Reginald G. Smart

Drug use and drinking among students in 36 countries

This article summarizes data on alcohol and drug use from studies of high school students in 36 countries. Drug use levels varied greatly among countries, but alcohol and cannabis were used most often, followed by amphetamines, ecstasy, and cocaine. In countries having high levels of cannabis use, the use of other drugs was also more common but there were no consistent differences for alcohol. Use of various drugs was correlated except for alcohol use, which was related to cannabis use only when some countries with low alcohol use levels were removed. In general, the studies show that drug use priorities for studies are mainly the same in the countries studied.

Alcohol, drugs and gambling in the Ontario adult population, 1994.

Objective: To demonstrate the link between gambling, alcohol and drug problems among Ontario adults and to present information on the relationship between expenditures on gambling and type of gambling with gambling problems. Method: Using data collected in a 1994 telephone survey of 2,016 randomly chosen Ontario adults, gambling problems are related to the CAGE scale of alcohol problems and the ICD-10 measure of alcohol dependence, as well as smoking, other drug use, and demographic variables. Descriptive tables based on crosstabulations and means are provided, as well as a series of 9 logistic regression models. Results: The most significant predictor of gambling problems was the amount spent on gambling in the preceding 30 days, with alcohol dependence on the ICD-10 scale and age also important predictors. Lottery players, compared to other gamblers, are more likely to be male, relatively less affluent, older on average, more likely to report alcohol problems (but not dependence) and be currently smoking. Conclusions: The results make clear that heavy drinking and drinking problems are associated with higher levels of spending on gambling and reports of gambling problems. This leads to the suggestion that treatment programs for those with gambling, alcohol or other drug problems should assess that possiblity of comorbidity, since the presence of more than one of these problems can significantly affect the success of treatment and contribute to relapse.

Who is Using Cannabis as a Medicine and Why: An Exploratory Study

Abstract This article reports on an exploratory study of medical cannabis users. Interviews were completed with 50 self-identified medical cannabis users recruited through notices in newspapers and on bulletin boards. They reported using cannabis for a variety of conditions including HIVAIDS-related problems, chronic pain, depression, anxiety, menstrual cramps, migraine. narcotic addiction as well as everyday aches, pains, stresses and sleeping difficulties. A majority also used cannabis for recreational purposes, and many were longer-term cannabis users. However, there were some notable exceptions. Almost all smoked cannabis and many did so two to three times a day. Few admitted negative experiences with cannabis, although some problems evident to the researchers were not clearly admitted. Those who told their doctors about their medical cannabis use found doctors noncommittal or supportive. The results raise questions about the definition of medical cannabis use and about policies that might be developed to accommodate such use. Limitations of the study are noted and further research suggested. Research priorities include population surveys, studies involving larger, more representative samples of medical cannabis users and studies of medical cannabis use among people with HIV-AIDS.

Crack cocaine use: A review of prevalence and adverse effects.

Crack is a potent form of cocaine which results in rapid and striking stimulant effects when smoked. This paper reviews epidemiological research on the extent of use as well as reports of adverse effects. Crack is used by a small minority of adult and student populations but by a large proportion of cocaine users and heavy drug-using groups. Use does not appear to be increasing in general populations, but there are no trend studies for high-risk groups. Crack users tend to be young, heavy polydrug users, many of whom have serious drug abuse problems. The adverse reactions to crack are similar to those of cocaine and include effects on offspring, neurological and psychiatric problems, as well as pulmonary and cardiac abnormalities. However, two adverse reactions unique to crack have been reported. One relates to lung infiltrates and bronchospasm. The other involves neurological symptoms among children living in crack smoke-filled rooms. There is a need for improved treatment and preventive programs for crack use.

A comparison of alcohol, tobacco and drug use as determined from household and school surveys.

Comparisons of results from different types of surveys are necessary to establish the best and cheapest methods of assessing drug use. This paper reports results from a school survey and a household survey conducted in Ontario. Both surveys were done in 1983 and used unbiased samples of the population in the same age groups. There are some methodological differences between the two studies. Younger students were more likely to report the use of tobacco, alcohol and cannabis in the student survey than in the household survey. Similarly, older students (18 and 19) reported more alcohol use in the student survey. In general, the results indicate that respondents are more likely to give socially desirable answers to questions answered at home than at school. Also, alcohol and drug users may be more likely to be missed in household than in school studies as the former have a much higher non-response rate.

RISK-TAKING AND DRUG USE BEHAVIOUR: AN EXAMINATION

The purpose of the present study was to investigate the relationship between several forms of drug-use behaviour and risk-taking propensity. Jacksons (1976) risk-taking measure was employed among a sample of high school students (N = 634) selected from a province-wide probability survey on student drug use. The authors predicted that risk-taking would be associated with: (i) the dependence potential of a given drug; (ii) level of drug use; (iii) polydrug use. No conclusive evidence was found confirming the first two hypotheses; however, the data clearly demonstrated that level of polydrug use was significantly related to risk scores. The authors suggest that risk-taking as a general personality trait may more readily distinguish non-users from users of various drugs than discriminate among degrees of use in the latter.

The Effects of High and Low Fear Messages about Drugs.

This paper reports two studies of the effects of high and low fear messages about drugs. In the first study three levels of threat appeal about marijuana were used. The interaction between the value of these messages and anxiety level was examined. The second study concerned attitudes toward a non-existent drug-MOT, on the expectation that attitudes to MOT would have few extraneous influences (outside the message itself). It was found that differences among the persuasive messages were very small and insignificant. However, the effects of fear level for MOT were very large and indicate that high fear appeals are superior. Where a new drug is involved it would be expected that a high threat will discourage use more than a low threat.

Alcohol and driving factors in collision risk.

In this study we examine the effect of several alcohol-related measures on self-reported collision involvement within the previous 12 months while controlling for demographic and driving exposure factors based on a large representative sample of adults in Ontario. Data are based on the 2002-2006 Centre for Addiction and Mental Health Monitor, an ongoing cross-sectional telephone survey of Ontario adults aged 18 and older (n=8542). Three logistic regressions of self-reported collision involvement in the past 12 months were implemented, each consisting of 3 steps: (1) demographic factors and driving exposure entered, (2) driving after drinking within the last 12 months entered, and (3) one of three alcohol-related measures (AUDIT subscales of alcohol consumption, dependence and problems) entered. In each step, measures from the preceding step were included in order to control for those variables. In Step 1, age (OR=0.989), region overall, Central East region (OR=0.71), West region (OR=0.67), and North region (OR=0.67), income overall and those who did not state income (OR=0.64), marital status overall and those married or living common law (OR=0.60), and number of kilometers driven in a typical week (OR=1.00) were found to be significant predictors of collision involvement. The analyses revealed that driving after drinking was a significant predictor of collision involvement in Step 2 (OR=1.51) and each of the Step 3 models (ORs=1.52, 1.37, 1.34). The AUDIT Consumption subscale was not a significant factor in collision risk. Both the AUDIT Dependence and AUDIT Problems subscales were significantly related to collision risk (ORs=1.13 and 1.10, respectively). These findings suggest that alcohol, in addition to its effects on collision risk through its acute impairment of driving skills, may also affect collision risk through processes involved when individuals develop alcohol problems or alcohol dependence.

ROAD RAGE EXPERIENCE AND BEHAVIOR: VEHICLE, EXPOSURE, AND DRIVER FACTORS

Road rage has generated increasing public concern. Research has shown that victimization and perpetration of road rage is more common among males and younger drivers. We aimed to extend the understanding of determinants of road rage to driving exposure and vehicle factors, based on a 2002–2003 population survey of 1,631 regular drivers in Ontario, Canada. Regression analyses revealed that number of times drivers reported experiencing road rage in the previous 12 months was significantly greater for males, younger respondents, and those residing in Toronto. Also, victimization was significantly greater for drivers who did all their driving on busy roads and increased with number of kilometers driven on a typical week; however, type of vehicle driven was not significant. Number of times road rage perpetration was reported in the past 12 months was significantly greater for males, younger respondents, and those residing in Toronto, and lower for those in the Eastern and Northern region. Road rage perpetration increased significantly with number of weekly kilometers driven and was significantly greater for drivers who are always on busy roads and lower for those who never drive on busy roads, and higher for high-performance vehicle drivers. Even after controlling for driving exposure, road rage victimization and perpetration were highest for drivers in Toronto, where the pace of life may be more demanding. As expected, high-performance vehicle drivers reported more road rage perpetration. These individuals may experience more frustration when they are prevented from using the full performance capacities of their vehicles by crowded urban roadways.

Party Subculture or Dens of Doom? An Epidemiological Study of Rave Attendance and Drug Use Patterns Among Adolescent Students

Based on 1853 questionnaires derived from adolescent students participating in the 1995 Ontario Student Drug Use Survey, this article describes the prevalence of rave attendance and the drug-use profile of rave attendees and those participating in similar activities (i.e. bush parties). The results showed that 13% of the sample attended a rave during the 12 months before the survey. Although rates of drug use were higher among rave attendees than nonattendees, differences were more related to participation in other recreational activities. The drug-use pattern for one-third of rave attendees (those who did not attend similar activities, i.e., bush parties) was not dramatically different from those who attended bush parties only. However, for two-thirds of rave attendees, drug use was significantly elevated. Although rave attendance is not prevalent, experienced drug users are attracted to raves, as earlier generations of drug users were attracted to rock concerts. Consequently, although the size of this population is relatively small, the implementation of harm reduction strategies is appropriate.