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|Major Studies of Drugs and Drug Policy|
|Canadian Senate Special Committee on Illegal Drugs|
|Volume 2 - Policies and Practices In Canada|
Chapter 16 - Prevention
that fall short of the mark
When Canada’s Drug Strategy was
launched in 1987, the government acknowledged that most federal initiatives had
focused on reducing supply and that there had to be more emphasis on
prevention. Of the $210 million initially allocated to the first five-year strategy,
no less than 32% was earmarked for prevention. In the second phase of the
strategy, which ran from 1992 to 1997, the total budget increased to $270
million, with a similar percentage earmarked for prevention.
1994, the Government of Canada introduced the National Strategy on Community
Safety and Crime Prevention and created the National Crime Prevention Council,
now the National Crime Prevention Centre (Department of Justice). When Phase II
of that strategy was launched in 1998, funding was $32 million annually; by
2001, funding had increased to more than $65 million. The strategy is aimed at reducing crime and
victimization by addressing their root causes through a social development
approach. Crime prevention through social development (CPSD) is a long-term,
proactive approach. It is directed at removing those personal, social and
economic factors that lead some individuals to engage in criminal acts or to
become victims of crime. The National Strategy is investing in projects that
address risk factors in people’s lives, such as abuse, violence, poor parenting
and drug and alcohol abuse. <![if !supportFootnotes]><![endif]>
Where do things really stand? The
stakeholders are probably in complete agreement that there is a need for
prevention. But they are equally unanimous that the actions that have been
taken are short of the mark. Otherwise stated, everyone talks prevention, but
no one does much about it. The observations made before the Committee cover
five sets of considerations: (1) there is not enough prevention;
(2) prevention lacks focus; (3) there is not enough evaluation of
preventive measures; (4) prevention and social messages about cannabis are
contradictory; and (5) there are exemplary practices and successful preventive
measures that need to be promoted more widely.
Not enough prevention
For many organizations, police
departments and government agencies involved in the war on drugs, it is clear
that there is not enough prevention. That view is measured in terms of spending
levels and cuts in prevention staff.
Think of the last time that you saw a drug prevention message on television. Probably one that many of us would recognize is the fried egg commercial representing what happens to your brain. Unfortunately, that was an American ad. I cannot recall a recent anti-drug ad on television. We have produced proactive materials on many other issues in our country. There are campaigns on tobacco and breast cancer. We really have very little material in the drug prevention area. We are not saying that we want more money for policing and arresting people. We agree with the current balance. We think that not only crime prevention, but also drug awareness is a vital tool in making a difference. […] We believe, first, that there is a role for police in prevention and awareness as well as in enforcement. We have excellent partnerships with teachers, parents and community groups. Community policing has really started to come together in the last 10 years. […] One of our problems is that some of our programs are dated. Very little effort is put into the prevention aspect. I do not want to be quoted exactly on dollars. However, a report about a year ago indicated that the United States spent about $12 per capita on prevention and awareness. In Canada, the comparative figure was less than $1. I think it was in the area of 20 cents or 30 cents. <![if !supportFootnotes]><![endif]>
Since 1988 and 1989, when we had the Really Me campaign, we have had no federal or, in B.C., provincial campaign speaking about drugs. […] When there was a decrease in consistent prevention messages and the National Drug Strategy ended, I witnessed numerous community coalitions and task forces on drugs that dried up and went away and no provincial funding followed it. I watched in Nakusp, Penticton, the Sunshine Coast, Whistler and many other places as excited people were no longer able to keep going because the attention in the country turned to the population health bandwagon. There was a loss of interest, funding levels and prevention, and at the same time, an increase in messages about hemp, “medical marijuana” and other ideas. […] When you have this going on for years, common sense would tell you we would have some erosion in the gains we had made in consumption. With that, and with some of the changes in drug sentencing and enormous growth in cannabis availability, certainly in British Columbia, it is no wonder we see these changes. <![if !supportFootnotes]><![endif]>
[Translation] Third observation: efforts to prevent substance abuse are
clearly inadequate. The task involves budget (increase allocations for
prevention in various areas), coordination (provide a better framework for
practices in this area) and research (establish clear program evaluation
parameters, determine the effectiveness of existing programs, promote winning
strategies). There is a particular need for more substance abuse prevention
initiatives in the following areas:
We had an excellent Canadian program developed in Nova Scotia in conjunction with the Nova Scotia Addictions Foundation known as PACE, the Police Assisted Community Education. We, along with a pharmacist, a doctor, a nurse and some athletes were among the people that went to schools to talk to the students about peer pressure, why some students feel compelled to use drugs, about stealing and different moral ethics, and other subjects relating to drug use. Unfortunately, because of the budget cuts, the programs were cut. The money for evaluations, for increasing the program, or for improving the program no longer exited. <![if !supportFootnotes]><![endif]>
In the 1970s and 1980s, there was support for community-based ongoing prevention efforts. However, in the 1990s, the federal and provincial governments cut a lot of the funding and there has been commensurate rise in drug use. During that same period, multi-faceted prevention efforts such as those directed at tobacco, seat-belts, fire safety, fitness, and dental health, to name a few, made major inroads. <![if !supportFootnotes]><![endif]>
Prevention of social and health
problems is often the poor cousin of practice. Whether in health or in justice,
the reality is that much more is spent on treatment and intervention after the
fact than on prevention. This is true for health issues in general and illegal
drugs in particular.
According to the study by Single et al.,<![if !supportFootnotes]><![endif]> the direct and indirect cost of illegal
drug abuse in 1996 was approximately $1.5 billion. Of that amount, $400 million
was spent on law enforcement (police, Customs, courts, correctional services,
etc.), and approximately $35 million was spent on prevention, that is, roughly
2% of the total, compared with more than 25% on efforts to fight drugs. Put a
different way, the per-capita cost of illegal drugs is roughly $48; by
comparison, about $12 is spent on drug control, and about $1 on prevention.<![if !supportFootnotes]><![endif]> We
agree with other stakeholders that spending on prevention is woefully
Prevention lacks focus
Preventing cannabis use probably
requires a different approach than preventing the use of heroin or ecstasy. By
the same token, prevention of use by students will not be handled the same way
as prevention of use by street kids, and preventive measures aimed at
Aboriginal youth will be different from those aimed at white youth. We will see
in the next section that the risk factors and protective factors are not the
same for all social groups.
However, stakeholders point out that prevention messages and the way they are delivered are often inaccurate. We see either universal messages the real effectiveness of which is hard to measure, or messages that are aimed at specific social groups but are not necessarily geared to the reality of the people being targeted.
[Translation] Of particular note are weaknesses in secondary prevention. Programs aimed more specifically at high-risk groups are not enough. There is little effective screening where early intervention might make all the difference in preventing problems from getting worse, and this is true not only of youth, but of client groups of all ages. There is at present a lack of consistency in the messages being conveyed and the initiatives being taken. There is a lack of program stability. And in some areas, a great deal of ground has been lost (e.g., gradual loss of substance abuse prevention educators). <![if !supportFootnotes]><![endif]>
Prevention is not ‘one size fits all.’ Broad population approaches are needed, but so too are narrow focussed activities that target a specific risk group. Of course, prevention is proactive. It promotes personal responsibility. It is highly cost effective: For the cost of one treatment centre, you can fund prevention initiatives that reach hundreds and, indeed, thousands of kids. <![if !supportFootnotes]><![endif]>
If the focus is prevention, the objectives have to be clarified: is the goal to prevent use, at-risk behaviour or abuse? The chosen preventive measures will be fundamentally different depending on what objectives are set. This point was made in a recent document produced for Health Canada on best practices in the area of prevention:
Clear and realistic goals that logically link program activities to the problems and factors found in a community are necessary to guide implementation. Clear and measurable goals will permit evaluation to determine whether the program achieved its objectives. Goals will vary with the community and the circumstances; however, important considerations for all programs are the points at which use and problematic use of different substances generally begin. […] Accordingly, for youth who are not yet using (i.e., either not considering use or thinking about use) the program aim would be primary prevention. Programs working with a population largely consisting of youth who have initiated use and continue to use, a secondary prevention or harm reduction aim makes most sense. Each of these aims logically lead to particular activities and messages (e.g., use of more intensive approaches with those using or preparing to use). <![if !supportFootnotes]><![endif]>
With respect to prevention, there is
also a sense that anything and everything is possible by adopting anti-drug
rhetoric. However, as we will show in the next section, preventive measures
have to zero in more on known risk and protective factors. And because there
are many risk factors, preventative action should be multifaceted and involve
There is not enough evaluation of preventive measures
Another reason there is not enough
prevention is that no one takes the time or devotes the resources to evaluate
programs and demonstrate their effectiveness. As the saying goes, an ounce of
prevention is worth a pound of cure. Similarly, one dollar invested in
prevention saves five dollars down the road. That may be true, but proving it
is something else.
evaluation studies is not an easy task. If they are to be credible, studies
often require a complex methodology. They are also expensive. And most
importantly, they cannot – or at least should not – be rushed in order to meet
political timelines: to determine, for example, whether a program aimed at
preventing drug use among youth is effective, “graduates” have to be monitored
for no less than a year (normally at least three years) after they received the
program. Canada is not in the habit of doing evaluative research, and, as we
saw for Canada’s Drug Strategy, we did not set clear objectives or provide the
means to evaluate initiatives.
As a result of this situation, prevention – a weak segment if ever there was one – pays the price when even the smallest budget cut is made.
One of the biggest problems is that our programs have never had an evaluation component. Whenever we had the opportunity to implement new programs, it was done “quick and dirty.'' There was very little money. Our only approach was to pump something out and see if it worked. We have all learned that if you are going to do something, do it properly. We should set up new programs with evaluative components in order to know that we are doing the right things at the right time for the right people. In other words, programs should consider the message, the messenger and effectiveness. <![if !supportFootnotes]><![endif]>
The Committee is of the opinion that any future Canadian drug strategy will have to include mechanisms and resources to evaluate the various components and in particular to evaluate preventive measures.
<![if !supportEmptyParas]> <![endif]>
<![if !supportFootnotes]><![endif]> National Crime Prevention Centre, statement of objectives, on line at www.crime-prevention.org
Barry King, Chief of the Brockville Police Service, testimony before the
Special Senate Committee on Illegal Drugs, Senate of Canada, First Session, 37th
Parliament, March 11, 2002, Issue 14, pages 82-83.
Dr. Colin R. Mangham, Director of Prevention Source B.C., testimony
before the Special Senate Committee on Illegal Drugs, Senate of Canada, First
Session, 37th Parliament, September 17, 2001, Issue 6, pages 74-75.
Quebec Standing Committee on the Campaign against Drugs (2000), Consultation 2000. La toxicomanie au Québec : Cap
sur une stratégie nationale, Quebec City: author, page 13.
Chief Superintendent R.G. Lesser, testimony before the Special
Senate Committee on Illegal Drugs, First Session, 37th Parliament,
October 29, 2002, Issue 8, page 14.
Art Steinmann, Executive Director, Alcohol-Drug Education Service,
testimony before the Special Senate Committee on Illegal Drugs, First Session,
37th Parliament, November 7, 2002, Issue 10, page 86.
Single, E., et al. (1996), The Costs of Substance Abuse in Canada,
Ottawa: Canadian Centre on Substance Abuse.
These figures do not take into account funds allocated to drug abuse
prevention by the National Crime Prevention Strategy that was really
implemented beginning in 1998.
Quebec Standing Committee on the Campaign against Drugs, op. cit., page 14.
<![if !supportFootnotes]><![endif]> Art Steinmann, Executive Director,
Alcohol-Drug Education Service, testimony before the Special Senate Committee
on Illegal Drugs, First Session, 37th Parliament, November 7, 2002,
Issue 10, page 85.
<![if !supportFootnotes]><![endif]> Roberts, G., et al. (2001),
Preventing Substance Abuse Problems Among
Young People. A Compendium of Best Practices, Office of Canada’s Drug
Strategy, Health Canada, Ottawa: Supply and Services, pages 30-31.
<![if !supportFootnotes]><![endif]> Barry King, Chief of the Brockville
Police Service, testimony before the Special Senate Committee on Illegal Drugs,
Senate of Canada, First Session, 37th Parliament, March 11, 2002,
Issue 14, pages 82-83.
Schaffer Library of Drug Policy
Major Studies of Drug and Drug Policy
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Short History of the Marijuana Laws
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Drug Abuse Treatment Resource List
American Society for Action on Pain
Let Us Pay Taxes
Marijuana Business News
Reefer Madness Collection
Medical Marijuana Throughout History
Drug Legalization Debate
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DEA Ruling on Medical Marijuana
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GAO Documents on Drugs
Response to the Drug Enforcement Agency
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