Factors associated with untreated remissions from alcohol abuse or dependence.

This paper describes an epidemiologic-based sample of individuals who remitted from alcohol abuse or alcohol dependence, both with and without treatment, to abstinence or moderate drinking. Inspection of the severity, onset, and duration of alcohol problems experienced by these individuals suggests that there may be two primary categories of drinkers with distinct pathways to remission. The first is a population of individuals who experience significant problems for an extended period of time who then resolve to abstinence through the use of treatment services. The second is a population of individuals who drink heavily at some point in their lives, experience some problems, and then "mature out" of this stage in their life as they age and take on other life roles.

On the high road: driving under the influence of cannabis in Ontario.

While cannabis is the most frequently found illegal drug in drivers killed or injured in motor vehicle collisions, little is know about driving under the influence of cannabis (DUIC) in the general population. We report information on the incidence of DUIC in a representative sample of the Ontario adult population. Among all drivers, 1.9% reported DUIC in the previous 12 months. Several factors influenced the likelihood of reported DUIC, including gender, age, marital status and education level. Among cannabis users, DUIC appeared to be a relatively common behaviour; 22.8% reported DUIC, and the probability of the behaviour was significantly influenced by gender and education level. As well, DUIC and drinking-driving were strongly related in this sample. These data underscore the need to obtain more information on this behaviour, including a more complete understanding of any risks involved.

Review of Canadian low-risk drinking guidelines and their effectiveness.

This study compared 18 low-risk drinking guidelines that were gathered from Canadian government agencies, non-government agencies, medical bodies, and public and private agencies involved in the treatment of addictions. The results show that two sets of guidelines are predominantly used in Ontario. The formulation of these guidelines was entirely independent and their intended audiences are also different. However, a direct comparison of the two guidelines shows that differences are more apparent than real. This study also examines the literature evaluating low-risk drinking guidelines Very little literature exists on evaluating low-risk drinking guidelines as vehicles for primary prevention and it is not known to what extent such guidelines influence knowledge and drinking behaviour. Future low-risk drinking recommendations should be evaluated for knowledge about standard drink units, awareness of the guidelines, use of materials and aids included in the dissemination program, and changes in behaviour from campaign exposure.

Procurement of alcohol and underage drinking among adolescents in Ontario.

OBJECTIVE: The purpose of this article is to examine the procurement of alcohol among underage drinkers. METHOD: The data are based on a survey of 3,571 students in Ontario schools. Underage drinkers were those younger than 19 years of age. Data were gathered with an anonymous questionnaire administered in classrooms in 1992. The data include descriptive analysis of underage procurement and a cluster analysis of underage drinker types (n = 1,125: 566 female). RESULTS: Most students found alcohol easy to obtain, with the most common access being from parents' supplies or older friends. Four types of underage drinkers were identified: bar drinkers (5%), frequent purchasers (10%), frequent obtainers (3%) and infrequent obtainers (83%). CONCLUSIONS: Frequent self purchasers and infrequent secondary purchasers have the highest levels of consumption and problems. However, most underage drinkers report no problems.

Enduring resurgence or statistical blip? Recent trends from the Ontario Student Drug Use Survey.

This paper describes trends in alcohol and other drug use among Ontario students between 1977 and 1995, especially those occurring between 1993 and 1995. Data are based on the Ontario Student Drug Use Survey, which to date represents 10 cross-sectional surveys conducted every two years since 1977. In each survey, approximately 4,000 students in grades 7, 9, 11 and 13 are interviewed in their classrooms. The findings show that after a decade of declining drug use, rates of use increased between 1993 and 1995. Of the 20 drugs surveyed in 1995, the use of 8 increased significantly from 1993. Increases in drug use were more common among 9th- and 11th-grades.

Do some types of alcoholic beverages lead to more problems for adolescents?

OBJECTIVE: In surveys of alcohol use the alcoholic beverage preferred is sometimes noted but rarely given much attention. What little research exists on how beverage type relates to alcohol problems, delinquency and drug use has produced inconsistent results. This study identifies groups of high school students who drink beer, wine or spirits exclusively as well as those who drink multiple beverage types and examines whether problems are limited to a beverage type or a combination of types. METHOD: This study uses data from the 1991 Ontario Student Drug Use Survey. The sampling design employs a stratified (grade by region) single-stage cluster sample of homeroom classes. Students who drank alcohol at least once a month are included (N = 1,557). RESULTS: Most students (82%) drink a combination of beer, wine and spirits. However, drinker type is not related to alcohol problems, drinking and driving, tobacco use, cannabis use or drug problems, holding constant age, gender and alcohol consumption. Only for heavy drinking and delinquency is there a significant association with drinker type. Exclusive beer and spirits drinkers and drinkers of all three beverages are more likely than the other drinker types to consume five or more drinks on a single occasion and to engage in delinquent behavior. CONCLUSIONS: Drinkers of beer and spirits and all three beverage types are not only heavier drinkers but probably more rebellious and deviant. Wine, if taken exclusively, appears to be the beverage of moderation.

Is the association between drug use and delinquency weakening?

In this paper we examine period or secular changes in the association between drug use and delinquency among Ontario adolescent students between 1983 and 1991. The results show that during this period drug use and drug-selling declined significantly, whereas reported non-drug-related delinquency increased. In addition to differing secular trends in rates of drug use and delinquent behaviour, the association between the two behaviours weakened. There was a steady decline in the correlations between drug use and delinquency across time, and the typological patterning of drug use and delinquency changed significantly.

The relationships between declines in drinking and alcohol problems among Ontario students: 1979-1991.

This article reports data from a 12-year cross-sectional study of drinking and drinking problems among students in grades 7-13 in Ontario schools. It was expected that rates of drinking and levels of drinking problems would be related. Large declines in drinking levels were found, however declines were found for only about half of the drinking-problem items. No declines were found in rates of the most serious problems and this indicates there is an unchanging proportion of students with drinking problems who will likely need interventions such as treatment and counseling.

Predictors of depression in street youth.

The extent of depression and other psychiatric problems among adolescent "street" and homeless populations is largely undocumented. Using a sample of 145 adolescent street youth interviewed in Toronto, Canada, this study attempted to extend the knowledge of street youth by examining the association of depression with alcohol and drug use and related problems, social supports, self-esteem, family background, and alcohol and drug use among family members. The results indicated that the best predictors of depression among street youth were self-esteem and length of time spent in a hostel.

Declining drug use in relation to increased drug education: a trend study 1979-1991.

During the 1980s alcohol and drug education increased in Ontario schools, especially at the Grade 7 level. This article reports aggregate relationships between increased levels of exposure to classroom alcohol, tobacco, and cannabis education, and the use of alcohol, tobacco, and cannabis by students in Ontario schools. The data were derived from repeated cross-sectional probability surveys of alcohol and drug use conducted every two years since 1979. There were strong inverse associations between increases in exposure to alcohol and drug education and reported levels of use of these substances, especially for alcohol and for Grade 7 students.

Adolescent drug sellers: trends, characteristics and profiles.

This study examines drug selling among representative samples of high school students in Ontario. It involves three approaches, (i) examining the trend in drug selling between 1983 and 1989, (ii) assessing differences between sellers and non-sellers on demographic characteristics, levels of alcohol and drug use, and problems, and (iii) drawing detailed profiles of drug seller types. Drug selling declined considerably between 1983 and 1989. Sellers were more likely to be males and to use alcohol and drugs more often than non-sellers. Sellers also had more alcohol and drug problems and engaged in more delinquent acts. Drug sellers who sold cannabis only were less frequent users of drugs, less likely to have drug problems, and were also delinquent.

Substance use and work disabilities among a general population.

Using data derived from a representative survey of 869 Ontario adults, we examined the association between work disabilities and substance use, i.e., drinking, alcohol problems, sleeping pills, and tranquilizers. Overall, we found a significant association between substance use and disability. For alcohol problems, we found that those with moderate limitations reported the greatest number of problems, holding constant age, gender, income, and frequency of drinking. For the use of sleeping pills and especially tranquilizers, we found a strong positive relationship to limitation status. A number of significant interactions involving tranquilizer use showed that two groups, females with total limitations and those aged over 40 years with sensory disabilities, reported exceptionally high rates of tranquilizer use.

Prolonged asystole during intraoperative myocardial reperfusion: an experimental study.

It has been observed in a proportion of patients, that clinically cardiac asystole persists for a prolonged period during intraoperative reperfusion. To evaluate this phenomenon, isovolumic functional indices (left ventricular [LV] balloon) and myocardial oxygen consumption (MV02) were compared in 22 canine preparations before and after two different interventions. After 45 minutes of normothermic global ischemia, (1) the control group (N = 11) was maintained on cardiopulmonary bypass with the hearts beating empty and (2) the experimental group (N = 11) was subjected to cardioplegia reperfusion at normothermia for one hour. In contradistinction to the initial hypothesis, functional recovery was better in the experimental group compared with the controls. Significant differences were observed in recovery of LV peak developed pressure (LVPDP) (controls, 66.8 +/- 7.3% [mean +/- standard error of the mean], and experimental group, 99.5 +/- 8.9%; p less than 0.05), maximum rate of rise of LV pressure (controls, 116.6 +/- 16.2%, and experimental group, 147.7 +/- 10.1; p less than 0.05), and maximum fall of LV pressure (controls, 100.3 +/- 15.8%, and experimental group, 143.1 +/- 11.5%; p less than 0.05). Correlation between LVPDP and MVO2 was also better preserved in the experimental group (controls: r = 0.15, N = 74, p = 0.18; experimental group: r = 0.47, N = 75, p less than 0.001). Values for myocardial water content and total creatine kinase in the two groups were similar. It was concluded that prolonged asystole during intraoperative reperfusion is not detrimental; on the contrary, there is enhanced functional recovery of the myocardium similar to that seen after secondary cardioplegia.