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An examination of marijuana use among a vulnerable population in Canada. Nicholas Spence, PhD Samantha Wells, PhD Julie George, PhD Kathryn Graham, PhD. Social Issue: Marijuana. Most commonly used illicit drug Lifetime use Canada (15+) in 2010: 41.5% Perceived risk decreasing over time
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An examination of marijuana use among a vulnerable population in Canada Nicholas Spence, PhD Samantha Wells,PhD Julie George,PhD Kathryn Graham, PhD
Social Issue: Marijuana • Most commonly used illicit drug • Lifetime use Canada (15+) in 2010: 41.5% • Perceived risk decreasing over time • Innocuous? • 1/10 ever use; 50% of daily users = dependent • Links to licit and illicit drugs • Poor education • Health links to poor respiratory health, accidents, psychosis, other mental health disorders, cancer risk, all cause mortality • Contribution to the burden of disease significant • High use group: Indigenous populations
Social Inequality in Canada: Human Development Index (HDI) 2001 Adapted from White, Beavon, Spence (2007), Aboriginal Well-Being
Social Determinants of (Aboriginal) Health • Traditional non-Aboriginal specific determinants • Aboriginal specific: Colonization, oppression, loss of culture, land and ways of life, racism • Intergenerational trauma and unresolved grief • Social ills • Maladaptive social and behavioural patterns, including substance use • Research gap -marijuana use -survey research approaches
Research Question • What are the factors associated with frequent marijuana use among First Nations on reserve?
Methods • Researching Health in Ontario Communities (RHOC), funded by CIHR • Mental health, substance use, violence • Sample (N=340), adults (18+) Kettle and Stony Point First Nation community
Analysis • General linear model (logistic regression) -Yes, responded has ever used marijuana more than once a week • Odds Ratios • Bivariate (unadjusted), Multivariate (adjusted) • * = p<0.05
Discussion: Age, Gender, Smoking • Patterns of use: Age, Gender, Smoking • Gendered approach across addiction cycle • Elevated use among younger age groups important in light of demography • 50% of First Nations <25 years of age vs. 30% of non-Aboriginals • Cigarette smoking: existing concern -Rates >3X rest of Canada -Co-occurring tobacco & cannabis use magnifies potential risk
Discussion: Normalization of Marijuana Use • Prevalence rate = 53.2% reported ever using marijuana more than once a week • Normalization • Social norms limit diversity and influence behavior • E.g., changes in drug use patterns of emigrants • Why? • Decline in perceived risk
Discussion: Program & Policy Implications • Focusing service priorities given normalization • Public health campaigns -harm -dependence -appropriate (timely, responsive, flexible) • Advocacy efforts founded on empirical research to secure resources
Conclusion • High prevalence rate • Gender, age, life course approach • Link - licit and illicit substance use • Public health programs: norms, gender, age, lifestyle • Continued focus on Aboriginal specific measures (colonialism, intergenerational trauma, historical loss, racism)