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4C Illicit Drug Use

Definition | Specific Indicators | Ontario Public Health Standards | Corresponding Indicator(s) from Statistics Canada and CIHI | Corresponding Indicator(s) from Other Sources | Data Sources | Survey Questions | Alternative Data Sources | Analysis Check List | Method of Calculation | Basic Categories | Indicator Comments | Definitions | Cross-References to Other Indicators | Cited References | Other References | Changes Made | Acknowledgements

 

Definition 
  • The proportion of the population that used an illicit drug 
Specific Indicators
  • Proportion of the population that have ever used or tried an illicit drug, including one-time use of cannabis
  • Proportion of the population that have ever used or tried an illicit drug, excluding one-time use of cannabis
  • Proportion of the population that have used an illicit drug in the past 12 months, including one-time use of cannabis
  • Proportion of the population that have used an illicit drug in the past 12 months, excluding one-time use of cannabis
  • Proportion of the population that have used or tried cannabis in the past 12 months, excluding one-time use
  • Proportion of the population that have used or tried cannabis in the past 12 months, including one-time use
  • Proportion of the population that have ever used or tried an illicit drug by drug type*
*cannabis (marijuana, hashish); cocaine or crack, speed (amphetamines); ecstasy (MDMA) or other similar drugs; hallucinogens (PCP or LSD (acid)); heroin; steroids (e.g. testosterone, dianabol or growth hormones); inhalants (e.g. sniffing or huffing of glue, gasoline, acetone or other solvents).  

Ontario Public Health Standards (OPHS)
The Ontario Public Health Standards (OPHS) establish requirements for the fundamental public health programs and services carried out by boards of health, which include assessment and surveillance, health promotion and policy development, disease and injury prevention, and health protection. The OPHS consist of one Foundational Standard and 13 Program Standards that articulate broad societal goals that result from the activities undertaken by boards of health and many others, including community partners, non-governmental organizations, and governmental bodies. These results have been expressed in terms of two levels of outcomes: societal outcomes and board of health outcomes. Societal outcomes entail changes in health status, organizations, systems, norms, policies, environments, and practices and result from the work of many sectors of society, including boards of health, for the improvement of the overall health of the population. Board of health outcomes are the results of endeavours by boards of health and often focus on changes in awareness, knowledge, attitudes, skills, practices, environments, and policies. Boards of health are accountable for these outcomes. The standards also outline the requirements that boards of health must implement to achieve the stated results.

Outcomes Related to this Indicator 
  • Board of Health Outcome (Prevention of Injury and Substance Misuse): The board of health is aware of and uses epidemiology to influence the development of healthy public policy and its programs and services for the prevention of injury and substance misuse.
  • Board of Health Outcome (Foundational Standard): The public, community partners and health care providers are aware of relevant and current population health information. 
Assessment and Surveillance Requirements Related to this Indicator 
  • The board of health shall conduct epidemiological analysis of surveillance data....in the areas of injury and substance misuse outcomes, including.......illicit substance use. 

http://www.ontario.ca/publichealthstandards 

 

Corresponding Health Indicator(s) from Statistics Canada and CIHI
Health Canada: 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 2008, based on telephone interviews with at least 10,000 people from across Canada, (approximately 1000 per province).
  • Percentage using cannabis in lifetime
  • Percentage using cannabis in the past year
  • Average age of initiation for youth cannabis use
  • Percentage using other illicit drugs in the past year by drug type (cocaine/crack; speed; hallucinogens, excluding salvia; ecstasy; salvia; methamphetamine/crystal meth)
Canadian Alcohol and Drug Use Monitoring Survey (CADUMS). Available at: http://www.hc-sc.gc.ca/hc-ps/drugs-drogues/stat/_2010/summary-sommaire-eng.php

Corresponding Indicators from Other Sources
Centre for Addiction and Mental Health (CAMH)
  • Percentage using cannabis in lifetime
  • Percentage using cannabis in the past 12 months
  • Percentage using cocaine in lifetime
  • Percentage using cocaine in the past 12 months

CAMH Monitor eReport: Addiction and Mental Health Indicators Among Ontario Adults, 1977 - 2009. Available at: http://www.camh.net/

 

Ontario Student Drug Use and Health Survey
  • Proportion of students between the grades of 7 and 12 using illicit drugs
  • Proportion of students between the grades of 7 and 12 using drugs by drug type

Available at CAMH: http://www.camh.net/

 

Data Source(s) (see Resources: Data Sources)

Numerator & Denominator: Canadian Community Health Survey (CCHS)
Original source:
Statistics Canada
Distributed by: Ontario Ministry of Health and Long Term Care (MOHLTC)
Suggested citation (see Data Citation Notes): Canadian Community Health Survey [year], Statistics Canada, Share File, Ontario Ministry of Health and Long-Term Care

 

Survey Questions
  

Data Source

Module

Question

Response Categories

Year

Variable

CCHS

Illicit Drugs (DRG)

Have you ever used or tried marijuana, cannabis or hashish?

1 Yes, just once

2 Yes, more than once

3 No

DK, R

2009/2010

IDG_01

2007/2008

*

2005

*

2003

DRGC_01

2000/2001

*

* module not selected by any Ontario health region or not included in the CCHS survey year or question not included in the module

 

Illicit Drug Use - Derived Variables
     

Data Source

Module

Data Element

Year

Variable

CCHS

Illicit Drugs (DRG)

Illicit drug use - Lifetime (Including "One Time Only" use of cannabis)

2009/2010

IDGFLA

2007/2008

*

2005

*

2003

IDGCFLA

2000/2001

*

Illicit drug use - Lifetime (Excluding "One Time Only" use of cannabis)

 

2009/2010

IDGFLAC

2007/2008

*

2005

*

2003

IDGCFLAC

2000/2001

*

Illicit drug use - 12 month (Including "One Time Only" use of cannabis)

 

2009/2010

IDGFYA

2007/2008

*

2005

*

2003

IDGCFYA

2000/2001

*

Illicit drug use - 12 month (Excluding "One Time Only" use of cannabis)

 

2009/2010

IDGFYAC

2007/2008

*

2005

*

2003

IDGCFYAC

 2000/2001

 *

* module not selected by any Ontario health region or not included in the CCHS survey year or question not included in the module
 

For details about derived variables, please refer to:
CCHS Annual Component, 2010 Common Content Derived Variable (DV) Specifications. Available from: http://abacus.library.ubc.ca/jspui/bitstream/10573/42660/4/cchs-escc2009-2010derived-var-eng.pdf

 

Illicit Drug Use - Derived Variables by Drug Type  
    

Data Source

Module

Data Element

Year

Variable

CCHS

Illicit Drugs (DRG)

Cannabis Drug Use - Lifetime (Including "One Time Only" use)

2009/2010

IDGFLCA

2007/2008

*

2005

*

2003

IDGCFLCA

2000/2001

*

Cannabis Drug Use - Lifetime (Excluding "One Time Only" use)

2009/2010

IDGFLCM

2007/2008

*

2005

*

2003

IDGCFLCM

2000/2001

*

Cannabis Drug Use - 12 month (Excluding "One Time Only Use)

2009/2010

IDGFYCM

2007/2008

*

2005

*

2003

IDGCFYCM

2000/2001

*

Cocaine or Crack Drug Use

2009/2010

IDGFLCO

2007/2008

*

2005

*

2003

*

2000/2001

*

Amphetamine (Speed) Drug Use - Lifetime

2009/2010

IDGFLAM

2007/2008

*

2005

*

2003

*

2000/2001

*

MDMA (ecstasy) Drug Use - Lifetime

2009/2010

IDGFLEX

2007/2008

*

2005

*

2003

*

2000/2001

*

Hallucinogens, PCP or LSD (acid) Drug Use - Lifetime

2009/2010

IDGFLHA

2007/2008

*

2005

*

2003

*

2000/2001

*

Glue, Gasoline or Other Solvent Use - Lifetime

2009/2010

IDGFLGL

2007/2008

*

2005

*

2003

*

2000/2001

*

Heroin Drug Use - Lifetime

2009/2010

IDGFLHE

2007/2008

*

2005

*

2003

*

2000/2001

*

Steroids Use - Lifetime

2009/2010

IDGFLST

2007/2008

*

2005

*

2003

*

2000/2001

*

* module not selected by any Ontario health region or not included in the CCHS survey year or question not included in the module

For details about derived variables, please refer to:
CCHS Annual Component, 2010 Common Content Derived Variable (DV) Specifications. Available from: http://abacus.library.ubc.ca/jspui/bitstream/10573/42660/4/cchs-escc2009-2010derived-var-eng.pdf

 

Alternative Data Source(s)
  • None
Analysis Checklist 
  • It is recommended that public health units use the Share File provided by the Ministry of Health and Long-Term Care rather than public use file (PUMF) provided by Statistics Canada. The Share File has a slightly smaller sample size because respondents must agree to share their information with the province to be included; however, the share file has more variables and fewer grouped categories within variables. The Share File is a cleaner dataset for Ontario analysis because all variables that were not common content, theme content or optional content for Ontario have been removed.
  • Users need to consider whether or not to exclude the ‘Refusal, 'Don't Know' and ‘Not Stated' response categories in the denominator. Rates published in most reports, including Statistics Canada's publication Health Reports generally exclude these response categories.
  • In removing not stated responses from the denominator, the assumption is that the missing values are random, and this is not always the case. This is particularly important when the proportion in these response categories is high.
  • Estimates must be appropriately weighted (generally the share weight for the CCHS) and rounded.
  • Users of the CCHS Ontario Share File must adhere to Statistics Canada's release guidelines for the CCHS data when publishing or releasing data derived from the file in any form. Refer to the appropriate user guide for guidelines for tabulation, analysis and release of data from the CCHS. In general, when calculating the CV from the share file using the bootstrap weights, users should not use or release weighted estimates when the unweighted cell count is below 10. For ratios or proportions, this rule should be applied to the numerator of the ratio. Statistics Canada uses this approach for the tabular data on their website. When using only the Approximate Sampling Variability (CV) lookup tables for the share file, data may not be released when the unweighted cell count is below 30. This rule should be applied to the numerator for ratios or proportions. This provides a margin of safety in terms of data quality, given the CV being utilized is only approximate.
  • Before releasing and/or publishing these data, users should first determine the number of sampled respondents who contributed to the calculation of the estimate. If this unweighted number is less than 30, the weighted estimate should not be released regardless of the estimate's coefficient of variation (C.V.). For unweighted estimates of 30 or more, users should determine the C.V. of the rounded weighted estimate and follow the guidelines below: 
    • Acceptable (C.V. of 0.0 - 16.5) Weighted estimates can be considered for general unrestricted release. Requires no special notation.
    • Marginal (C.V. of 16.6 - 33.3) Weighted estimates can be considered for general unrestricted release but should be accompanied by a warning cautioning of high sampling variability.
    • Unacceptable (C.V. greater than 33.3) Statistics Canada recommends not releasing estimates of unacceptable quality. However, if the user chooses to do so then estimates should be flagged and the following warning should accompany the estimates: "The user is advised that . . .(specify the data) . . . do not meet Statistics Canada's quality standards for this statistical program. Conclusions based on these data will be unreliable and most likely invalid". These data and any consequent findings should not be published. If the user chooses to publish these data or findings, then this disclaimer must be published with the data.

Method of Calculation


Proportion of the population that ever used or tried an illicit drug, including one-time use of cannabis

weighted total number of respondents that ever used or tried an illicit drug, including one time use of cannabis (IDGFLA)

x 100

weighted total number of respondents (IDGFLA=1 or 2)



 
Proportion of the population that ever used or tried an illicit drug, excluding one-time use of cannabis

weighted total number of respondents that ever used or tried an illicit drug, excluding one-time use of cannabis (IDGFLAC)

x 100

weighted total number of respondents (IDGFLAC=1 or 2)

 

Proportion of the population that used an illicit drug in the past 12 months, including one-time use of cannabis

weighted total number of respondents that used an illicit drug in the past 12 months, including one-time use of cannabis (IDGFYA)

x 100

weighted total number of respondents (IDGFYA=1 or 2)



 
Proportion of the population that used or tried an illicit drug in the past 12 months, excluding one-time use of cannabis 

weighted total number of respondents that used an illicit drug in the past 12 months, excluding one-time use of cannabis (IDGFYAC)

x 100

weighted total number of respondents (IDGFYAC=1 or 2)

 

Proportion of the population that used or tried cannabis in the past 12 months, excluding one-time use

weighted total number of respondents that used or tried cannabis in the past 12 months, excluding one-time use (IDGFYCM)

x 100

weighted total number of respondents (IDGFYCM=1 or 2)

 

Proportion of the population that used or tried cannabis in the past 12 months, including one-time use

weighted total number of respondents that used or tried cannabis in the past 12 months, including one-time use (IDG_01=1 or 2)

x 100

weighted total number of respondents (IDG_01=1, 2 or 3)



Proportion of the population that ever used or tried an illicit drug by drug type

weighted total number of respondents that ever used or tried an illicit drug (drug type)

x 100

weighted total number of respondents

 

Note: 2009/2010 variable names are provided in the above equations. Please consult data dictionaries, 'Derived Variable Specification' manuals or Survey Questions section for changes in variable names over CCHS cycles.

 

Basic Categories
  • Ages: 12-19, 20-24, 25-44, 45-64, 65+. It may be necessary to aggregate data based on age groups to produce stable rates. (Refer to Document: Methods for Calculating Moving Averages).
  • Sex: male, female and total
  • Geographic areas of residence: Ontario, public health unit
Indicator Comments
  • Knowledge about the pattern of substance use is important for prevention programming, health and social policy and treatment response (1).
  • Cannabis is the most commonly used substance in Canada (2). It may be useful to examine illicit drug use and illicit drug use excluding cannabis.
  • The prevalence of past year cannabis use in Ontario has been increasing since 1996, for men and women and among all age groups, but most notably in users 50 years of age and older (1).
  • In Canada, the prevalence of illicit drug use is higher among youth 15 - 24 years than adults 25 years and older (3).
  • Among Canadian youth aged 15 to 24 years, past-year use of at least one of five illicit drugs (cocaine or crack, speed, hallucinogens, ecstasy, and heroin) decreased from 11.3% in 2004 to 7.0% in 2010 (3).
  • The CCHS Illicit Drug Use module contains questions about frequency of illicit drug use in the past year, withdrawal symptoms and ways in which drug use interferes with activities/responsibilities. Please refer to data dictionary and survey for details.
  • CCHS surveys civilian, non-institutionalized, community-dwelling individuals and therefore excludes groups that may be at risk of illicit drug use, such as those in hospitals, jails, prisons, the military, people living on reserves and the homeless.
  • "Illicit Drug Use" is optional content in the CCHS and was selected as follows:
    • 2001 (cycle 1.1): not included in the CCHS
    • 2003 (cycle 2.1): Durham; Haliburton, Kawartha, Pine Ridge District; Peterborough; Peel.
    • 2005 (cycle 3.1): no Ontario health regions
    • 2007/2008: no Ontario health regions
    • 2009/2010: all Ontario health regions
  • Since not all health regions chose "Illicit Drug Use" as optional content in 2003, a provincial estimate is not available from this survey.
  • The CCHS relies on self-reported information and may be subject to recall bias, social desirability bias, or non-response bias.
Definitions 
  • Illicit Drugs - the CCHS examines use of cannabis (marijuana, hashish); cocaine or crack, speed (amphetamines); ecstasy (MDMA) or other similar drugs; hallucinogens (PCP or LSD (acid)); heroin; steroids (e.g. testosterone, dianabol or growth hormones); inhalants (e.g. sniffing or huffing of glue, gasoline, acetone or other solvents).  

 

Cross-References to Other Indicators
  • None
Cited References
  1. Ialomiteanu AR, Adlaf EM, Mann RE. Addiction and mental health indicators among Ontario adults, 1977-2009: highlights from the CAMH monitor eReport. CAMH population studies ebulletin. 2012 [cited 2012 Mar 29];13(4). Available from: http://www.camh.ca/en/research/news_and_publications/Population%20Health%20eBulletin/eBulletins%20for%202012/ebv13_n4_CM2011_ReportHighlights.pdf
  2. Royal Canadian Mounted Police [homepage on the Internet]. Ottawa: Her Majesty the Queen in Right of Canada; 2011 Feb 17 [cited 2012 Mar 29]. Prevalence of illicit drug use in Canada: report on the illicit drug situation in Canada - 2008. Available from: http://www.rcmp-grc.gc.ca/drugs-drogues/2008/p1-eng.htm.
  3. Health Canada [homepage on the Internet]. Ottawa: Health Canada; 2012 Jul 3 [cited 2012 Jul 9]. Canadian Alcohol and Drug use Monitoring Survey: summary of results for 2010. Available from: http://www.hc-sc.gc.ca/hc-ps/drugs-drogues/stat/_2010/summary-sommaire-eng.php.

 

Other References 
  1. Royal Canadian Mounted Police [homepage on the Internet]. Ottawa: Her Majesty the Queen in Right of Canada; 2011 Feb 2 [cited 2012 Mar 27]. Report on the illicit drug situation in Canada - 2009. Available from: http://www.rcmp-grc.gc.ca/drugs-drogues/2009/index-eng.htm.
  2. Health Canada [homepage on the Internet]. Ottawa: Health Canada; 2008 Mar 28 [cited 2012 Mar 27]. Substance use by Canadian youth - A national survey of Canadians' use of alcohol and other drugs - Canadian Addiction Survey (CAS). Available from: http://www.hc-sc.gc.ca/hc-ps/pubs/adp-apd/cas_youth-etc_jeunes/index-eng.php.
  3. Health Canada [homepage on the Internet]. Ottawa: Health Canada; 2009 Nov 9 [cited 2012 Mar 27]. Attitudes and knowledge - A national survey of Canadians' use of alcohol and other drugs - Canadian Addiction Survey (CAS). Available from: http://www.hc-sc.gc.ca/hc-ps/pubs/adp-apd/cas_opinions-etc/index-eng.php.
  4. Adlaf EM, Begin P, Sawka E, editors. Canadian Addiction Survey (CAS): A national survey of Canadians' use of alcohol and other drugs: prevalence of use and related harms: Detailed report. Ottawa: Canadian Centre on Substance Abuse; 2005 [cited 2012 Mar 27].   Available from: http://www.ccsa.ca/2005%20CCSA%20Documents/ccsa-004028-2005.pdf.

 

Changes Made 

Date

Type of Review (Formal Review or Ad Hoc?)

Changes made by

Changes

April 10, 2012

New Indicator

Injury and Substance Misuse Prevention Work Group

New Indicator

 

Acknowledgements 
 

Lead Author(s)

  • Suzanne Fegan, KFL&A Public Health (Subgroup Lead)
  • Natalie Greenidge, Public Health Ontario

Contributing Author(s)

  • Injury and Substance Misuse Prevention Subgroup
    • Christina Bradley, Niagara Region Public Health
    • Badal Dhar, Public Health Ontario
    • Jeremy Herring, Public Health Ontario
    • Sean Marshall, Public Health Ontario
    • Jayne Morrish, Parachute
    • Lee-Ann Nalezyty, Northwestern Health Unit
    • Michelle Policarpio, Public Health Ontario
    • Narhari Timilshina, Toronto General Hospital

Reviewers

  • Luanne Jamieson, City of Hamilton Public Health Services (Core Indicators Work Group Member)
  • Mary-Anne Pietrusiak, Durham Region Health Department (Core Indicators Work Group Member) 
 
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