1. SUBSTANCE USE IN TORONTO 1Running head: SUBSTANCE USE IN TORONTO Substance Use in Toronto, Ontario, Canada Assignment 2: Module 2 Submitted to: Dr. Mark Welty Date: October 31, 2012 Prepared by: Jennifer Ouellette Substance Abuse Counseling | FP6900 A01 Argosy University
2. SUBSTANCE USE IN TORONTO 2 Substance Use in Toronto, Ontario, Canada Located on the Northwest Shore of Lake Ontario (the 8th largest fresh-water lakein the world), Toronto, Ontario Canada, has 2.7 million residents and one of the worldsmost diverse and multicultural populations. Toronto is in plant hardiness zone 6, and onthe eastern edge of the Carolinian Forest zone (Toronto, 1998-2012). There areapproximately 10 million trees in Toronto and more than 1,600 parks which spanapproximately 8,000 hectares of land (Toronto, 1998-2012). Nevertheless, among all this beauty and nature is a dark side, as with all big citiesin North America or even around the World, Toronto struggles with economic issues justthe same. It is estimated that as of May 2011, there were 400 homeless people living onthe streets and approximately 5,086 homeless in total. Shelters were used by 22,276people with only 56 homeless shelter facilities available (Toronto, 2011) and some of theharshest weather conditions. In 2010, the unemployment rate was 10%, which is quite high, the youthunemployment was even higher at approximately 18%. It is estimated that in 2010,160,000 people were unemployed and only 40,000 were able to receive EmploymentInsurance assistance (less than 25% of the unemployed). Toronto has a higherconcentration of poverty than its surrounding areas with 1 in 6 families living in poverty. Unfortunately, high levels of unemployment, homeless, and poverty cause peopleto want to make more money and/or become depressed. In the author’s opinion, these arethe very reasons people turn to drugs. Drug abuse affects everyone, from children to the
3. SUBSTANCE USE IN TORONTO 3elderly. It has been noted in many studies that drugs are related to criminal behavior andso on down the road. The illicit drug market in Toronto is booming. Police are seizingtonnes of this crap from Toronto, where it is being shipped across borders into othercountries. Despite efforts to make drugs illegal, to warn people of the side-effects, and totreat people with addiction, drugs still remain as big of an issue as ever.3–4 commonly used drugs in Toronto, Ontario, Canada (ingredients) According to the Research Group on Drug Use, current trends in substance abusereveal alcohol, marijuana and “designer” drugs as the top used substances amongTorontonians (Toronto, 2002). In Toronto, 78% adults indicated using alcohol in the pastyear (CAMH, 2004). In a student survey, 61.5% of the 6,616 students surveyed admittedto using alcohol at least once in the past year; and approximately 26.5% of the studentsreported binge drinking (more than 5 drinks on one occasion) in the past year (CAMH,2004). Marijuana is one of the top illicit drugs used in Toronto. In a study completed bythe Canadian Association of Mental Health, 15% of our adults, 25% of our students(CAMH, 2004), and 72% of our street youth (Toronto, 2002) have reported usingmarijuana in the past year. “Designer drugs” are also becoming quite popular in Toronto. Designer drugs aremixtures of the popular drug ecstasy, examples of these Designer drugs are MDMA, andPMA (Toronto, 2002). Designer drugs caused 27 known deaths in Toronto from 1999 to2002 (CAMH, 2004). Current statistics report that 4% students and just under 3% adultsreport using Designer drugs (CAMH, 2004)(Toronto, 2002). In a hospital emergency
4. SUBSTANCE USE IN TORONTO 4study, 10.4% of the patients reported using one or more "Designer drugs" within 24 hoursof their visit, these included Ecstasy, GHB or Ketamine (Toronto, 2002).Effects and symptoms for each drug: both short-term and long-term effects Toronto’s youth often drink alcohol in excess. Older youth tend to pre-drinkbefore going out to a club or bar. Alcohol is a suppressant, it loosens the muscles andreduces activity of the central nervous system, causing loss of fine-motor coordinationand a staggering gait (Indiana University, 1995). Excessive alcohol intoxication candecrease heart rate, lower blood pressure, breathing, and result in poor reflex reactions.Some facts from Indiana University reveal the following symptoms after a certain levelof alcohol intoxication is reached: a Blood Alcohol Concentration (BAC) of 0.10-0.125impairs motor coordination and good judgement, affects speech, poor balance, blurredvision, delayed reaction time and impaired hearing. Driving a motor vehicle is illegal atthis level of intoxication. With a BAC of 0.13 to 0.15, symptoms continue as above, buteuphoria dissipates and dysphoria sets in, which is a feeling of anxiety and restlessness.A BAC of 0.16 to 0.20 continues the symptoms, making the person quite sloppy,dysphoric and nauseated. A person with a BAC of 0.25 now requires assistance withwalking and is now in a state of total mental confusion, dysphoria with nausea and somevomiting usually occurs. A 0.30 BAC causes further loss of consciousness and, worse, a0.40 BAC and up will cause a coma and possible death due to respiratory arrest (IndianaUniversity, 1995). Binge drinking and alcohol addiction cause many health problems, including, butnot limited to, alcohol poisoning, high blood pressure, stroke, heart disease, liver disease,
5. SUBSTANCE USE IN TORONTO 5damage to nerves, sexual problems, permanent brain damage, deficienct Vitamin B1(amnesia, apathy and disorientation), ulcers, inflammation of stomach walls,malnutrition, and mouth or throat cancer (Foundation for a Drug-Free World, 2006–2012). The next most common drug in Toronto is marijuana. Marijuana is derived fromthe Cannabis sativa plant, it comes in clumps of dry, shredded green and brown mix offlowers, stems, seeds, and leaves. There are approximately 400 different chemicals inmarijuana, but the main active chemical is delta-9-tetrahydrocannabinol (THC). The only reported deficits related to marijuana use are a decline in attention andmemory abilities (Levinthal, 2008) and, the inhalation process, which obstructs breathing.One marijuana joint is said to be the equivalent of (up to) five tobacco cigarettes(Levinthal, 2008). However, no evidence has linked marijuana smoking to increased lungillnesses or risks thereof. The biggest concern with marijuana is the effect of drivingunder the influence of this drug (Toronto, 2002). It is said to cause impairments invisibility, reaction time, and coordination, which can significantly affect driving ability. According to the Canadian Association of Mental Health (CAMH), afterMarijuana, Ecstasy and Ketamine are very popular among Torontonians. These drugs areconsidered “designer” drugs. Ketamine although legal for its intended use, is a veterinaryanesthetic and is often classified as a “designer” drug because it is used in combinationwith other drugs. It can be bought in liquid and powder form and is taken orally, injected,smoked or snorted (CAMH, 2004). While using Ketamine, and for several weeks afterusing, psychological difficulties will occur such as confusion, depression, insomnia,
6. SUBSTANCE USE IN TORONTO 6craving, anxiety, and paranoia. The physical changes associated with Ketamine useinclude muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eyemovement, fever, chills or sweating (ACDE, 2001). Ecstasy or, more technically, MDMA, a chemical found in Ecstasy, was originallyan appetite suppressant and psychiatric drug that became illegal in 1985. It is normallysold in pill form and it can be injected or, less popular, crushed and snorted. It is quickacting, it speeds up the nervous system and enhances mood. The effects of Ecstasy canlast for 4 - 6 hours or longer. Toxicity, consequences, and symptoms of Ecstasy are often difficult to measurebecause of different drug sources, chemicals and agents used to manufacture them, aswell as the possibility of contaminants in those chemicals (American Council for DrugEducation, 2001). However, the American Council for Drug Education has put together alist of effects normally felt by a person using Ecstasy, these effects are: rapid heart rate,higher body temperature, elevated blood pressure, nausea, anxiety, feelings of euphoria,excessive sweating and no appetite. If a user takes a higher dose than his or her body canhandle, the drug can cause convulsions, irrational behavior, and hallucinations (TheAmerican Council for Drug Education, 2001). After taking Ecstasy, users have reportedinsomnia, anxiety, paranoia, concentration and depression (The American Council forDrug Education, 2001). Ecstasy is a “Schedule 1” controlled substance alongside heroin, cocaine, andLSD. The fine for possession, dealing or manufacturing Ecstasy can be as high as
7. SUBSTANCE USE IN TORONTO 7$100,000 and up to 99 years or life in prison, depending on the amount (AmericanCouncil for Drug Education, 2001). If the user overdoses, he or she will start to feel hot and ill, complain of aheadache, racing heart, feeling faint, tremors and unable to urinate; he or she will becomeconfused and speak weird. If medical attention is not sought, asphyxiation and death byhyperthermia, hyponatremia, and over stimulation of the nervous system (causing heartattack or brain hemorrhage) can occur. The long term effect of Ecstasy use is memory loss and, because it depletesserotonin, sleeping, eating, thinking, behavior, sexual function, and sensitivity to pain arealso affected (American Council for Drug Education, 2001).Toronto: Relating the Community with the Popular Drugs • The most commonly used drugs for which youth seek treatment are alcohol andcannabis which are available pretty much anywhere in the world. The other most commonly used drugs, the “designer” drugs, have actually beencoming from Toronto, so there is an abundance of these drugs in this city. Toronto,unfortunately, has been found to be one of the leading exporters in “designer” drugs asColombia is for cocaine (Godfrey, 2012). From ecstasy to methamphetamines, tonneswere found by the police being shipped abroad after being made in the Greater TorontoArea (Godfrey, 2012). Young people like designer drugs because they are cheap, one pill is usually 50cents to make and is sold for sometimes $15. The effects of these drugs can last for many
8. SUBSTANCE USE IN TORONTO 8hours, they look harmless, and they are easily hidden; consequently, adding popularity tothese drugs. Unfortunately, drugs often start out as “experiments”, but because of thechemicals, individual reactions, and genetic make-up of an individual, he or she maydevelop an addiction to the drug and continue to use it. This addiction can lead to seriousconsequences, physically, emotionally, and socially; therefore, it is important to look athow substance abuse can be corrected and treated.Treatment Options When treating for substance abuse, the goal is to prevent re-lapse. Treatmentaims at minimizing risk factors and maximizing resilience. An individual going throughtreatment experiences five distinct “stages of change.” (Levintal, 2008). These are:“precontemplation, contemplation, preparation, action, and maintenance.” (Levinthal,2008, p. 405). A good treatment program will recognize these changes. Also, atreatment program that has different cultural perspectives would be ideal, so that theindividual can relate his or her problem to their cultural understanding. A successful treatment for abuse of Alcohol and Marijuana would be alternative-behavior programming; the patient learns to trade the negative dependence (on alcohol ormarijuana) that harms him or her to a positive dependence. The positive dependencealternative causes no harm and is enjoyed (Levinthal, 2008). An Alcoholics Annonymousprogram that has group counseling is a good idea for alcohol dependence. For Marijuana,a good remedy for quitting tobacco smoke would be a good treatment for marijuanaabuse and dependence because the withdrawal effects are similar to tobacco withdrawal.
9. SUBSTANCE USE IN TORONTO 9 For long terms users of the “designer” drugs, the withdrawal symptoms can besevere and cause medical complications. Treatment programs for “designer” drugs shouldoffer sedatives, counseling, behavior modification, and detoxification. Aiming to reducethe risks of detoxification over time (Addiction Search, 2012). Any healing process takes time and the person that is healing should be madeaware of this. The treatment should be seen as a healing process and just like any otherhealing process, it takes time to fully recover. Therefore, a good substance abusetreatment program will acknowledge this and allow the patient to recover at his or herown pace.
10. SUBSTANCE USE IN TORONTO 10 ReferencesAddiction Search (2012). Ecstasy addiction, abuse, and treatment. Addiction Search. Retrieved on October 31, 2012 from http://www.addictionsearch.com/treatment_articles/article/ecstasy-addiction- abuse-and-treatment_31.htmlAmerican Council for Drug Education. (2001). Ecstasy. Basic Facts About Drugs. American Council for Drug Education. Retrieved on October 31, 2012 fromhttp://www.acde.org/common/ecstasy.htmCanadian Association for Mental Health. (CAMH). (2004). Drug Use by Population. Drugs 2004 Section 1A and 1B. Retrieved on October 30, 2012 from http://www.toronto.ca/health/rgdu/pdf/rgdu_2004_drug_use_in_the_mainstream_ population.pdfFoundation for a Drug-Free World. (2006–2012). Alcohol. Drug Facts. The Truth About Alcohol. Foundation for a Drug-Free World. Retrieved on October 30, 2012 from http://www.drugfreeworld.org/drugfacts/alcohol/short-term-long-term- effects.htmlGodfrey, T. (2012). Exclusive: Canadas illicit drug export boom. Toronto Sun Newspaper, January 28, 2012. Retrieved on October 30, 2012 from http://www.torontosun.com/2012/01/28/exclusive-canadas-illicit-drug-export- boom
11. SUBSTANCE USE IN TORONTO 11Indiana University. (1995). Effects of Alcohol Intoxication. University of Indiana. Last updated April 3, 1995. Retrieved on October 30, 2012 from http://www.indiana.edu/~adic/effects.htmlLevinthal, C. F. (2008). Chapter 10: Marijuana. Drugs, Society and Criminal Justice, 3/e XML VitalSource eBook for Education Management Corporation, 3rd Edition. Pearson Learning Solutions.Toronto (2011). Quick Facts. Shelter, Support & Housing Administration, May 2011. Toronto, Ontario, Canada. Retrieved on October 30, 2012 from http://www.toronto.ca/housing/pdf/quickfacts.pdfToronto. (2002). Report on Drug Use in Toronto. May 16, 2002. Access Toronto. Toronto, Ontario, Canada. Retrieved on October 28, 2012 from http://wx.toronto.ca/inter/it/newsrel.nsf/9da959222128b9e885256618006646d3/0 3734a016e0c00c685256df60045f1b7?OpenDocumentToronto (1998-2012). Toronto’s Geography. City of Toronto Website. Toronto, Ontario, Canada. Retrieved on October 30, 2012 from http://www.toronto.ca/toronto_facts/geography.htm