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 (continued)

Canadians' Perceptions of Options for Addressing Drug Use

The next series of question focussed on Canadians' perceptions of options, including law enforcement and legal ones, for addressing drug use.

When asked to choose between prevention and treatment and law enforcement and incarceration (Figure 7.5), Canadians preferred prevention and treatment by a wide margin (78.0% vs. 18.7%). Canadians confirmed this preference by expressing agreement with an alternative wording of this question stating "Governments must provide a variety of treatments rather than making drug use a crime" (55.4% strongly and 27.4% somewhat) (Table 7.5). Still, when not forced to make a choice between health and justice as means to address drug issues, Canadians were split about stating that making drug use criminal is the best way to deal with drug use, with 47.9% strongly and somewhat agreeing and 47.6% strongly and somewhat disagreeing (Table 7.5). While it is clear that Canadians prefer health approaches to enforcement, this does not imply that they do not see enforcement as important. This is high-lighted by the fact that 78.3% of Canadians strongly or somewhat agreed that governments should invest massively in law enforcement (Table 7.5). Next is an examination of the characteristics of respondents who agreed to these statements.

Figure 7.5: What do you perceive to be the best way to address the drug issue in Canada?

Governments must provide a variety of treatments rather than making drug use illegal

The logistic regression was not conducted for this variable because there was a very strong level of agreement with this statement and low variability (Table 7.6).

The best approach to deal with drug problems is to make its use criminal

In examining the characteristics associated with Canadians who agree (50.1%) with this statement (Table 7.6), males (45.2%) were less likely than females (54.5%) to agree. Regarding age, there were two significant shifts in opinion: first, at ages 45-54, and again, at ages 65-74. Those aged 45-54 were less likely than those aged 35-44 to agree (45.8% vs. 55.4%), and those aged 65-74 were less likely than those aged 55-64 to agree (49.0% vs. 53.5%). In terms of education, those with some post-secondary education (49.1%) or a university degree (36.0%) were less likely than those who had not finished high school (61.1%) to agree. In terms of user-type, the non-users (77.0%) were more likely to agree than the alcohol-only users (59.2%), who in turn were more likely than at-least-cannabis users (40.8%). There was no significant difference between the illicit drug users and at-least-cannabis users regarding agreement with this statement, suggesting that the significant difference in opinion was between those who have tried drugs and those who have not. There were no differences in agreement with this statement in terms of household location, province, marital status or income adequacy.

The government should invest massively in law enforcement against drugs

In terms of the characteristics associated with agreement with this statement (80.2%), there were significant differences in terms of sex, age, province, education, income adequacy and user-type (Table 7.6). Males were less likely than females to be in agreement (74.1% vs. 86.3%). In addition, respondents aged 75+ were less likely than those 65-74 to agree with this (81.7% vs. 90.0%). Compared with the rest of Canada, residents of Newfoundland and Labrador (89.5%) and Prince Edward Island (87.4%) were more likely to be in favour, whereas residents from British Columbia were less likely to agree (73.7%). Respondents with some post-secondary education or a university degree were less likely than those with less than a high school education to agree with massive investment in law enforcement against drugs (79.6% and 70.7% vs. 86.6%, respectively). Respondents in the middle (83.1%) and highest (71.3%) income adequacy groups were less likely than those in the lowest income group (88.5%) to be in favour. Respondents who were illicit drugs users were less likely than those who were at-least-cannabis users to have responded that they thought the government should invest massively in law enforcement against drugs (57.9% vs. 76.2%), and those who had consumed at-least-cannabis were less likely than those who had used only alcohol (or non-users) to agree with this (76.2% vs. 87.8%).

Should the Government Pursue Legal Action and Make Sentencing Tougher?

As mentioned earlier, Canadians do agree to a role of enforcement in addressing drug use. Two questions asked Canadians if they felt the government should pursue legal action; one question asked about legal action aimed at users, the other about legal action aimed at those who sell drugs (Table 7.7). In both cases Canadians agreed, but at stronger levels for those who sell drugs. When asked whether governments should pursue legal action against those who use drugs, 77.7% agreed (50.9% of those strongly). When asked whether governments should pursue legal action against individuals who sell illicit drugs, 94.5% agreed (82.2% strongly). When asked whether governments should make criminal sentencing tougher for drug addicts, 65.6% agreed (37.2% strongly). When asked whether governments should make criminal sentencing tougher for first drug offences, 67.1% agreed (41.4% strongly). The characteristics of Canadians who agreed to these statements have been examined.

The government should pursue legal action against illicit drug users

There were significant differences in terms of sex, provinces, education and user-type (Table 7.8). Males were less likely than females to be in favour (74.1% vs. 84.0%). Residents from Prince Edward Island (89.8%) were more likely than the rest of Canada (79.1%) to agree, whereas residents from Quebec (66.5%) and British Columbia (73.6%) were less likely to agree. In terms of education, as respondents' level of education increased, their agreement decreased. Those with a university degree (71.0%) or some post-secondary education (76.8%) were less likely than those with less than high school (86.3%) to agree. There was an increasing gradient in terms of user-type, with agreement significantly higher for at-least-cannabis users than for illicit drug users (74.7% vs. 48.8%), higher for alcohol-only users than for at-least-cannabis users (89.1% vs. 74.7%) and higher for non-users than for alcohol-only users (94.3% vs. 89.1%).

The government should pursue legal action against those who sell illicit drugs

The logistic regression was not conducted for this variable because there was a very strong level of agreement with this statement and low variability (Table 7.8).

Tougher criminal sentencing for drug addicts

In terms of the characteristics associated with Canadians in favour of tougher criminal sentencing for drug addicts (67.7%), there were significant differences in terms of sex, age, education, income and user-type (Table 7.8). Males were less likely than females to be in favour (62.7% vs. 72.6%). In terms of age, respondents aged 45-54 (60.6%) were less likely than those aged 35-44 (70.8%) to be in favour. Respondents with some post-secondary education or university degree were less likely than those who had not completed high school to be in favour (66.8% and 54.1% vs. 79.9%). In terms of income adequacy, respondents in the highest group were less likely than those in the lowest group (55.1% vs. 78.0%). There were differences in opinion in terms of user-type. Respondents who had used illicit drugs were less likely than at-least-cannabis users to agree (41.6% vs. 61.0%), and those who were at-least-cannabis users were less likely than alcohol-only users to be in favour (61.0% vs. 76.8%). Substance use is inversely related to favouring tougher criminal sentencing (i.e. the fewer substances used during their lifetime, the more they were in favour with tougher sentencing).

Tougher criminal sentencing for first drug offences

In terms of the characteristics associated with Canadians in favour of tougher criminal sentencing for first drug offences (69.8%), there were significant differences in terms of sex, age, province, education, marital status, income adequacy and user-type (Table 7.8). Males were less likely than females to be in favour (65.0% vs. 74.5%). In terms of age, respondents aged 45-54 were less likely than those aged 35-44 to be in favour (63.8% vs. 71.5%). Residents of Prince Edward Island (77.1%) were more likely to be in favour of tougher sentencing than the rest of Canada (69.8%), whereas residents from Nova Scotia (62.0%) and Saskatchewan (65.7%) were the least likely to be in favour. Respondents with some post-secondary education or university degree were less likely than those who had not completed high school to be in favour (65.8% and 60.7 vs. 79.9%). Respondents who were single were less likely than those who were married (63.0% vs. 71.3%) to be in favour. In terms of income adequacy, respondents in the highest group were less likely than those in the lowest group to be in favour (58.6% vs. 76.5%). Finally, those who had used illicit drugs were less likely than at-least-cannabis users to agree (43.3% vs. 59.7%), and those who were at-least-cannabis users were less likely than alcohol-only users to be in favour (59.7% vs. 81.3%). These findings suggest that substance use is inversely related to one's position on tougher criminal sentencing, and that the fewer substances used during their lifetime, the more likely they are to be in favour of tougher criminal sentencing for first drug offences.

Canadians' Perceptions of Various Programs to Address Drug Use

In this section, Canadians were asked questions concerning their opinion, knowledge and support for various specific programs to address drug use. A first set of questions related to a series of program options: use of non-jail sentences, drug treatment programs, needle exchange, harm reduction and "wet" shelters for homeless people. In a second set of questions, Canadians were asked whether they had heard of a specific type of program and then, whether they supported it. These programs were drug treatment courts, harm reduction strategies, needle exchange programs and methadone maintenance programs.

Non-jail sentences

Canadians were divided in terms of whether non-jail sentences should be allowed for illegal drug use (Table 7.9). In examining the characteristics of Canadians who agree with this statement (50%), there were significant differences in terms of province, education and lifetime user-type (Table 7.10). Residents of Nova Scotia (56.4%) were more likely than residents from other provinces to agree. Respondents with a university degree were more likely than those who had less than secondary education to agree (56.9% vs. 49.5%). In terms of user-type, those who had used illicit drugs were more likely than those who had used at-least-cannabis to agree (59.9% vs. 53.3%). Those who had used at-least-cannabis were more likely to agree than those who had used only alcohol (53.3% vs. 45.5%). There were no differences in agreement with this statement in terms of sex, age, household location, marital status or income adequacy.

Drug treatment programs

The majority of Canadians (80.3%) strongly agreed with the statement that "Drug treatment programs should be available to help addicts reduce or stop their consumption of illicit drugs" (Table 7.9). Given the high level of approval, the logistic regression was not conducted (Table 7.10).

Programs that offer clean needles or drug kits

Close to two thirds of Canadians agreed (50.0% strongly, 24.4% somewhat) with the statement that "Programs that offer clean needles or drug kits should be available to users to avoid the spread of infectious diseases" (Table 7.9). In examining the characteristics of Canadians who agreed with this statement (Table 7.10), there were differences in terms of province, income adequacy and user-type. Residents of Quebec (83.5%) were more likely than residents from the rest of Canada to agree and residents from Ontario (71.3%) and Manitoba (72.9%) were less likely. In terms of income adequacy, respondents who were in the middle group were more likely than those in the lowest group to agree (79.8% vs. 67.6%). There were no differences between respondents in the highest group and those in the lowest. Respondents who have used illicit drugs other than cannabis were more likely to agree than those who had used at-least-cannabis to agree with such programs (85.2% vs. 78.2%). Those who had used at-least-cannabis were more likely than alcohol-only users to agree (78.2% vs. 73.2%). There were no differences in terms of age, household location, education or marital status.

Health programs to reduce harm without requiring users to stop

When asked to identify their level of agreement with the statement that "Health programs aimed to reduce the harm from drug use should be available to drug users without requiring clients to stop using drugs," a small majority (56.5%) of Canadians agreed with this statement (Table 7.9). In examining the characteristics associated with respondents who agreed with these programs, there were significant differences in terms of province and education (Table 7.10). Residents of Prince Edward Island (68.2%) were more likely than the rest of Canada (59.3%) to agree with these harm reduction health programs (68.2%) and residents of Quebec were the least likely to do so (49.0%). In terms of education, having a university degree was related to support as compared to having less than high school (67.2% vs. 59.0%). There were no differences in terms of sex, age, household location, marital status, income adequacy or user-type.

Night shelters for the homeless not requiring them to give up their drugs/alcohol use

The majority of Canadians strongly disagreed (36.1%) and somewhat disagreed (22.3%) with the statement that "Night shelters should be available for the homeless without requiring them to give up their alcohol or drugs" (Table 7.9). Such programs are often referred to as "wet shelters." In examining the characteristics of Canadians who agreed with this statement (40.0%), there were differences in terms of age, province, education and marital status (Table 7.10). Regarding age, there was a significant linear relation between age and agreement; as age increased so too did respondents' agreement. In addition, there was a shift in opinion around ages 45-54, with those aged 45-54 more likely than those aged 35-44 to agree with allowing night shelters for the homeless without requiring them to give up their alcohol or drugs (45.3% vs. 36.0%). Respondents above age 45 were more likely to agree with night shelters for the homeless than those below the age of 45. Residents from Prince Edward Island were more likely (50.5%) than the rest of Canada to agree, whereas residents from Quebec (30.8%) and Alberta (37.5%) were the least likely to agree. In terms of education, respondents with a university degree were more likely to agree with this statement, compared with those with less than a high school education (49.6% vs. 36.2%). Although marital status showed a main effect, none of the inter-group comparisons was significant. There were no significant differences in terms of sex, household location, income adequacy or user-type.

Knowledge of and Support for Specific Programs

This section examines responses to questions that addressed Canadians' perceptions of specific programs but used an alternate type of formulation. The questions were subdivided; the first part of the question defined what the program was and asked whether respondents had ever heard of such a program, then a follow-up question was asked whether they supported it. This type of formulation demands more time in the interview but has the advantage of measuring both knowledge and support, and allows examination of the extent of interrelation between knowledge and support.

Knowledge of and support for drug treatment courts

Drug treatment courts were described to respondents as programs that provide court-supervised treatment for addicted users of cocaine or heroin who have been charged with drug offences as an alternative to a jail sentence. When asked if they have ever heard or read about drug treatment court programs, almost two thirds of Canadians (64.5%) had never heard or read about drug treatment court programs and only 34.7% stated that they had heard about them (Table 7.11). When asked if they supported drug treatment court programs, Canadians were generally in support of such programs, with 42.6% stating that they strongly support, and 36.3% stating that they somewhat support such programs.

In terms of the characteristics of Canadians who had heard about drug treatment court programs, there were differences in age and user-type (Table 7.12). There was a significant linear relation between age and knowledge of drug treatment court programs; older respondents were more likely than younger respondents to have heard about these programs. In addition, respondents aged 45-54 were more likely than those aged 35-44 (39.0% vs. 29.3%), and those aged 65-74 were more likely than those aged 55-64 (52.2% vs. 40.5%) to have heard about it. In terms of user-type, respondents who only used alcohol in their lifetime were less likely than those who had used at-least-cannabis to have heard about drug treatment court programs (34.4% vs. 36.0%). There were no significant differences between illicit drug users and at-least-cannabis users, or between alcohol-only users and non-users, suggesting that those who had engaged in illicit drug use in their lifetime (be it cannabis or other illicit drugs) were more likely than those who had not to have heard about drug treatment court programs.

Regarding differences between respondents in terms of support for drug treatment court programs, the logistic regression was not conducted due to a high approval rate and low variability (Table 7.12).

Knowledge of and support for harm reduction strategies

Harm reduction strategies were described to respondents as public health policies or programs that intend to reduce the harms caused by drug use and that these programs do not necessarily require users to stop their substance use. When asked if they have ever heard or read about harm reduction strategies, the majority of Canadians (77.8%) stated that they had never heard or read about such programs, and only 20.2% stated that they had (Table 7.11). When asked if they support harm reduction strategies, Canadians were generally in support of such programs, with 24.8% strongly supporting and 34.2% somewhat supporting such programs.

In terms of the characteristics of Canadians who had heard or read about harm reduction strategies (Table 7.12), there were significant differences in terms of sex, age, province, education and user-type. Males were more likely than females to have read or heard about harm reduction strategies (24.3% vs. 17.1%). The older the age group, the more likely respondents were to have heard about them. There was a significant shift in opinion at age 45; those respondents who were 45-54 were more likely than those aged 35-44 to have heard about these strategies (27.9% vs. 17.6%). Residents of Saskatchewan (25.1%) and British Columbia (33.1%) were more likely than the rest of Canada to have heard about harm reduction strategies, and residents from Nova Scotia (15.8%) and Quebec (15.1%) were less likely to have heard or read about them. In terms of education, respondents with a university degree were more likely than those with less than high school to have heard about these strategies (28.2% vs. 13.2%). Finally, respondents who had used at-least-cannabis were more likely than those who had used only alcohol to have heard or read about harm reduction strategies (24.2% vs. 16.4%). There were no significant differences between illicit drug users and at-least-cannabis users, or between alcohol-only users and non-users, suggesting that those who had used some illicit drug were more likely to also have heard about harm reduction strategies than those who had never used drugs.

Regarding Canadians' support for harm reduction strategies, there were no significant individual differences in terms of sex, age, province, household location, education, marital status, income adequacy or user-type.

Knowledge of and support for needle exchange programs

Needle exchange programs (NEP) were described to respondents as being programs that provide clean needles to drug users in order to reduce the spread of infectious disease. When asked if they had ever heard or read about NEP, most Canadians (82.5%) stated that they had heard or read about such programs, with only 17.2% stating that they had not (Table 7.11). In terms of support for such programs, 45.9% of Canadians strongly supported needle exchange programs and 26.2% stated that they somewhat supported these programs (Table 7.11).

In terms of the characteristics associated with Canadians who had heard about NEP (Table 7.12), there were significant differences in age, household location, province, education and user-type. There was a significant linear relation between age and knowledge, as age increased, so too does knowledge of NEP. In addition, there was a spike in opinion at age 25; respondents aged 25-34 were more likely than those aged 20-24 to have heard about NEP (83.2% vs. 72.6%). In terms of household location, those from non-rural areas were less likely than those from rural areas to have heard about NEP (82.3% vs. 85.9%). Residents from British Columbia (92.8%) were more likely than residents from the rest of Canada (82.8%) to have heard about NEP, and residents from Newfoundland and Labrador (65.0%) and Ontario (78.8%) were less likely. In terms of education, as education level increases, respondents' knowledge of NEP also increases. Respondents with some post-secondary education (90.7%) or a university degree (87.6%) were more likely than those who had not completed high school (69.9%) to have heard about such programs. Knowledge of NEP increased with user-type. Respondents who had used at-least-cannabis were more likely than those who had used only alcohol to have heard about NEP (86.9% vs. 81.1%), and those who had used alcohol were more likely to have heard about such programs than non-users (81.1% vs. 57.4%).

Regarding the characteristics of Canadians who support NEP, there were differences in terms of province, education and user-type. Residents of Prince Edward Island (81.1%) and Quebec (83.2%) were more likely to support such programs while residents from Saskatchewan (68.9%) were less likely to support such programs. In terms of education, respondents with some post-secondary education (76.5%) or a university degree (82.4%) were more likely than those who had not completed high school (68.1%) to support NEP. Regarding user-type, there were no differences between at-least-cannabis users and alcohol-only users in their support for NEP, but there were differences between illicit drug users and at-least-cannabis users and between alcohol-only users and non-users. At-least-cannabis users were less likely than illicit drug users to support NEP (76.6% vs. 86.7%), and non-users were less likely than alcohol-only users to support such programs (54.1% vs. 73.5%).

Knowledge of and support for methadone and methadone maintenance programs

In measuring respondents' support and knowledge of methadone maintenance programs (MMP) an extra step was added; respondents were first asked whether they had heard about the drug methadone, then whether they had heard about MMP, and finally, whether they supported this program (Table 7.11). Methadone was described to respondents as being a drug similar to morphine and heroin that is often used to treat heroin addiction. Almost two thirds of Canadians (64.2%) had heard or read about the drug methadone (Table 7.11). Methadone maintenance programs were described as programs that allow doctors to provide methadone as a safer substitute for heroin users in order to treat their addiction. When asked if they had ever heard or read about MMP, a slight majority (54.7%) had heard about such programs and 44.0% of Canadians had not. In terms of support for such programs, Canadians were generally in support of MMP, with 39.6% of respondents stating that they strongly support and 38.3% stating that they somewhat support such programs.

In terms of the characteristics associated with knowledge of methadone and MMP, there were significant differences in terms of age, province, education and user-type (Table 7.12). There was a significant linear relation between age and knowledge of methadone and MMP; older respondents were more likely than younger respondents to have heard about these two issues. Respondents aged 35-44 were more likely than those aged 25-34 to have heard about methadone (67.8 vs. 58.8%) and MMP (60.0% vs. 49.3%), and respondents aged 45-54 were more likely than those aged 35-44 to have heard about methadone (76.1% vs. 67.8%) and MMP (68.1% vs. 60.0%). Regarding provincial differences, residents of Newfoundland and Labrador, New Brunswick and Quebec were less likely than residents from the rest of Canada to have heard about methadone and MMP, and residents from Saskatchewan and British Columbia were more likely than the rest of Canada to have heard about them. In terms of education, respondents with more education were more likely to have heard about methadone and MMP. Respondents with some post-secondary or university education were more likely than those with less than high school to have heard about methadone (71.6% and 75.8% vs. 48.2%) and MMP (63.1% and 68.7% vs. 37.0%). Regarding user-type, there was an increasing gradient with increasing use. Illicit drug users were more likely than at-least-cannabis users to have heard about methadone (80.4% vs. 70.7%) and MMP (74.1% vs. 58.4%), at-least-cannabis users were more likely than alcohol-only users to have heard about methadone (70.7% vs. 60.1%) and MMP (58.4% vs. 50.3%), and alcohol-only users were more likely than non-users to have heard about methadone (60.1% vs. 30.8%) and MMP (50.3% vs. 30.0%).

There was a high level of approval in terms of support for MMP and the logistic regression was not conducted due to lack of variability (Table 7.12).

Relation between knowledge and support

In order to examine whether there was a significant relation between knowledge of a program and support for it each of the previous four regressions were rerun, including knowledge of such programs as an independent variable (data not shown). The programs for which support was influenced by knowledge were needle exchange programs and methadone maintenance programs. Canadians who had heard about needle exchange programs were more likely to support such programs than those who had not heard about them (79.3% vs. 56.1%) and Canadians who had heard about methadone maintenance programs were more likely to support them than those who had not (90.2% vs. 83.4%). These two programs are among the oldest and most accepted harm reduction approaches in the field. These results confirm that understanding and acceptance of these programs are also shared by the Canadian public. The strong relation between knowledge and support suggests that efforts to publicly discuss programs for addressing drug use could have beneficial effects in terms of support for such programs.

Differences Between Users and Non-users

Level of involvement with substance use, as measured by the user-type variable, was not associated with perceptions of how well Canada is dealing with illicit drug use. However, users and non-users differed in their opinion of how best to deal with the issue. The influence of the user-type variable on levels of agreement to various items usually followed one of three patterns: the variable did not predict differences between users and non-users; it predicted a dichotomy between illicit drug users (illicit drugs and at-least cannabis) and non-illicit drug users (alcohol-only and non-users); or finally, it predicted a gradient with at least three, in some cases four, significant differences across groups following an ordered increase or decrease (from non-use to alcohol to at-least cannabis to illicit drug use).

Cases when the user-type variable did not come out as significant in the regression equation, indicating users and non-users agreed, corresponded almost exclusively to the questions for which there was a high level of consensus across the population as a whole: disagreement that Canada is dealing well with substance use issues overall; low level of support for wet shelters; strong support for international drug strategies, drug treatment programs and MMP, and agreement for legal action against those who sell drugs. The one exception to this concerned support of harm reduction measures on which agreement and disagreement was split close to the middle both for users and non-users. This may be an indication that the controversy surrounding harm reduction is not one of users against non-users but one of fundamental disagreement about how best to deal with the issue. For example, in the case of non-users, it is possible to infer that the split in responses may be driven by ideological conflicts between those who hold compassion for the users and those who feel that harm reduction programs may in some ways act to condone drug use. In the case of those classified as users, the ideological divide may be between those promoting abstinence (no use) as the best approach and those who see reducing harms, not ending use, as the first priority.

The second pattern of responses, characteristic of those who had used at least one illicit drug, appeared for the following items: the role of abstinence, the belief that smoking cannabis leads to other drug use, the possibility of having a society free of drugs, whether making drug use criminal is the best way to deal with the issue, and in some cases, the knowledge of programs designed to address drug use issues. Two possible hypotheses could explain these findings, particularly on the abstinence, dependence and society free of drug items: (1) illicit drug users are in denial of the true dangers of experimenting with and using drugs; or (2) users have a more accurate understanding of the risks of illicit drug use since they are personally acquainted with them. Unfortunately, the present data do not allow favour of one hypothesis over the other.

Finally, there are the cases where the predictions of the user-type variable follow more or less a gradient from non-use to illicit drug use: substance use should be dealt with by doctors and hospitals; there should be increases in law enforcement for drugs, tougher sentencing for addicts and first-time offences, pursuit of legal action against users, and finally, knowledge and support of NEP and knowledge of MMP. Needle exchange programs and MMP are established approaches in the field, and it is not surprising that increasing experience with substances comes with increasing knowledge of these approaches. All but one of the other items concerned the status of law enforcement to address drug use. It is interesting to note that at-least-cannabis users seem to have a tendency to differ from only illicit drug users mostly when it comes to enforcement-related issues, while they seem to be more alike in regards to more sociological-type issues (abstinence, dependence, society free of drugs).

The sum of these conclusions suggests that the user-type variable was useful in confirming that personal experiences with substances have measurable and distinct influences on opinions. This result would have been missed if the data had been pooled instead of broken out by user-type. Furthermore, that the variable did not produce results along a sew-saw pattern is promising and can seen as indicative that it is truly measuring an underlying phenomenon existing along a graded continuum.

Summary and Discussion

Canadians were most likely to have identified that the availability of drugs, psychological distress and family problems are the main causes of drug problems. They saw everybody to be at risk but youth in general as the highest risk group. Canadians responded that criminality was the area most impacted by drugs.

Canadians did not believe that alcohol and other drug issues are being addressed adequately in Canada. While they clearly expressed a preference for treatment and prevention approaches, Canadians still saw a need for enforcement and legal approaches, particularly as it applies to those who sell drugs. However, it can be inferred that the low satisfaction of Canadians towards the country's antidrug efforts is more an issue of quantity rather than of quality since Canadians tended to be in support of existing programs.

Canadians' level of approval of specific approaches was relatively high: 78.9% for drug treatment programs; 72.1% for needle exchange programs; and 77.0% for methadone maintenance programs. It is somewhat contradictory to note, however, that even though both needle exchange and methadone maintenance programs are normally considered as exemplars of "harm reduction," fewer Canadians (59%) responded that they supported harm reduction as a general strategy. The only specific program for which support fell below the majority line was for wet shelters, shelters that accept homeless people without requiring them to give up their substance use. One possible explanation would be that Canadians expressed favour for programs that were described according to their positive aspects (e.g. clean needles, maintenance), whereas favour dropped when the idea of maintained use was made more explicit (e.g. supplying alcohol to residents of wet shelters). This could be an interesting subject of investigation in further surveys or polls.

Level of involvement with substance use, as measured by the user-type variable, was not associated with perceptions of how well Canada is dealing with illicit drug use. Users and non-users differ in their opinion about how to best deal with the issue according to meaningful patterns, suggesting that the user-type variable was useful in confirming that personal experience with substances has a measurable influence on opinions.

The level of agreement was usually satisfying for specific approaches, whereas the level of agreement with harm reduction or the level of satisfaction with how Canadians feel the country is dealing with the issue was disputed. It appears that there would be benefits for maintaining or enhancing the dialogue between Canadians and their governments, if only to ensure that perceptions do not diverge too much about the extent to which the issue is properly addressed.