hazardous forms of non-beverage alcohol (antifreeze, rubbing alcohol and mouthwash) were still cheaper. ••Other estimated lowest prices were $1.07 for a small joint of cannabis, $1.25 for half a tablet of ecstasy, $2.57 for 0.075 g of crack, $3.33 for 0.1 g of cocaine, $4.00 for 0.1 g of crystal meth and $8 for 0.1 g of heroin. ••The lowest price for exceeding national low risk drinking guidelines on a single day was $2.32 for a woman (4+ standard drinks) and $2.80 for a man (5+ standard drinks). ••Lowest prices for five “standard doses” of illicit substances were estimated to be: $5.35 for cannabis, $6.25 for ecstasy, $12.85 for crack, $16.67 for cocaine, $20 for crystal meth and $40 for heroin. ••Cannabis had the lowest median price of $1.87 for a small joint (0.25 g) followed by alcohol ($3.25) and ecstasy ($3.75). Alcohol had by far the highest price of $994 per standard drink for one product. ••Alcohol causes more preventable death, injury and illness in British Columbia than do illicit drugs and results in more presentations to treatment agencies. ••Minimum prices for alcoholic drinks in BC are not linked to the cost of living or to the alcohol content of drinks and are considerably lower than in Saskatchewan and Ontario. ••These findings are interpreted as supporting the need for a better cocktail of supply, demand and harm reduction strategies in BC e.g. more targeted alcohol pricing policies, managed alcohol programs, heroin prescription, opioid drug substitution programs
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    Regional Variations and Trends in Substance Use & Related Harm in BC
    (Centre for Addictions Research of BC, 2008-11) Martens, Lorissa; Stockwell, Tim; Buxton, Jane; Duff, Cameron; Macdonald, Scott; Richard, Krista; Chow, Clifton; Ivsins, Andrew; Michelow, Warren; Puri, Ajay; Tu, Andrew; Zhao, Jinhui
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    Reducing Alcohol-Related Harms and Costs in British Columbia: A Provincial Summary Report
    (Centre for Addictions Research of BC, 2013-08) Thompson, Kara; Stockwell, Tim; Vallance, Kate; Giesbrecht, Norman; Wettlaufer, Ashley
    Overview • This bulletin reports on the current state of alcohol policy in British Columbia (BC) from a public health and safety perspective using results from a comprehensive national study • BC’s alcohol policy strengths and weaknesses are highlighted in comparison with other provinces and specific recommendations for improvement provided. • The 10 policy dimensions were weighted by their potential to reduce harm and reach the populations at risk. • BC ranked 2nd overall nationally with 53.4% of the ideal score (see Fig. 1), but it fared poorly on the more important policy dimensions of pricing and regulatory control system. Therefore much unrealized potential remains in BC for further public health and safety benefits. Rankings and Recommendations In order of potential for impact on harms and costs: 1. Pricing (9th): Set minimum prices to at least $1.50 per standard drink in liquor stores and $3.00 for bars and restaurants. Adjust prices to keep pace with inflation and to reflect alcohol strength 2. Control System (10th): Reduce access to alcohol through other channels (e.g. online sales and u-brew ); increase social responsibility messaging 3. Physical Availability (2nd): Restrict outlet density based on population; reduce hours of sale 4. Drinking and driving (1st): Implement all MADD Canada recommendations 5. Marketing and advertising (1st): Restrict quantity of advertisements; introduce a formal complaint process for advertising violations 6. Legal drinking age (1st): Consider increasing the legal drinking age to 21 years of age 7. Screening and Brief Intervention (1st): Seek to increase utilization by health care providers 8. Server Training, Challenge and Refusal (1st): Offer face-to-face training; require training and regular recertification for all servers; evaluate strategies to reduce service to intoxicated and underage customers 9. Provincial alcohol strategy (2nd): Develop an overarching alcohol specific provincial strategy 10. Warning labels and signs (5th): Implement mandatory warnings on alcohol containers and in all liquor outlets; create specific messages (e.g. include low-risk drinking guidelines)
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    Overdose Events in British Columbia: Trends in Substances Involved, Contexts and Responses
    (Centre for Addictions Research of BC, 2012-05) Vallance, Kate; Martin, Gina; Stockwell, Tim; Macdonald, Scott; Chow, Clifton; Ivsins, Andrew; Buxton, Jane; Tu, Andrew; Sandhu, Jat; Chu, Tim; Fair, Ben
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    Cannabis Use in British Columbia: patterns of use, perceptions, and public opinion as assessed in the 2004 Canadian Addiction Survey
    (Centre for Addictions Research of BC, 2006-09) Stockwell, Tim; Sturge, Jodi; Jones, Wayne; Fischer, Benedikt; Carter, Connie
    Overview: This bulletin examines aspects of cannabis use in BC compared with the rest of Canada, with special attention paid to potentially risky patterns of use1. Cannabis use is more widespread in BC than in the rest of Canada, and its illegal production contributes significantly to the local economy. Analysis of the 2004 Canadian Addiction Survey (CAS) suggests that 1.84 million persons in BC have tried cannabis at least once. Compared with other Canadians, significantly fewer BC respondents said they believed cannabis use should be illegal (42% versus 49%), while significantly more stated they: • had ever used cannabis in the past—53% in BC versus 44% elsewhere • experienced access to be ‘very easy’—65% in BC versus 44% elsewhere • believed both occasional and regular cannabis use to be harm–free. There was mixed evidence suggesting that this situation has led to increased levels of risky use and harm. Age of first use (18.6 years versus 18.9 years elsewhere) and rates of daily use (3% in BC and elsewhere), dependence, and of driving under the influence of cannabis were not significantly different. However, significantly more BC users reported trying to control their use, having friends express concern about their use, having combined their cannabis with alcohol, and were classified as “moderate risk users” on the WHO ASSIST scale. There was also less concern about alcohol in BC than in the rest of Canada, but more concern about heroin and methamphetamine. In general, cannabis users were more likely to be young, male, and have higher education than non-users. Overall, these results suggest that greater availability, prevalence, and acceptability of cannabis in BC than in the rest of Canada has resulted in modest increases in potentially hazardous use. It would appear cannabis is regarded in BC in a similar way to alcohol, with many using it in a relatively low-risk manner and many still underestimating its risks.
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    Alcohol Consumption in British Columbia and Canada: A Case for Liquor Taxes that Reduce Harm
    (Centre for Addictions Research of BC, 2007-12) Stockwell, Tim; Pakula, Basia; Macdonald, Scott; Zhao, Jinhui; Reist, Dan; Thomas, Gerald; Puri, Ajay; Buxton, Jane; Tu, Andrew; Duff, Cameron
    Overview • Alcohol consumption in Canada has increased by over 11% in the past decade. • Per adult absolute alcohol consumption in British Columbia has increased from 8.18 litres in 2002 to 8.53 litres in 2005. • Since 2002 the numbers of hospitalizations and neuro-psychiatric deaths attributable to alcohol in BC have increased by 11.7% and 18%, respectively. • In 2005 there were an estimated 25,194 alcohol-related injuries and illnesses in BC requiring hospitalization compared with 4,817 related to illicit drug use. • There is extensive scientific evidence to support the use of pricing and taxation strategies as effective means of reducing alcohol consumption and related harms. • In British Columbia such strategies are readily achievable because the government alcohol monopoly directly controls liquor prices. • 65% of the coolers now sold in BC contain 7% alcohol content and have an average price of $5.41 per litre, compared with $8.07 for coolers with a 5-5.9% alcohol content. • We recommend that liquor prices more closely reflect alcohol content and that these are regularly updated with the cost of living. • Beers and coolers with low alcohol content should have significantly lower price ‘mark-ups’ applied to give manufacturers, retailers and consumers incentives to produce, market and consume these products. • Minimum prices also need to be set and updated regularly to ensure there are no cheap high strength products available. • We also recommend that a “nickel a drink” tax be introduced to generate $95.7 million per annum for treatment and prevention programs. • Detailed results are available at the BC Alcohol and Other Drug Monitoring website (www.AODmonitoring.ca) Revised January 29, 2008
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    Patterns of Risky Alcohol Use in British Columbia– Results of the 2004 Canadian Addiction Survey
    (Centre for Addictions Research of BC, 2007-04) Stockwell, Tim; Surge, Jodi; Macdonald, Scott
    Overview • Drinking patterns in BC and Canada were compared against guidelines for low risk alcohol consumption using the 2004 Canadian Addiction Survey (CAS) • The low response rate (44% in BC, 47% in Canada) and other differences prevented valid comparisons with the last national survey in 1994 • The CAS greatly underestimated alcohol consumption, and reported consumption accounted for only 32% to 35% of known alcohol sales in Canada and 30% to 38% of sales in BC (depending on types of survey questions used) • It is likely that the estimates of illicit substance use reported in the CAS would similarly, or even more significantly, under–estimate actual consumption • 73% of all reported alcohol consumption was in excess of Canadian low–risk drinking guidelines and 53% was above less conservative international guidelines • Over 90% of the alcohol consumption reported by males aged 15 to 24 years was consumed in excess of Canadian guidelines and over 85% of that consumed by young females exceeded the guidelines • Just under 30% of males and 14% of females reported regularly drinking at risk levels for short–term and/or long–term harm • 40% of British Columbians at least occasionally drink above low risk levels and put themselves and others at risk of short–term harm • There were very similar levels of at risk drinking across urban, rural and intermediate regions of BC • It is recommended that improved survey methods are employed in the future to assess risky consumption patterns with an emphasis on achieving higher response rates and fuller coverage of known alcohol sales • Detailed statistical tables are available in the Appendix at http://www.silink.ca/Portals/0/Resources/AlcoholBulletin2005App.pdf
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    Adolescent Substance Use and Related Harms in British Columbia
    (Centre for Addictions Research of BC, 2009-10) Stewart, Duncan; Vallance, Kate; Stockwell, Tim; Reimer, Bette; Smith, Annie; Reist, Dan; Saewyc, Elizabeth
    The 2008 BC Adolescent Health Survey IV (N=29,440) included 50 of BC’s 59 school districts and 92% of public school students (grades 7 to 12). There have been encouraging downward trends in usage rates for alcohol, tobacco and marijuana over the past 10 years in BC. However, rates of risky use and related harms remain a significant concern, particularly among older students.
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