Canadian Alcohol and Drug Use Monitoring Survey

Summary of Results for 2011

• Introduction
• Detailed Tables
• Cannabis Use
• Other Illicit Drug Use
• Use and Abuse of Psychoactive Pharmaceutical Drugs
• Harms related to illicit drug use
• Alcohol
• Definitions
• Reference Information

Introduction

The Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) is an on-going general population survey of alcohol and illicit drug use among Canadians aged 15 years and older, that was launched in April 2008. Derived from and similar to the Canadian Addiction Survey (CAS) of 2004, CADUMS was designed to provide detailed national and provincial estimates of alcohol and drug-related behaviours and outcomes. The following report presents results from the fourth annual CADUMS data collection which commenced in February 2011.

The results for 2011 are based on telephone interviews with 10,076 respondents, across all 10 provinces, which represent 25,957,435 Canadian residents, aged 15 years and older. Since CADUMS is an on-going survey, it allows for the examination of trends over time. As such, the current Summary of Results for 2011 presents data from the latest CADUMS with a comparison to 2010 and to estimates from the Canadian Addiction Survey (CAS) of 2004 to identify any changes that have taken place in the past 7 years. A discussion of the results from CADUMS 2011, detailed tables and some definitions used in this report are also provided.

Detailed Tables

• Table 1: Main 2011 CADUMS indicators by sex and age - Drugs
• Table 2: Main 2011 CADUMS indicators by province - Drugs
• Table 3: Prevalence of drug use and harms, total population, CAS 2004, CADUMS 2008-2011
• Table 4: Prevalence of drug use and harms, by age group, CAS 2004, CADUMS 2008-2011
• Table 5: Prevalence of drug use and harms, by sex, CAS 2004, CADUMS 2008-2011
• Table 6: Main 2011 CADUMS indicators by sex and age - Alcohol
• Table 7: Main 2011 CADUMS indicators by province - Alcohol
• Table 8: Prevalence of alcohol use and exceeding low-risk drinking guidelines, total population, CAS 2004, CADUMS 2008 - 2011
• Table 9: Prevalence of alcohol use and exceeding low-risk drinking guidelines, by age, CAS 2004 and CADUMS 2008 - 2011
• Table 10: Prevalence of alcohol use and exceeding low-risk drinking guidelines, by sex, CAS 2004 and CADUMS 2008 - 2011

Cannabis Use

The prevalence of past-year cannabis use among Canadians 15 years of age and older was 9.1% in 2011, a statistically significant decrease from 2010 (10.7%) that continues the decline in prevalence observed since 2004 (14.1%). Although there was no change in prevalence among subgroups of the population compared to 2010, the prevalence of past-year cannabis use was statistically significantly lower than in 2004 among males (12.2% versus 18.2%), females (6.2% versus 10.2%), youth aged 15 to 24 years (21.6% versus 37.0%) and adults aged 25 years and older (6.7% versus 10.0%).

In 2011, the prevalence of past-year cannabis use by youth was 21.6%, three times higher than that of adults (6.7%). Despite the decrease in prevalence of past-year cannabis use among both males and females compared to 2004, prevalence among males remained twice as high as that of females (12.2% vs. 6.2%).

Provincial prevalence of past-year cannabis use ranged from 7.9% in Ontario to 12.4% in Nova Scotia. The only province with a statistically significant year-to-year change was Ontario, with a decrease in cannabis use to 7.9% from 11.2% in 2010. Each province's past-year cannabis prevalence was compared with the average prevalence for the remaining 9 provinces. Of these, Nova Scotia (12.4%) and British Columbia (12.1%) both experienced higher than average prevalence.

The average age of initiation for cannabis use among youth 15 to 24 years of age has remained unchanged over the past 7 years at approximately 15.6 years of age.

Cannabis Use for Medical Purposes

Among those who used cannabis, 17.7% (representing about 420,000 Canadians or 1.6% of the Canadian population aged 15 years and older) reported doing so for medical purposes. Prevalence of use for medical purposes was similar between male and female cannabis users (17.3% versus 18.4%, respectively), while more than one in five (21.8%) cannabis users aged 25 years and older reported using it for medical purposes, representing 1.5% of all adults in this age group. The percentage of youth who used cannabis for medical purposes is not reportable.

Half (49.7%) of those who used cannabis for medical purposes did so mainly for chronic pain caused by conditions such as arthritis, back pain and migraines, while the remaining 50.3% used cannabis primarily for one of a variety of conditions that included insomnia, depression and anxiety. These numbers do not in any way measure or reflect enrolment in the federal Marihuana Medical Access Program.

Other Illicit Drug Use

In 2011, past-year use of the most commonly reported illicit drugs after cannabis was estimated to be less than 1% for each (hallucinogens including salvia (0.6%); ecstasy (0.7%), cocaine or crack (0.9%) and speed (0.5%)). Past-year use of methamphetamine is not reportable. The only statistically significant change noted among these substances over time was a decrease in cocaine or crack to 0.9% in 2011 from 1.9% in 2004.

In 2011, the prevalence of use of at least one of six drugs [cannabis, cocaine or crack, speed, ecstasy, hallucinogens (excluding salvia) or heroin] in the past year was 9.4%, a statistically significant decrease from 11.0% in 2010. While past-year use among males also showed a statistically significant decline (12.4% in 2011 versus 15.0% in 2010), the rate of use by males was almost double that of females (6.5%), which is unchanged from 2010. Prevalence of use was three times higher among youth (21.9%) than adults (6.9%).

Use of at least one of five illicit drugs excluding cannabis [cocaine or crack, speed, ecstasy, hallucinogens (excluding salvia) or heroin] was reported by 1.7% of Canadians. The reported rate of such use by males (2.4%) was statistically significantly higher than that reported by females (1.0%), while the rate of use by youth at 4.8% was almost five times higher than that reported by adults at 1.1%. Past-year use of at least one of five drugs excluding cannabis in 2011 (1.7%), was a statistically significant decrease from 2004 (3.0%), but not significantly different from 2010 (1.8%). Use of at least one of these drugs also decreased since 2004 among males (2.4% in 2011 versus 4.3%) and youth (4.8% in 2011 versus 11.3%).

Use and Abuse of Psychoactive Pharmaceutical Drugs

CADUMS includes questions relating to the abuse of three classes of psychoactive pharmaceutical drugs. The three classes of drugs are: opioid pain relievers, (such as Percodan®, Demerol® and OxyContin®); stimulants, (such as Ritalin®, Concerta®, Adderall® and Dexedrine®); and tranquillizers and sedatives, (such as Valium®, Ativan® and Xanax®). While these drugs are prescribed for therapeutic purposes, they have the potential to be abused due to their psychoactive properties. To provide a baseline on overall use, including therapeutic use, respondents were asked whether or not they had used opioid pain relievers, stimulants, or sedatives.

A statistically significant decline was seen in psychoactive pharmaceutical use between 2011 (22.9%) and 2010 (26.0%), which was driven by a statistically significant decrease in the use of opioid pain relievers to 16.7% in 2011 from 20.6% in 2010. There were no significant changes in the rates of past-year use of stimulants or sedatives. Use of psychoactive pharmaceuticals was higher among females (25.5%) than males (20.2%) and among adults aged 25 years and older (23.9%) than youth 15 to 24 years of age (17.6%).

Among those who had used these drugs, further questions were asked to determine whether the drugs were used for more than prescribed therapeutic purposes. Previous CADUMS results reported on the use of psychoactive pharmaceuticals for the experience, the feeling they caused or to get high. In 2011, questions were added to determine whether opioid pain relievers or stimulants were being abused for other purposes. Past-year users of opioid pain relievers were asked whether they used pain relievers to feel better, to cope with stress or problems or for any other reason. Past-year users of stimulants were asked if they ever used stimulants for other reasons, such as, to study, stay alert or decrease appetite. For these two classes of drugs, the new definition of abuse now being applied includes "to get high" from previous years as well as use for other reasons.

In 2011, 22.9% of Canadians aged 15 years and older indicated they had used a psychoactive pharmaceutical in the past year and 3.2% of these users (corresponding to 0.7% of the total population) reported they abused such a drug. The 2011 rates of abuse should not be compared with 2010 rates that were based on "to get high" only. When the 2010 definition of abuse is applied to the 2011 data (and "other reasons" are excluded) the 2011 rate drops to 1.5% (corresponding to 0.3% of the population), which is unchanged from 2010 estimate.

Of the three categories of pharmaceuticals, opioid pain relievers were the most commonly used in 2011, with one in six (16.7%) Canadians aged 15 years and older reporting their use in the 12 months preceding the survey. The rate of abuse of opioid pain relievers is unreportable.

Almost one in 10 Canadians (9.1%) reported using sedatives or tranquilizers in the past year. Abuse of sedatives is measured by use for the experience, the feeling they cause or to get high. Abuse of sedatives is not reportable.

The use of stimulants in the past year was reported by 0.9% of Canadians, and the rate of abuse is not reportable.

The abuse of dextromethorphan, an active ingredient found in many over-the-counter cough suppressant cold medicines, was monitored for the first time in 2011. Less than 1% (0.7%) of Canadians aged 15 years and older reported past-year use of a cold or cough medicine for non-medicinal reasons, that is: only for the experience, the feeling it caused or to get high. Dextromethorphan abuse was reported by 0.9% of adults, while abuse among youth is not reportable. There was no difference in prevalence of abuse between males (0.9%) and females (0.6%).

Harms related to illicit drug use

In 2011, 1.8% of Canadians aged 15 years and older reported experiencing at least one harm in the past year due to their illicit drug use, a rate that is statistically significantly lower than in 2004 (2.8%). Youth 15 to 24 years of age were approximately five times more likely than adults aged 25 years and older to report harm due to drug use, with 5.8% of youth reporting such harm, compared to 1.1% of adults. Among current users of any drug, which has included abuse of psychoactive pharmaceuticals since 2008, the reported rate of past-year harm has not changed since 2004, with approximately one in six (17.6%) users reporting having experienced some harm in the past year due to their drug use.

Alcohol

Prevalence of Alcohol Use

In 2011, 78.0% of Canadians reported drinking in the past year, a rate not statistically different from that reported in 2010 (77.0%). Since 2004 there has been a statistically significant decrease in past-year alcohol use among youth 15 to 24 years of age, to 70.8% in 2011 from 82.9%. A significantly higher proportion of males than females reported past-year alcohol use (81.9% versus 74.3%, respectively) in 2011, while the prevalence of past-year drinking among adults (79.3%) was significantly higher than among youth (70.8%).

Provincial rates of current drinking ranged from 72.7% in Prince Edward Island to 81.7% in Quebec. The only statistically significant change in past-year alcohol use was in Alberta, where the percentage increased to 80.0% from 73.8% in 2010. Each province's past-year alcohol prevalence was compared with the average for the remaining nine provinces. Three provinces had lower than average prevalence (Prince Edward Island (72.7%), New Brunswick (73.3%) and Nova Scotia (73.8%)), while the prevalence of past-year alcohol use in Quebec (81.7%) was higher.

Low-risk Alcohol Use

In November 2011, the Canadian federal, provincial, and territorial health ministers received  Canada's Low-Risk Alcohol Drinking Guidelines, which consist of five guidelines and a series of tips. These guidelines are an update to those previously published in 1997. Guidelines 1 and 2 are explained in the definitions section below.

The first two guidelines apply to all Canadians and address long-term (chronic) effects (guideline 1) like liver disease and certain cancers, and short-term (acute) effects (guideline 2) such as injuries and overdoses. The percentages of Canadians who exceeded the guidelines are reported below. People who drink within the low-risk alcohol drinking guidelines consume no more than the recommended quantity of alcohol within the number of days specified, whereas those who exceed the guidelines consume more alcohol than recommended within the stated timeframe.

Among people who consumed alcohol in the past 12 months, 18.7% (representing 14.4% of the total population) exceeded the guideline for chronic effects and 13.1% (10.1% of the total population) exceeded the guideline for acute effects. A higher percentage of youth drinkers aged 15-24 years (18.1%) than adult drinkers aged 25 years and older (12.2%) exceeded the acute-risk guideline, while there was no significant difference between these groups for exceeding the chronic-risk guideline. Significantly more males than females drank in patterns that exceeded both guidelines. The chronic-risk guideline was exceeded by 22.3% of male drinkers and 15.0% of female drinkers, while the acute-risk guideline was exceeded by 16.6% of male drinkers and 9.5% of female drinkers.

Definitions

The terms used above have the following definitions:

Prevalence

- the proportion of a group or population reporting the indicated behaviour or outcome, usually expressed as a percentage.

Past-year use

- reported use in the 12 months preceding the interview.

Age of initiation

- the age at which a person first used alcohol or a drug.

Harm

- Drug related harms include harms in any of the following 8 areas: physical health; friendships and social life; financial position; home life or marriage; work, studies or employment opportunities; legal problems; difficulty learning; and housing problems.

Low-risk drinking guideline 1

(chronic) - People who drink within this guideline must drink no more than 10 drinks a week for women, with no more than 2 drinks a day most days and 15 drinks a week for men, with no more than 3 drinks a day most days. Plan non-drinking days every week to avoid developing a habit.

Low-risk drinking guideline 2

(acute) - Those who drink within this guideline must drink no more than 3 drinks (for women) and 4 drinks (for men) on any single occasion. Plan to drink in a safe environment. Stay within the weekly limits outlined in Guideline 1.

Reference Information

The Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) is an on-going general population survey of alcohol and illicit drug use among Canadians aged 15 and older, sponsored by Health Canada. It was developed in collaboration with the Centre for Addictions and Mental Health (CAMH), the Centre for Addiction Research - British Columbia (CAR-BC), Alberta Health Services (formerly, Alberta Alcohol and Drug Abuse Commission), Manitoba Health, the Centre québecois de lutte aux dépendances (CQLD), and the Canadian Centre on Substance Abuse (CCSA). Designed to provide annual national and provincial estimates of alcohol and drug-related behaviours and outcomes, CADUMS was launched in April 2008.

Within each year, the targeted number of CADUMS interviews to be conducted by telephone is 1,008 per province, randomly selected to produce a national survey of 10,080 interviews annually. Due to methodological issues, the territories are not included in the survey. For the 2011 calendar year, the final sample was 10,076 respondents, representing approximately 25,957,435 Canadians aged 15 and older. The response rate for the 2011 CADUMS was 45.5%, similar to the rate of 44.4% in 2010. For purposes of this report only univariate and bivariate analyses were conducted, with statistical significance being determined by confidence interval overlap for 2011 to 2004 comparisons, and t-testing for 2011 to 2010 comparisons. The data presented in this report have been weighted to allow the results to be generalized to the Canadian population. Should you wish further details on the survey methodology, a technical guide will be available upon request after August 1, 2012.

For more information about the survey and its results, please write to the Office of Research and Surveillance, Controlled Substances and Tobacco Directorate, Health Canada, 123 Slater Street, Address Locator 3506D, Ottawa, ON, K1A 0K9, or send an e-mail request to ORS_BRS@hc-sc.gc.ca.