Public Opinion, Attitudes and Knowledge - A National Survey of Canadians' Use of Alcohol and Other Drugs - Canadian Addiction Survey (CAS)

Chapter 7: Public Opinion on Illicit Drugs

Highlights

• Canadians reported they perceived that the major reason they thought people use drugs is because of their availability (28.4%); this is followed by psychological distress (15.1%), family problems (14.6%), stress (10.9%), poverty (9.0%) and other reasons.
  
  
• When asked who they felt was most at risk of using drugs, the answer Canadians gave most frequently (52.3%) was anyone; other groups Canadians see as most likely at risk were youth (23.5%), individuals with a history of drug abuse (7.0%), low-income people (4.7%), street kids (4.1%) and prostitutes (3.5%).
  
  
• When asked to select the area of society on which substance use has the most impact, Canadians reported criminality (38.7%), followed by family problems (29.0%), law enforcement costs (12.8%), health care costs (6.6%) and other reasons.
  
  
• A small majority of Canadians felt that Canada was not dealing with drug use adequately: 53.6% disagreed that "all required programs and tools to deal with drug use in Canada are in place," 64.9% disagreed that "Canada is well prepared to deal with drug use," 50.5% did not think that "adequate measures are in place to address drug problems" and 58.7% did not think that "the governments are investing enough resources to deal with drug use."
  
  
• About two thirds (65.6%) of Canadians agreed that "total abstinence is the only effective means to overcome drug problems."
  
  
• A small majority (58.7%) of Canadians disagreed with the following statement: "Drug problems such as abuse, addiction, dependence should only be addressed through doctors/hospitals."
  
  
• A majority (64.8%) of Canadians agreed that "if you try drugs you are likely to become dependent."
  
  
• The majority of Canadians (85.3%) agreed that "international strategies are needed to address drug problems."
  
  
• The majority of Canadians (71.4%) did not think that "it is possible to have a society free of drugs."
  
  
• Canadians preferred prevention and treatment (78.0%) to law enforcement and incarceration (18.7%) as means of addressing drug issues, and 82.8% of Canadians thought the government should provide a variety of treatments rather than make drug use a criminal act.
  
  
• However, Canadians still see a role for enforcement, with about half of them split on the value of making drug use criminal but a majority (78.3%) recognizing the need for increased investments in enforcement.
  
  
• Canadians stated they agreed that the government should pursue legal action against people who sell illicit drugs (94.5%) or who use drugs (77.7%), 65.6% reported that the government should make criminal sentencing tougher against drug addicts and 67.1% felt that criminal sentencing should be made tougher for the first drug offence.
  
  
• Canadians were asked whether they agreed or disagreed with various options for addressing substance use issues: 96.4% agreed (80.3% of those strongly) with drug treatment programs, 74.4% (50.0% strongly) agreed with programs that offer clean needles and 56.5% (28.4% strongly) agreed with health programs to reduce harms without requiring users to stop. However, 58.4% (36.1% strongly) were not in favour of night shelters for the homeless that do not require them to give up their drugs/alcohol use, and Canadians were also split about the use of non-jail sentences, with 47.3% (20.5% strongly) agreeing and 47.4% (29.9% strongly) disagreeing.
  
  
• A majority of Canadians reported having heard of needle exchange programs (82.5%), methadone (64.2%) and methadone maintenance programs (54.7%) but less than the majority reported having heard of drug treatment court programs (34.7%) or of harm reduction as a strategy (20.2%).
  
  
• Canadians' level of approval of specific approaches are relatively high: 78.9% for drug treatment programs, 72.1% for needle exchange programs and 77.9% for methadone maintenance programs. However, although all of these types of programs are usually defined as harm reduction, not as many Canadians (59%) are willing to report they support harm reduction as a strategy. Understanding this last result could be important in communications about strategies.

This chapter examines the perception of Canadians on various issues related to the use of illicit drugs. The reader is cautioned that most questions refer to "drug" in a generic manner, as this was not defined specifically for respondents. The first series of questions queried Canadians' perceptions of the causes, groups-at-risk and impacts of drug use on society. The next group of questions was designed to address Canadians' views on the issue in general or with concepts and basic principles that form the underlying foundation on which drug strategies, policies and programs are being developed in Canada. Many questions on the role of the justice and legal system in addressing drug issues are examined. Finally, the last series of questions addressed Canadians' perceptions on specific approaches such as methadone maintenance, drug treatment courts, needle exchange programs and others.

While there are a range of factors that determine the adoption and success of any initiative as part of a drug strategy, it is of critical importance to monitor the support for such approaches because public support is often essential for successful implementation.

The Why, Who and What of Drug Use According to Canadians

The first section begins with an examination of the why, who and what of drug use according to Canadians. Canadians were asked what they consider to be the main cause of drug problems, who are the groups they feel are most at risk of using drugs, a series of questions on whether they thought drug use had an impact on many spheres of life, and finally about which of these areas of life drug use has the most impact.

What do you consider to be the main cause of drug problems?

Canadians were asked to identify what they considered to be the main cause of drug problems. Although respondents were asked to provide their answer freely, it was not an open-ended question. Once the respondent gave an answer, the interviewer confirmed from an available pre-coded list and confirmed if that corresponded to what had been said. If not, the answer was coded as "other." If necessary, the list was read to the respondent.

Responses to this question varied (Figure 7.1), with the most frequently quoted answer being that Canadians felt that the availability of drugs (28.4%) is the main cause of drug problems. This was followed by psychological distress (15.1%), family problems (14.6%), stress (10.9%), poverty (9.0%), other (8.5%) and a family history of drug problems (7.4%).

Figure 7.1: Factors Seen as the Main Cause of Drug Problems by Canadians

Who do you think is most likely to be at risk of using drugs?

Using a similar coding scheme, Canadians were asked to identify who they thought was the most likely to be at risk of using drugs from a list (Figure 7.2). The most frequent answer chosen by Canadians (52.3%) was to say that anyone is likely at risk of using drugs. Following this, about a quarter (23.5%) of respondents felt that youth in general were the most likely to be at risk of using drugs; this was followed by individuals with a history of drug abuse (7.0%), low-income people (4.7%), street kids (4.1%) and prostitutes (3.5%).

Figure 7.2: Groups Canadians See Most at Risk of Using Drugs

From a list of possible ways drug use can have an impact on society, which one do you think drug use has the largest impact on?

This question was asked in two steps. In a first step, respondents were asked to respond to each option whether they felt drug use had a large, moderate, small or no impact at all. Then they were asked to select the one for which they felt the impact was the greatest.

Figure 7.3 shows that the majority of Canadians felt that drug use has a large impact on criminality (76.1%), family problems (73.1%), law enforcement costs (71.1%), costs to the welfare system (68.9%), costs to the health care system (62.9%) and costs of HIV and AIDS (60.4%). Only for problems in the workplace (34.9%) was there less than the majority reporting large impact even though the majority still reported impact when the moderate and large impact categories are added together (34.9% + 39.9% = 74.8%).

Figure 7.3: Canadians' Opinion Regarding the Impact of Drug Use

Figure 7.4 presents results when respondents were asked to pick the one option for which they felt drug use has the most impact. Criminality was the answer selected most often by 38.7% of Canadians followed by family problems (29.0%), law enforcement costs (12.8%), health care costs (6.6%), "I don't know" (5.8%), welfare system costs (3.3%), HIV/AIDS care costs (2.6%) and workplace problems (1.2%). These findings indicate that Canadians see a fairly strong association between drug use and criminality.

Figure 7.4: Canadians' Opinion on Area Most Impacted by Drug Use

Canadians' Perceptions on the Country's Readiness to Address Drug Use

A number of questions were asked so that respondents could identify how they felt Canada is dealing with drug use (Table 7.1). Specifically, respondents were asked to state their level of agreement with the following statements: "All required programs and tools to deal with drug use in Canada are already in place," "Canada is well prepared to deal with drug use among Canadians," "Adequate measures are in place to address drug problems" and "Governments are investing enough resources to deal with drug use." Taken together, responses to these questions reflect that a majority of Canadians did not feel that Canada was dealing with drug use adequately. A slim majority of Canadians did not feel that all required programs and tools are in place to deal with drug use in Canada (53.6%); 64.9% answered they did not think that Canada is well prepared to deal with drug use; 50.5% did not agree that adequate measures are in place to address drug problems; and 58.7% did not think that governments are investing enough resources to deal with drug use.

Taking into account only respondents who provided an answer that reflected their level of agreement or disagreement with the above statements (i.e. omitting those who said they did not know), 58.6% did not think that all required programs and tools are in place to deal with drug use in Canada; 69.7% did not think that Canada is well prepared to deal with drug use; 52% did not think that adequate measures are in place to address drug problems; and 63.1% did not think that governments are investing enough resources to deal with drug use (Table 7.2).

All required programs and tools to deal with drug use in Canada are in place

Among respondents who felt that all required programs and tools to deal with drug use in Canada are in place (41.4%) (Table 7.2), those aged 55-64 were less likely than those aged 45-54 to have agreed with the statement (29.9% vs. 41.1%). Residents of New Brunswick (48.9%) were the most likely to have agreed while residents of British Columbia were the least likely (32.6%). In terms of education, the higher the education level achieved, the lower the level of respondents' agreement with this statement. Respondents who had obtained a university education were less likely than those who had less than a high school education to have agreed with this statement (28.3% vs. 50.8%). No other differences in respondents' agreement with this statement were apparent in terms of household location, marital status, income adequacy or user-type.

Canada is well prepared to deal with drug use among Canadians

Only 30.3% of Canadians agreed with the statement that "Canada is well prepared to deal with drug use." There was a significant inverse relation between agreement with the statement and age (i.e. as age increased agreement with this statement decreased). In addition, there was a shift in opinion evident in the 25-34 age category; respondents aged 25-34 were less likely than the preceding younger age group to agree with the notion that Canada is well prepared to deal with drug use (30.9% vs. 42.8%). There was a significant main effect of education with respondents at the end of the spectrum, with those either with less than secondary or university education more likely to agree. However, none of the specific group comparisons was significant. No other differences in respondents' agreement with this statement were apparent in terms of sex, household location, province, marital status, income adequacy or user-type.

Adequate measures are in place to address drug problems

Almost half (48.0%) of Canadians stated that they felt adequate measures are in place to address drug problems (Table 7.2). There was also a significant inverse relation between age and agreement; as age increased respondents were less likely to feel that adequate measures are in place to address drug problems. Among these respondents, there was a shift in opinion apparent with respondents aged 25-34 being less likely than those aged 20-24 to agree (50.6% vs. 64.3%). There was a difference in opinion apparent in terms of household location. Residents from non-rural areas were less likely than residents from rural areas to agree (46.9% vs. 54.4%). In terms of provincial differences, residents of Saskatchewan (45.2%) and British Columbia (38.4%) were less likely than residents from the rest of Canada to agree. As education level increased, respondents were less likely to agree. Residents with some post-secondary (43.7%) and university (42.2%) were less likely than those with less than a high school education (62.3%) to agree. No other differences in respondents' agreement with this statement were apparent in terms of sex, marital status, income adequacy or user-type.

Governments are investing enough resources to deal with drug use

A minority of people (36.9%) agreed that governments are investing enough resources to deal with drug use (Table 7.2). Of these respondents, males were more likely than females to agree with this statement (40.3% vs. 33.6%). Again, there was a significant inverse relation between age and agreement with this statement. As age increased, respondents were less likely to agree. Regarding provincial differences, residents of Manitoba (44.3%) and Alberta (42.1%) were more likely than the rest of Canadians to agree with this statement, and residents from British Columbia were the least likely to agree (30.0%). Again, as with the previous statements, respondents' level of agreement tended to decrease as their education level increased. Respondents who had some post-secondary education (32.2%) or university degree (33.1%) were less likely than those with less than a high school education (46.1%) to feel that governments are investing enough resources to deal with drug use. No other differences in respondents' agreement with this statement were apparent in terms of household location, marital status, income adequacy or user-type.

Various Opinions and Beliefs of Canadians About Drug Use

Table 7.3 includes various summary statements addressing basic concepts or beliefs that are important for programs or policies addressing drug issues. Results are presented broken down by major demographic variables in Table 7.4.

Total abstinence is the only effective means to overcome drug problems

Overall, about two thirds (65.6%, of those 46.7% strongly) of Canadians agreed with the statement that "Total abstinence is the only effective means to overcome drug problems" (Table 7.3). The characteristics associated with agreement (68.1%) with this statement were examined (Table 7.4). Respondents with a university degree were less likely to believe this was the case (57.5%) compared with those having less than a high school education (75.6%). There was a change in opinion among user-type. Respondents who use alcohol only were more likely to have agreed that total abstinence is the only effective means to overcome drug problems, compared with those who had consumed at-least-cannabis (77.2% vs. 59.1%). There were no significant differences arising from any other comparisons among user-types. The results suggest that those who have consumed any illicit drug (including cannabis) were less likely to agree that total abstinence is the only effective means to overcome drug problems.

Drug problems such as abuse, addiction and dependence should be addressed only through doctors/hospitals

Overall, a small majority (58.7%, of those 32.0% strongly) of Canadians disagreed with the statement that "Drug problems such as abuse, addiction dependence should be addressed only through doctors/hospitals," and the largest proportion of respondents strongly disagreed with this statement (32.0%) (Table 7.3).

In examining the characteristics of Canadians who agree with this statement (40.4%), males (43.4%) were more likely than females (37.4%) to agree (Table 7.4). Residents of Newfoundland and Labrador were more likely (51.2%) and residents of Manitoba were less likely (34.6%) than residents of the rest of Canada (40.4%) to agree with this statement. Education plays a role in respondents' opinions regarding this issue, and respondents with some post-secondary education (33.3%) and those with a university degree (27.1%) were less likely than respondents with less than a high school education (58.5%) to agree. Income adequacy was another significant factor in respondents' opinions. Respondents in the highest income category (28.8%) and income not stated (43.4%) were less likely than those in the lowest income group (52.7%) to agree. Opinions and agreement with this issue were significantly and directly related to user-type. At-least-cannabis users (32.4%) were more likely than illicit drug users (25.5%) to think that drug problems should be addressed only through doctors and hospitals, with agreement growing in significant increments to 46.4% for alcohol-only users and 65.3% for non-users.

If you try drugs you are likely to become dependent

Almost two thirds of Canadians (64.8%, of those 39.0% strongly) agreed with the notion that "If you try drugs you are likely to become dependent" (Table 7.3). The characteristics associated with agreement with this statement were examined (Table 7.4). Of the 67.1% of respondents who felt that if you try drugs you are likely to become dependent, males were less likely than females (63.5% vs. 70.5%) to have agreed with this statement. In terms of differences among age groups, there was a significant linear relation between agreement and age; as age increased so too did respondents' agreement with this statement. In addition, there was a shift in opinion apparent at ages 45-54. Respondents in the 45-54 age category were more likely than those in the previous age group 35-44 to agree (71.7% vs. 62.2%). Among the provinces, residents of New Brunswick (75.4%) and Quebec (82.8%) were more likely than residents from the rest of Canada (67.1%) to agree with this statement, and those from Ontario (59.1%) and Manitoba (60.6%) were less likely to agree. There is a significant difference in opinion between respondents who do and who do not use illicit drugs.

There is a change in opinion between those who have used only alcohol (78.8%) and those who have used at-least-cannabis (55.4%). No other significant differences are seen between other groups, suggesting that drug use exposure had an influence on opinions regarding this statement.

International strategies are needed to address drug problems

The great majority of Canadians (85.3%, of those 60.0% strongly) strongly agreed with the statement that "International strategies are needed to address drug problems" (Table 7.3). There was a very strong level of agreement and very little variability regarding this question so a logistic regression was not performed (Table 7.4). This high level of approval is consistent with the view held by many in the addictions field that international strategies are considered to be essential for addressing the global drug problem and is reflective of Canada's involvement in many international fora and initiatives.

It is possible to have a society free of drugs

The majority of Canadians (71.4%, of those 45.5% strongly) did not think that "It is possible to have a society free of drugs" (Table 7.3). In examining the characteristics of respondents who thought this possible (27.3%), there were significant differences in terms of sex, age, province, income adequacy and user-type (Table 7.4). Males were more likely to have answered that it is possible to have a society free of drugs than females (28.0% vs. 26.5%). There was a significant inverse relation between age and agreement with this statement. Older respondents were less likely than younger respondents to agree. Residents of New Brunswick (34.3%) and Quebec (39.1%) were more likely, and residents from Nova Scotia (19.5%) and Manitoba (22.3%) were less likely than residents from the rest of Canada to agree. In terms of income adequacy, respondents' agreement decreased as income increased. Specifically, the middle (26.9%) and highest (19.9%) income adequacy groups were less likely than those in the lowest income adequacy group (39.9%) to think that it is possible to have a society free of drugs.

There were differences in agreement with this statement between those who have used cannabis and those who have consumed only alcohol in their lifetime. Alcohol-only users (32.0%) were more likely than at-least-cannabis users (21.7%) to agree. There were no significant differences between illicit drug users and at-least-cannabis users, or between alcohol-only users and non-users, suggesting that there was a significant difference in the opinion between those who have used illicit drugs (including cannabis) and those who had not. Respondents who have used drugs were significantly less likely to think that it is possible to have a society free of drugs. There were no differences in agreement with this statement in terms of household location, education or marital status.