Data from the 1990 Ontario Health Survey were used to investigate the association of socio-economic status with the likelihood of meeting current recommendations for four health behaviours (smoking, fat intake, alcohol consumption, and physical activity level) in adults living in Ontario (Canada). Health behaviours were categorised as ‘unhealthy’ if they did not meet current recommendations in Ontario (smoking, fat intake < 30% of dietary energy, alcohol intake < 14 units per week, low level of leisure-time physical activity). Two summary variables based on the number ofO unhealthyO behaviours were also examined: the crude number of ‘unhealthy’ behaviours reported and the likelihood of reporting 3 or 4 ‘unhealthy’ behaviours. Four measures of socio-economic status were used: educational achievement, household income status, source of household income, and occupational prestige. Multiple logistic and linear regression analyses were performed to explore the association of each ‘unhealthy’ behaviour and of the summary variables with socio-economic status indicators (taken independently or simultaneously), controlling for demographic characteristics. Except for the positive relationship between income status and high alcohol intake, measures of ‘unhealthy’ behaviours were inversely associated with the socio-economic indices, suggesting that individuals in lower socio-economic groups are at an increased risk for health problems.

Health behaviours and socio-economic status in Ontario, Canada.

South Africa is one of the six southern African countries where the HIV levels for childbearing women are 20% or higher. We conducted two focus groups aimed at developing an understanding of the intersections of substance abuse, sexual behavior, and violence affecting the lives of women of color in Cape Town, South Africa. Both Colored and Black/African participants reported using cannabis, methaqualone, and alcohol, although they differed on other drugs used. Black/African women also used heroin, and crack cocaine, whereas Colored women used methamphetamines. For participants in both groups, relationships with men affected sexual and substance use risk behaviors. Although the Black/African women did not trust men to use condoms, the Colored women in the study believed that almost all men use condoms. Both groups of women reported high rates of violence, with Colored participants reporting more gang violence and woman-on-woman violence compared with Black/African participants. The paper discusses...

Cultural similarities and differences between a sample of Black/African and colored women in South Africa: convergence of risk related to substance use, sexual behavior, and violence.

Background: Drug-death bereavement is an understudied topic. We explore what bereaved parents experience after losing their child to drug use. The aim of the paper is to provide knowledge about wha...

Sounds of silence. The “special grief” of drug-death bereaved parents: a qualitative study

The purpose of this paper is to elaborate on the existing information about driving under the influence of cannabis (marijuana). Data suggest that more young people are driving after using cannabis, and there is concern about whether or not cannabis impairs cognitive functioning, which could have a negative impact on highway safety. This paper utilizes data from the Canadian Addiction Survey to provide current evidence of the prevalence of individuals who drive after using cannabis in Canada. It also describes the characteristics of people who drive after using cannabis. Some of these characteristics include demographics, whether or not the individual abuses other substances such as alcohol or other drugs, how often and how much cannabis is used, marital status, and residential location.

Driving Under the Influence of Cannabis: Analysis Drawn from the 2004 Canadian Addiction Survey

Primary care practitioners encounter a spectrum (figure 1) of alcohol-related problems.(Figure 1 omitted) At one end are patients with severe alcohol dependence; at the other end are patients with hazardous patterns of alcohol consumption but no identifiable adverse consequences of drinking. In between are patients with a diverse array of alcohol-related problems.Until recently, practitioners have focused largely on diagnosing alcohol disorders and referring patients with established alcohol abuse and dependence (for definitions of terms used in this article, see p. 99) to treatment specialists to prevent additional alcohol problems and minimize disability (Barnes et al. 1987). This type of intervention can be thought of as tertiary prevention (see the sidebar, p. 100). Recent research, however, has demonstrated that counseling patients with hazardous drinking patterns or mild alcohol-related problems that do not meet diagnostic criteria for alcohol disorders, or secondary prevention, also is effective in primary care settings (Bien et al. 1993). Although the efficacy of advising all patients about safe drinking practices, or primary prevention, is not known, it is practiced in some primary care settings (e.g., obstetrics).This article describes the roles of primary care practitioners in the identification and management of alcohol problems and suggests ways that practitioners can improve the prevention of alcohol problems in primary care settings.EPIDEMIOLOGY OF ALCOHOL DISORDERSAlcohol Abuse and DependenceThese disorders are common in primary care settings. Their prevalence ranges from 11 to 20 percent in general medical clinics (Bradley 1992), 8 to 16 percent in family practice clinics (Leckman et al. 1984; Schorling et al. 1994), and 12 to 16 percent in obstetrics and gynecology practices (Halliday et al. 1986; Russell and Bigler 1979). Their prevalence in emergency departments is nearly 20 percent (Rund et al. 1981). Although few general pediatric patients meet the criteria for alcohol abuse or dependence (Duggan et al. 1991), an estimated one in eight children in the United States has a parent with a drinking problem (Kemper 1992).Known risk factors for alcohol abuse and dependence include gender, age, family history, and ethnicity. Men are three to four times more likely than women to develop drinking problems (Bradley 1992). In men, heavy drinking often begins in the teenage years, with the risk of alcohol-related problems reaching a peak in the early twenties (Bradley 1992). Women tend to develop drinking problems at a slightly older age than men, but medical complications tend to occur at similar ages in men and women (Blume 1986). Youth who begin to use alcohol before age 16 (Smith 1993), or those with antisocial behavior (Vaillant 1983), are more likely to develop alcohol problems.A genetic or cultural predisposition clearly places some people at higher risk than others (Schuckit 1985; Vaillant 1983). Men with two or more alcoholic relatives are about three times more likely to become alcohol dependent than those without (Vaillant 1983). Northern Europeans (Vaillant 1983) and some Native American groups (Institute of Medicine [IOM] 1990) also are at increased risk of developing drinking problems.HAZARDOUS DRINKINGAvailable evidence suggests that hazardous drinking is relatively common among primary care patients. Saunders and colleagues (1993a) reported that 19 percent of patients who drank alcohol consumed potentially hazardous amounts. Russell and Bigler (1979) found 19 percent of women in a gynecology practice to be heavy drinkers. Although the prevalence of hazardous drinking among pediatric primary care patients is not known, one-third of high school seniors engage in binge drinking at least every 2 weeks (Smith 1993).Epidemiologic studies have identified several patterns of drinking that place people at increased risk for alcohol problems. …

V.L. Smith

Papers

Alcohol and other drug use