stakeholder views of crystal meth use in alberta€¦ · stakeholder views of crystal meth use in...

Stakeholder Views of Crystal Meth Use in Alberta

Dr. Cameron Wild Addiction and Mental Health Research Lab

Centre for Health Promotion Studies, and Department of Public Health Sciences

Meth Scan

Overview

1. Background: Why is it so hard to determine the extent of any drug problem?

2. Community Perception Survey � Method, respondents � Meth use and associated risks � Priority actions and targets

3. Summary and main conclusions

Background

Substance abuse impacts every aspect of modern life, butis also difficult to study because:

� of the great variety of drugs available for abuse (licit andillicit)

� of the great variety of subpopulations that use and abuse drugs: some obvious, others very ‘hidden’

� of the fact that drugs are simultaneously � pharmacological agents (they affect our brains to modify our

feelings, thoughts, behaviour)

� articles of commerce (they’re bought and sold)

� powerful cultural symbols (about morality, lifestyle, etc)

Background

Any drug-using population will consist of several subgroups…

Use Abuse/ Problems

Formal TreatmentDependence

…so the size of any ‘drug problem’ depends on the subpopulation of interest!

Background

Different systems collect information on substance abuse problems…

Drug Use

Enforcement

Addiction Treatment

Health Services Medical Examiner

Population Surveys

Social Services

…so the size of any ‘drug problem’ also depends on who is asking the question and recording the information!

Background

It is vital to understand that any data source has limitations for inferring the extent of drug use, abuse, and problems

� Primary data: often obtained via self-report. Subject to selection bias, memory bias

� Secondary data: data reflects priorities of the stakeholder agency and is typically not representative

All data are imperfect indicators of drug problems, but by using the same (fallible) indicators over time, trends can be seen

Background

Canada (in general) and Alberta (in particular) does a fairly poor job of routinely collecting information on substance use, abuse, and dependence

Main barriers 1. Administrative data systems that: � Don’t talk to each other � Weren’t built to address substance abuse specifically � Have the interests of their main business at the forefront

(e.g., policing, health care, social work, addiction treatment)

2. Little primary research/population survey work

Background

� There is generally a poor empirical base upon whichto judge the extent of crystal meth use, abuse, anddependence

� However, there are some existing studies that can besummarized

Meth Use in the General Population� USA: National Household Survey on Drug Abuse

showed 4% of the general population have tried methin their lifetime (Cretzmeyer et al., 2003)

� NZ: 5% of a representative sample of over 5000respondents aged 15-45 reported using stimulants(including meth) in their lifetime (Wilkins et al., 2004)

� Alberta: Our lab conducted a phone-based survey of3500+ Alberta adults in 2002, showing that…

Background

il lts (2002)

0 2 4 6 8

j

i i

i

i

ll

in

le

Drug Use in previous 12 months n a Representative Sample of A berta Adu

12.5

5.1

3.1

0.7

0.1

1.7

1.6

10 12 14

Mari uana

Pa nk llers

Sedat ves

Amphetam nes

Cocaine

Ha ucinogens

Hero

Percentage of Samp

Background

Meth use in subpopulations � A secondary analysis of student surveys from 36

countries found drug preference order was: (1)alcohol, (2) cannabis, (3) hallucinogens andamphetamines (Smart, 2000) � A 1996 report stated that 64% of high school

seniors in the US could easily obtain meth (U.S.Department of Justice) � Drug use at dance/rave parties in the gay

community: 36% of men use crystal meth atdance parties: � Ecstacy (75%), ketamine (58%), crystal meth

(36%; Mansergh et al., 2001)

Background

Meth use in subpopulations (Alberta)

� AADAC’s Youth Experience Survey reported that 5.3% of grade 7-12 respondents said they used ‘club drugs’ (including both ecstacy and/or crystal meth) in the year preceding the survey (2.7% for grades 7-9 vs. 7.6% for grades 10-12) � Some 8.1% of 400 Edmonton-area street youth

reported using crystal meth at least once (Edmonton CCENDU report, 2001-2002)

Background

Meth use from the perspective of health services � US treatment admission rates for meth abuse per

100,000 population have increased over time(Yudko et al., 2003):

� 1993 – 14/100 000 � 1996 – 24/100 000 � 1999 – 32/100 000

� Of US ER department admissions in 2002 forabuse of club drugs, meth accounted for largestshare (Yudko et al., 2003) � No ability to share Alberta-wide statistics

Background

Addiction Treatment Services (B.C.) � % clients seeking assistance for meth-related

problems � 1999 – 4% � 2003 – 11% (BC Ministry of Health services, 2003)

Background

Addiction Treatment Services (Alberta)

� Drugs Used in Previous 12 months (Proportions of AADAC clients, 2002-2003 fiscal year) � Alcohol: Alberta = 74.8%; Edmonton = 75.3% � Cannabis: Alberta = 46.1%; Edmonton = 46.0% � Cocaine: Alberta = 28.5%; Edmonton = 39.3% � Heroin/opiates: Alberta = 19.6; Edmonton = 24.6% � Hallucinogens: Alberta = 13.6%; Edmonton = 11.7% � Amphetamines/stimulants: Alberta = 11.9%; Edmonton = 16.5%

� Some 6.2% of adult clients seeking treatment at Alberta-wide AADAC programs reported amphetamines as their primary drug of concern (10.2% for Edmonton-area services)

� Among Edmonton-area youth attending AADAC programs, amphetamines are reported by 12.3% of clients as their drug of concern (second only to cannabis)

Background

Enforcement (Alberta)

� In 2002, RCMP opened 164 methamphetaminetrafficking files in Alberta, 12 times the number fiveyears ago (Purdy, 2003)

� Edmonton Police Services reports increases in drugseizures and charges in relation to crystal meth fromthe period 1999 - 2003

Background: Summary

� The extent to which crystal meth is being used and abused varies greatly by region, population being studied, and data source. Tentative summary: � Amphetamine use (and meth/crystal meth use in particular)

is low in most general population surveys � Fairly consistent pattern of drug preferences in the general

population: amphetamines typically the 4th most widely useddrug after alcohol, cannabis, cocaine and heroin

� But there is evidence of increased use and abuse amongsubpopulations (e.g., dance culture, gay communities, youth)

� Some indication that problems associated with crystal meth use are being seen with increasing frequency in health services

� Clear indication of increasing problems associated with crystal meth from the enforcement/policing side

Survey: Role of CCENDU

� CCENDU = Canadian Community EpidemiologyNetwork on Drug Use

� CCENDU starts from the premise that it is extremelydifficult to get a comprehensive picture of drug use inany given jurisdiction; CCENDU was designed to fillthis gap

� CCENDU has sites in Vancouver, Edmonton, Winnipeg, Toronto, Montreal, Halifax, St John’s (NB),and is expanding with NCPC funds

� U of A Addiction and Mental Health Lab hosts the Edmonton CCENDU site

� Edmonton CCENDU site was invited to participate inthis process

Survey: Methods

� Invitations were sent to 1700+ individuals representing a broad cross-section of Albertastakeholders interested in the issue of crystal meth use

� Data collected from 3rd week of July 2004 to August30, 2004 (some surveys still incoming)

� Low (< 30%) response rate, plus selective invitationsmean that the survey results are not representative ofall stakeholders

� However, broad regional and professionalrepresentation was obtained

Survey: Methods

Online (web-based) survey consisting of 4 parts:

� Demographics � Perceptions of community assets and risks � Perceptions of meth use and associated risks

in one’s community � Views on appropriate community responses to

meth use (division of effort, resources, priorities)

Survey: Respondents

As of August 30, 2004: 435 respondents completed the survey

� 199 women � 225 men � M age = 42.8 years (SD = 10.98)

Survey: Resopndents

• North (includes GrandePrairie & Ft. McMurray): n =99 (23%)

• Edmonton (and area): n =126 (30%)

•• Central (includes Red Deer):Central (includes Red Deer): n = 102 (24%)n = 102 (24%)

•• Calgary (and area): n = 52Calgary (and area): n = 52 (12%)(12%)

• South (includes Lethbridge &Medicine Hat): n = 45 (11%)

Survey: Respondents

(

0 5 10 15 20 25 30

i

i

i

ial i

i

Respondents by Professional Role N =435)

26.5

17.6

16.3

15.5

14.4

9.6

Health Serv ces

Enforcement/Just ce

Government

Commun ty

Soc Serv ces

Educat on

Percentage of Sample

Perception of the Problem

13.7

0

10

20

30

40

l l

Agreement that 'There is a problem with crystal meth use in this community'

25.4

35.7

4.4

20.6

32.7

Tota Calgary Edmonton South Centra North

Area

Perc

enta

ge


0 0 2 4 6 8

10 12 14

l l

Agreement that 'This community is unsafe because of crystal meth use'

7.3

12.7

2.2

4.9

7.3


Area

Perc

enta

ge


11.5 6.7

25.7

0 5

10 15 20 25 30 35

l

Agreement that 'Crystal meth is easy to access in this community'

24.5

32.8 27.6

Total Calgary Edmonton South Centra North

Area

Perc

enta

ge


)

13 16.3

0

5

10

15

20

25

l

Estimated Percentage of the Community Using Crystal Meth (Ever

14.99

10.8

19.2

9.2

Total Calgary Edmonton South Centra North

Area

Perc

enta

ge


g y g Cry)

13.8

5.4

0

5

10

15

l l

Estimated Percenta e of the Communit Usin stal Meth (Regularly

9.35 7.5 7.2

9.2


Area

Per

cent

age

Contributing Factors

Top 4 perceived contributing factors to crystal meth use: � Low cost of crystal meth (78% agreement) � Peer pressure (77% agreement) � Easy access to meth (75% agreement) � Boredom (73% agreement)

Bottom 4 perceived contributing factors to crystal meth use: � Poor communication skills in community (46%

agreement) � Unemployment (43% agreement) � Low police visibility (42% agreement) � Importation of meth from elsewhere/USA (42%)

Harm

� Most respondents thought meth was harmful or very harmful to users in relation to: � Addiction (93% agreed that this is a harm) � Physical Health (92% agreed about harm) � Mental Health (92% agreed about harm) � Home life and relationships (92% agreed about

harm)

� In fact, 98.1% of all respondents agreed that the consequences of crystal meth use are more harmful than for other drugs (alcohol, cannabis, hallucinogens)

Harm

� Respondents uniformly believed that crystal methproduction contributes to harms in the community: � Level of violence (91% agreed that meth labs

contribute) � Level of crime (93% agreed that meth labs

contribute) � Level of fear and anxiety (88% agreed that meth

labs contribute) � Damage to physical environment (83% agreed

that meth labs contribute) � Damage to health of community members (88%

agreed that meth labs contribute)

Responses to Crystal Meth

l i

46.3

32.3

44

22.7

33.3

0

10

20

30

40

50

Agreement that Crystal Meth Should be Dea th W th as a Separate Drug

38.4

Total Calgary Edmonton South Central North

Area

Perc

enta

ge


56

0

20

40

60

80

100

l l

Agreement that Crystal Meth Should be Dealth With as Part of an Overall Alcohol/Illicit Drug Strategy

61.6 66.7 53.7

77.3 61.6


Area

Perc

enta

ge


( )

29.7

i ion

Percentage of Resources Money, Staff, Time Directed to Community Responses to Crystal Meth That Should Go To...

30.3 39.7 Enforcement

Treatment Educat on/Prevent


Top 4 activities believed to be effective � Youth activities, e.g., rec programs (77% believe

they are effective) � School-based activities, e.g., drug education (76%

believe they are effective) � Social support activities, e.g., peer mentoring

(75% believe they are effective) � Creating a drug strategy, e.g., developing goals,

objectives, action plan (69% believe this would be effective)


Bottom 4 activities believed to be effective � Career-training programs (60% believe this is

effective) � Community activities, e.g., local theatre (55%

believe this is effective) � Cultural activities, e.g., heritage days (44% believe

this is effective) � Alternative sentencing for users caught (40%

believe this is effective)


94.7

62.2

49.9

0

Hi i

Hi l

il

i

Percentage Agreeing that this group should be the 'highest priority' for receiving education, interventions, program s

86.6

69.2

51.3

49.1

20 40 60 80 100

Youth (13-18)

gh-r sk youth

Young adults

gh-risk adu ts

Ch dren (0-12)

Famlies

Communities

Percentage of Sample

What’s been done

� Some 45% of participants reported that they knew of activities that were directed at reducing harms related to crystal meth use in their communities � Examples: DARE program, AADAC activities,

seminars, meth lab detection training, drug task force

Community Resources

Respondents reported substantial agreement that theircommunities have assets

� 90% agreement that streets are safe (day) � 87% agreement that police help when needed � 82% agreement that people living here have skills to

work � 81% agreement that there is community spirit � 53% agreement that people are bored � 26% agreement that people feel frightened

Summary and Main Conclusions

Summary: In this sample of stakeholders…

� There is unanimous agreement about risksassociated with crystal meth use and production(everyone agrees it’s harmful to users and thoseexposed to production)

� There is unanimous agreement that crystal meth ismore harmful than alcohol and other illicit drugs

� But overall, only about 25% of stakeholders acrossthe province believe that crystal meth is currently aproblem in their communities � Support for the view that meth is currently a

problem is highest in Edmonton and the north,lowest in Calgary and the south



� Estimated rate of crystal meth use (ever) incommunities is about 15%

� Estimated rate of regular crystal meth use incommunities is about 9% � Estimated rates are highest for youth (12-17) and young

adults (18-24) � Low cost, easy access, peer pressure, and boredom

are believed to be the main factors contributing tometh use



� Most (62%) believe that crystal meth should behandled as part of a more comprehensive strategy toaddress alcohol and illicit drug use – this judgement held up across enforcement, health, social services,education, government, and community members

� Resources to the issue should be divided up between prevention/education (40%), enforcement (30%) andtreatment (30%)

� Youth (13-18 years) and young adults (19-25 years)are believed to be the highest priority target groups,both in the general population and among high riskgroups (e.g., unemployed, homeless, etc.)



� Activities believed to be most effective in local communities include � Recreation programs, drug education programs,

peer mentoring programs, and a comprehensive drug strategy

� Respondents generally believe that communities possess good assets/resources


Conclusions

� Administrative data sources aren’t currently built toprovide timely information on alcohol/drug use (letalong meth use and abuse). Information infrastructure is required in order to discern trendsover time

� Stakeholders don’t need further, extensive education on the dangers and risks associated with meth use

� Stakeholders want a comprehensive alcohol/drugstrategy, rather than a strategy focused specificallyon meth

� Coordination and integration of prevention,enforcement, treatment activities is required

Thank you!

Addiction and Mental Health Research Laboratory is supported by:

Canadian Institutes of Health Research

stakeholder views of crystal meth use in alberta€¦ · stakeholder views of crystal meth use in...

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