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Focus on Gender - A National Survey of Canadians' Use of Alcohol and Other Drugs - Canadian Addiction Survey (CAS)

Chapter 5 - Harms of the Use of Alcohol and Drugs

Highlights

• One in every five women (18.4%) and almost one third of men (30.2%) reported that they experienced harm from their own alcohol use. It was reported by 7.1% of women and 10.5% of men that their own alcohol use in the 12 months prior to the survey had harmed them.
• According to the AUDIT, the highest rates of hazardous drinking behaviors are among women and men aged 18 to 19 years (34.7% and 52.9% respectively).
• For women and men, the most common types of harm experienced among those who consumed illicit drugs were to one's physical health and to one's friendships and social life.
• Among past-year drinkers who reported that they had been hit or physically assaulted by a person who was drinking, one third of women reported their spouse or partner (33.9%) as the aggressor, whereas three quarters of men reported a stranger (74.2%).

Results

Hazardous Drinking

Table 5.1 provides the demographic characteristics of past-year drinkers who scored 8 or more on the AUDIT³, reflecting a hazardous pattern of drinking. Among Canadian women, a score of 8 or more on the AUDIT varied with age, marital status, and location of household; for men, it varied with age, province, marital status and education.

Women aged 18 to 19 years were the most likely to drink hazardously (34.7%), almost three times more likely than women aged 15 to 17. The rate of hazardous drinking declined with age among women, with a significant decline at age 25 to 34. In comparison, the proportion of men who drank hazardously was almost three times higher than that of women (25.1% vs. 8.9%). As they did with women, AUDIT scores of 8 or more also declined with age among men. However, males aged 18 to 19 were not significantly more likely to drink hazardously than those aged 15 to 17. In addition, a significant decrease in hazardous drinking occurred later among men aged 35 to 44.

Men from Newfoundland and Labrador were 1.5 times more likely to drink hazardously, in comparison to men in the rest of Canada, whereas men from Quebec and Saskatchewan were significantly less likely (22.4% and 23.0%). The province of residence did not predict hazardous drinking for women.

Drinking hazardously was three times more likely for women who were single or never married and almost two times more likely for those who were divorced, separated or widowed, compared to married women. Among men, the impact of marital status was not as strong, but the findings are similar. Men who were single or never married and those who were divorced, separated or widowed were more likely than married or partnered men to drink hazardously.

Hazardous drinking became less likely for men as their education level increased: 33.8% of men who had less than a secondary education reported drinking hazardously, compared to 29.7% of those with a secondary education, 24.9% of those with some post-secondary education and only 16.8% of those with a university degree.

Women living in non-rural locations were four times more likely to drink hazardously than those living in rural locations.

Key Differences and Similarities: Overall, the proportion of men who drank hazardously was almost three times greater than that of women. Although with increasing age, hazardous drinking decreased for both women and men, the first significant decrease in the rate of hazardous drinking occurred at a younger age for women than for men. Among men, the rate of hazardous drinking varied significantly with province and education, but this was not observed for women. The odds of hazardous drinking were highest among women and men who were not married or partnered. As education increased, the rate of hazardous drinking for men decreased. Women from nonrural households were more likely to drink hazardously than women from rural households. For men, however, household location was not associated with hazardous drinking.

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Harm from One's Own Drinking

Women were less likely than men to report harm in their lifetime as a result of their own drinking. Almost one in every five women reported that they had experienced harm from their own alcohol use in their lifetime, compared to 30.2% of men (Table 5.2). Among women, the two most commonly cited lifetime harms were to physical health (11.3%) and friends and social life (10.1%). This was also reflected in reports of past-year harms by women, with 3.9% reporting physical harm and 2.1% harm to friendships and social life. Among men, harm to physical health and harm to friendships and social life were also the most commonly identified lifetime (18.3% and 18.4%) and past year (6.8% and 3.9%) harms. In each of the areas identified, males reported significantly more harms than did females.

Table 5.3 presents the demographic characteristics of Canadians who experienced harm from their own drinking in the 12 months prior to the survey. This table provides the adjusted odds ratios from two separate logistic regressions for both males and females. The first regression includes all the demographic characteristics, and the second regression also takes into account the respondents' pattern of drinking.

On average, 7.1% of women and 10.5% of men reported having experienced harm in the past year. When controlling for demographic characteristics only, past-year harm was associated with age and marital status for women and with age and income adequacy for men. When drinking pattern was controlled for, age and marital status were still significant predictors among women, and age and income adequacy remained significant for men.

The rate of harm experienced by women and men during the past year decreased with age. There was a significant decrease in the rate of reported harm at ages 25 to 34 for women. The odds of having experienced harm were 2.4 times more likely for males aged 18 to 19 than for those aged 15 to 17, and the first significant decrease in reported harm was apparent among males 20 to 24 years of age, and then reported harm decreased steadily with increasing age. When drinking pattern was controlled for, the effects of age remained the same among women. For men, when controlling for drinking pattern, 18- to 19- year-olds were no longer more likely than 15- to 17-year olds to report experiencing harm when the pattern was the same. However, 20- to 24-yearolds remained significantly less likely than 18- to 19-year-olds to report at least one harm.

The odds of women reporting past-year harm from their drinking were 2.5 times greater among those who were formerly married and 1.7 times higher among those who were single in comparison to women who were married. When controlling for pattern of drinking, however, there was no difference between single women and married women in terms of their reported harm. However, even when drinking similarly, formerly married women still had increased odds of reporting harm in comparison to married women. Marital status did not predict reported harms due to drinking among men.

For men, income adequacy was associated with reported harm, and although no significant effects were noted between the groups, it appears that, as income adequacy increased for men, their odds of reporting harms due to drinking decreased.

For both women and men, the odds of reporting harm during the past year increased significantly as quantity and frequency of consumption increased. Those who drank lightly and infrequently were significantly less likely to report having experienced harm than those who drank lightly and frequently, heavily and infrequently or heavily and frequently.

Key Differences and Similarities: Women who were formerly married or single were more likely than married women to report harm from their alcohol use. However, marital status did not predict the likelihood of harm for men. For women there was a significant decrease in reported harm at ages 25 to 34, but this significant shift occurs earlier for men, at age 20 to 24. For both gender groups, as age increased the prevalence of reported harm decreased, and as drinking frequency and quantity increased, the prevalence of reported harm also increased.

Harm from the Drinking of Others

Table 5.4 shows the type of harm experienced in the prior year resulting from the drinking of others. Approximately one third of women (32.5%) and one third of men (32.9%) had experienced harm from the drinking of others. Having been insulted and humiliated was the most commonly reported harm among women (21.9%), followed by having serious arguments or quarrels (16.1%), verbal abuse (14.5%) and family or marriage problems (13.1%). Having been pushed or shoved and hit or physically assaulted were the least-reported harms (8.3% and 2.0% respectively).

Among men, the rate of reported harm is similar to that of women, with having been insulted or humiliated the most common (22.3%), followed by having experienced verbal abuse (17.2%), serious arguments and quarrels (14.8%) and having been pushed or shoved (13.3%). In comparison to women, men reported fewer family or marriage problems resulting from others' drinking (7.7%). However, men reported significantly higher rates of aggressive harms, including being pushed or shoved, verbally abused or being hit or physically assaulted.

Among those who reported having been hit or physically assaulted in the past year as a result of others' drinking, differences exist between males and females as to the relationship between the aggressor and the victim (Table 5.5). Approximately one third of women (33.9%) reported that their aggressor was a spouse or partner. The number of such reports among men, however, was so low as to be non-reportable. The majority of men (74.2%), compared to 34.2% of women, reported that their aggressor was another person.

About one in five women (20.8%) who had been assaulted reported it had been by a friend. More than one in 10 women (11.2%) reported that a family member other then their spouse or partners, such as parent, child or relative, had assaulted them. Among men who reported being hit or physically assaulted by someone who had been drinking, 13.0% reported that the aggressor was a friend, while the number reporting the aggressor being another family member was nonreportable.

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Table 5.6 presents the demographic characteristics of Canadian women and men who experienced at least one type of harm from the drinking of others during the year prior to the survey. When adjusted for drinking patterns and other demographics, incidence of harm varied with age, province, marital status, location of household and drinking pattern among women, and with age, province, marital status, education, and drinking pattern among men.

Younger women and men were most vulnerable to experiencing harm from other people's drinking. Among 20- to 24-year-olds, 58.2% of women and 58.5% of men reported experiencing at least one harm. There was a significant decrease in reported harm with increasing age for both women and men.

Women from British Columbia, Saskatchewan and Manitoba were more likely to have experienced alcohol-related harm from others' drinking, when compared to those in the rest of Canada (35.9%, 37.7%, and 36.3% respectively), whereas those from Newfoundland and Labrador were the least likely to report having experienced such harm (28.0%). When controlling for drinking pattern, men from Alberta were more likely to have experienced alcohol-related harm from the drinking of others, when compared to the rest of Canada (39.9%), and those from Ontario were least likely (31.2%).

Formerly married women and single or nevermarried women were more likely than married or partnered women to have experienced harm. This pattern is also observed in men.

Education overall predicted harm from others' drinking among men when controlling for drinking pattern, but there were no significant differences between each level of education and the comparison group of less than secondary schooling.

Women from non-rural locations were less likely (31.9%) to report harm, compared to women residing in rural locations (36.2%). Household location did not predict harm from others' drinking for men.

The incidence of reported harms as a result of another person's drinking increased notably with more frequent and heavy drinking patterns. Women who drank heavily and frequently reported experiencing significantly more alcoholrelated harm from the drinking of others in the 12 months prior to the survey than was reported by abstainers (68.8% vs. 19.4%). Although drinking patterns overall were significant predictors of harm from others' drinking for men, significant differences among each of the patterns were not observed.

Key Differences and Similarities: In terms of reported harm from the drinking of others, an equal proportion of women and men reported having experienced harm from others' drinking. For both women and men, having been insulted or humiliated was the most commonly reported harm, and having been hit or physically assaulted was the least common. Among those who had been hit or physically assaulted, however, there were differences between men and women in terms of their relation to their aggressor. For women, one third were victimized by a spouse or partner, while the rate of victimization in such a relationship was so low among men as to be nonreportable. Instead the majority of men were victimized by some other person. As age increased, the proportion of women and men reporting harm from others' drinking decreased. Marital status and drinking pattern predicted harm from the drinking of others for both women and men. However, women who drank heavily and frequently were four times more likely to have experienced harm than those who abstained from drinking.

Harms Resulting from One's Own Illicit Drug Use

Table 5.7 presents the types of harms experienced as a result of one's own use of illicit drugs for women and men. One in every five women (19.8%) who have ever used any of eight illicit drugs (cannabis, cocaine, speed, hallucinogens, ecstasy, inhalants, heroin, and steroids) reported that they had experienced harm from their drug use. The proportion of men reporting such harm was significantly greater at 27.2%. Among women, harm to physical health (13.5%) was the most commonly cited, followed by friendships and social life (7.7%), home life or marriage (6.5%) and work, studies or employment opportunities (6.4%). Among men, harm to physical health was also the most commonly cited (16.4%), followed by friendships and social life (13.2%), and work, studies and employment opportunities (11.6%).

Among women who had used any of five illicit drugs (cocaine, speed, hallucinogens, ecstasy and heroin), 40.4% reported that they had experienced at least one harm from their drug use. Among men who had used any of those five illicit drugs, almost half (48.9%), reported experiencing harm. The most commonly cited harms among both women and men were harm to physical health (27.9% and 31.8%) and harm to friendships and social life (16.9% and 25.5%). Harms to home life or marriage, work, studies or employment, and harm to financial position were similar among women and men; approximately 15% of women and 20% of men reported harm in each category.

Table 5.8 presents the demographic characteristics of Canadian women and men who experienced at least one type of harm from their own illicit drug use. Women who had used any of eight illicit drugs were less likely to have experienced harm from their own drug use than were men (19.8% vs. 27.2%). Among women, reported harm varied with age and income adequacy. For men it varied with age, region, and education.

Among women and men, those in the younger age categories reported more harm as a result of their illicit drug use, and the rate decreased steadily with increasing age.

Women in the highest income-adequacy group were significantly less likely than those in the lowest to report having experienced harm from their illicit drug use (14.0% vs. 32.6%). Income adequacy was not associated with harm from illicit drug use for men.

Among men, those from British Columbia were more likely to experience harm (29.6%) than those from the rest of Canada. However, there was no association between region and illicit drug related harm for women.

Men with higher education were at a lower risk for experiencing harm as a result of their illicit drug use, but this was not demonstrated for women.

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Key Differences and Similarities: Younger women and men reported a greater proportion of harm than those in the older age groups. Women in the highest income-adequacy group were less likely to experience harm than those in the lowest income group, while there was no association between income adequacy and harm for men. Males from British Columbia were more likely to experience harm than males from other regions of Canada, but such regional differences do not exist for women. As education level increased, men were less likely to experience harm from their own drug use, but there was no relation between education and harm for women.

Summary and Discussion

In general, the proportion of men reporting drinking hazardously in the past year was almost three times that of women. Men were also significantly more likely to report experiencing at least one harm in the past year from their own drinking, and significantly more likely to report experiencing one or more types of harm from their own use of illicit drugs. For both sexes, young adults were the most likely to drink hazardously, and the odds were highest among women and men who were not married or partnered.

For both women and men, the most commonly reported harms experienced as a result of their own use of alcohol or illicit drugs were similar. For both women and men, the prevalence of reported harm due to their use of alcohol decreased with increasing age. For women, however, having been formerly married resulted in an increased likelihood of alcohol related harm, while marital status was not associated with reported harm for men.

In terms of harms due to their illicit drug use, men reported significantly higher rates of harm in each of the eight areas examined, with the exception of physical health and learning. As with alcohol, for both women and men, the likelihood of reported harm as a result of one's own drug use decreased with increasing age. Women in the highest income adequacy group were significantly less likely to report harm from their own use of illicit drugs than those in the lowest, and for men, increased education was associated with a lower likelihood of illicit drug related harm.

In terms of reported harm due to the drinking of others, women and men reported similar rates of harm overall, and the most commonly cited harm was the same for both: having been insulted or humiliated. Women were more likely than men to report family or marriage problems resulting from the drinking of others, whereas men were more likely than women to report having been pushed or shoved or verbally abused. Differences in the relationship to the perpetrator of physical violence were found, with the perpetrator of violence toward women most often being a partner, while the perpetrator of violence toward men was most often a stranger.

The 2004 CAS questionnaire did not inquire about the types of harms experienced from other people's illicit drug use. This and other questions identified in this section will need to be investigated in future surveys, to support our understanding of and action on gender-specific strategies to prevent harms associated with substance use.

• Table 5.1 Percentage of hazardous drinking (AUDIT 8+) during the past year among current drinkers, by sex, Canada, aged 15+, 2004.
• Table 5.2 Percentage of lifetime and past-year harms from one's own alcohol use among lifetime and past-year drinkers, by sex, Canada, aged 15+, 2004.
• Table 5.3 Percentage experiencing at least one harm during the past year resulting from one's own drinking among pastyear drinkers, by sex, Canada, aged 15+, 2004.
• Table 5.4 Percentage of past-year harms resulting from the drinking of others, by sex, Canada, aged 18+, 2004.
• Table 5.5 Relationship between aggressor and victim among those reporting past-year physical harm or assault resulting from the drinking of others, by sex, Canada, aged 18+, 2004.
• Table 5.6 Percentage of one or more harms resulting from the drinking of others in the past year, by sex, Canada, aged 18+, 2004.
• Table 5.7 Percentage of lifetime harms resulting from one's own drug use, by sex, Canada, aged 15+, 2004.
• Table 5.8 Percentage of one or more harms resulting from one's own lifetime drug use, by sex, Canada, aged 15+, 2004.