SNUD Committee Report

CHAPTER 4: RESEARCH AND KNOWLEDGE

Research and other methods of knowledge development must form the foundation of policy and program development. Analysis of this information and data leads to consideration of policy alternatives and goals, the determination of appropriate programming interventions, the setting of performance measures, and the allocations of resources.⁹⁹

Governing bodies depend on the availability of reliable up-to-date information to design effective supply and demand reduction policies. Research and surveys on the nature, prevalence and trends regarding the use and harmful use of substances help policy-makers gain an insight into the complex social and health related issues. Although the current Canada’s Drug Strategy recognizes the importance of knowledge and research in developing and implementing public policy, the federal government has spent very little since 1997 on research related to the use and harmful use of substances.

Early in its investigation, the Committee became conscious of the lack of up-to-date reliable Canada-wide data on substance use patterns and law enforcement activities. Without such data, developing proactive strategies to respond to emerging trends is difficult, if not impossible. The vast majority of witnesses appearing before the Committee reinforced these findings, indicating that there is an urgent need for more and better Canada-wide and regional data on substance use in Canada. Data on addictions in Aboriginal communities, on and off reserve, and on the misuse of prescription drugs is basically non-existent. Limited information on possible cases of prescription drug misuse may be produced through provincial monitoring programs, but there is no federal database gathering such data. A number of provinces conduct regular surveys on substance use among the general population and among students (e.g., Ontario Student Drug Use Survey which has been collecting data since 1977) but each province uses different methodologies, which make it impossible to compare data. We also have very little information on the social and health costs associated with the use and harmful use of substances. For example, Canada-wide data on overdose deaths is not being collected; however, such data would be an important indicator of the extent of harm caused by the use of some psychoactive substances. The most recent study on the costs of substance abuse to society dates back to the study published by the Canadian Centre on Substance Abuse in 1996, using 1992 data.¹⁰⁰ Law enforcement statistics are also lacking. Only partial statistics are available on drugs seized in Canada. There are no national statistics on illicit drug convictions and sentencing in Canada. The existing provincial statistics that are reported are limited in detail.¹⁰¹

While the national statistics on police charges break down the number of drug charges by both type of substance (for example, heroin, cocaine, and cannabis) and act (for example, possession, trafficking, importation, and cultivation), the statistics on convictions are broken down into only two categories — possession and trafficking.¹⁰²

Health Canada agreed that knowledge of current Canadian trends and patterns of use and harmful use of substances is poor and that data collection has been, for the most part, piecemeal and sporadic. They reported, “there are no funds dedicated to national monitoring of rates of use of illicit drugs in Canada.”¹⁰³ In fact, Health Canada stated, “in 1998-1999, the U.S. government awarded six times as much money to support addictions research being conducted in Canada as did the Canadian government.”¹⁰⁴ This was reiterated by a number of researchers who testified before the Committee, including Eric Single, professor of public health sciences at the University of Toronto and senior research associate at the Canadian Centre on Substance Abuse, who stated:

Despite the fact that the federal government receives more than $3 billion a year from alcohol and tobacco taxes alone, the U.S. government spends significantly more on substance abuse research in Canada — this is the substance abuse problems of Canadians being researched by Canadians. The U.S. government spends six times as much on research on our drug problems than the Canadian government does. These cutbacks have led to a tremendous loss. We’ve lost almost all of our major senior scientists. I’m feeling quite lonely. Young, promising researchers have been driven to work in other countries or other fields.¹⁰⁵

The gaps in knowledge were also acknowledged by the Office of the Auditor General of Canada, which completed a study on the role of the federal government with respect to Canada’s Drug Strategy.

Information on the extent of the drug problem is either restricted, outdated or unavailable. This also applies to general basic information and management information.

… There is no complete and consolidated information on what federal departments are spending on addressing illicit drugs, either reducing supply or reducing demand. This is basic information essential to managing any program.¹⁰⁶

1. NATIONAL SURVEYS

The most recent national surveys that dealt specifically with the prevalence of alcohol and other licit and illicit substance use among the general population were conducted in 1989 and 1994. As well, the Canadian Campus Survey, conducted in the fall of 1998, provided national data on alcohol and other substance use, alcohol problems, consequences of alcohol use, and the context and characteristics of drinking occasions of undergraduate students. Until recently, national health surveys of the general population (e.g., National Population Health Survey) have included questions on the use of alcohol and tobacco, the use of prescription drugs, and at times alcohol dependence, but not on the use of illicit substances.

A new survey, the Canadian Community Health Survey (CCHS), will temporarily remedy this situation and provide, at the end of summer 2003, data on substance use and dependence including illicit substances among persons aged 15 years and older living in private occupied dwellings in ten provinces. This survey has been developed to provide regular Canada-wide estimates of major mental health disorders and problems. The CCHS has a two-year collection cycle “comprised of two distinct surveys: a health region-level survey in the first year with a total sample of 130,000 respondents and a provincial-level survey in the second year with a total sample of 30,000 respondents.”¹⁰⁷ Each second year of the survey cycle is designed to focus in-depth on a particular topic. In 2002, the topic selected was mental health and well-being which included numerous questions on the use and harmful use of substances, and dependence, including solvents and steroids. Currently, there are no plans to survey the use and harmful use of substances other than alcohol and tobacco in the next cycle. Questions on alcohol, harmful use of alcohol, alcohol dependence, and smoking are common content and will be part of every cycle. The Committee believes that consideration should be given to integrating questions on licit and illicit substances in every cycle of the Canadian Community Health Survey.¹⁰⁸

Another potential source of information will be the Human Resources Development Canada (HRDC) National Longitudinal Survey of Children and Youth. This survey was designed in 1994 to collect data at two-year intervals on a representative sample of Canadian children and youth from 0 to 25 years of age.¹⁰⁹ The objective is to “provide data to support longitudinal analysis on the prevalence of various biological, social and economic characteristics and risk factors among children and youth.”¹¹⁰ The first cohorts included 22,831 children aged 0 to 11. Information was collected from the parents, the children themselves (for children of 10-11 years of age), schoolteachers and principals. Data on young people aged between 10 and 17 is expected to be available in the spring of 2003 and will include some information on first-time use of substances. This survey has the potential to develop empirical evidence and policy relevant information for the development of prevention and education programs by isolating predictive factors and distinguishing critical points of intervention for changing a trajectory toward substance use.

Canada-wide surveys offer insight into the use and harmful use of substances that is essential to an overall assessment of the problem. However, these data sources, with the exception of the new Canadian Community Health Survey, are for the most part of limited use at the provincial and local levels. Canada-wide surveys supplement other available data sources but certainly do not replace valuable provincial and local data sources on the use and harmful use of substances. Nonetheless, more in-depth research and knowledge into public health and public safety issues related to the harmful use of substances, and dependence, is needed to inform policy decisions and to address the multitude of related problems.

Our foundation would point out, however, that we need much more than research into drug use patterns. While this and other epidemiological data are essential to good policy development, no less important is research into best practices and program effectiveness. In order to move toward an evidence-based system, policy-makers, program developers, and funders all need access to quality data.¹¹¹

Federal funds, albeit limited, support in part the development, coordination and dissemination of research and knowledge on the use and harmful use of substances primarily through work done by the Canadian Centre on Substance Abuse (CCSA), the Canadian Institutes on Health Research (CIHR) and other federal initiatives such as the Addictions Research Centre (ARC) of Correctional Service Canada.

2. RESEARCH ON THE USE AND HARMFUL USE OF SUBSTANCES AND KNOWLEDGE MANAGEMENT

a) Coordinated Efforts at the Canadian Centre on Substance Abuse

The Canadian Centre on Substance Abuse (CCSA), funded in part by Health Canada, is the main agency through which existing data on the use and harmful use of substances is being collected and disseminated across Canada. “The CCSA monitors research developments, participates in research forums and seeks to inform key stakeholders of innovative and relevant developments, which may bear on policy and programming.”¹¹² The CCSA is also a substance abuse and addictions affiliate for the Canadian Health Network.

Health Canada supports the work done by the CCSA in the area of information and knowledge management, and recognizes the need for more funding for research coordination. In the interim of a federal commitment to substantially fund Canada’s Drug Strategy, Health Canada took an expediential measure in March 2002 and increased funding for the CCSA from $500,000 per year to $1.5 million for each of the next three years to allow the Centre to expand its activities in support of policy development. However, this level of funding does not allow the CCSA to adequately fulfill the mandate it was given by Act of Parliament in 1988.¹¹³

The Canadian Centre on Substance Abuse has spearheaded a number of important research and knowledge networks and services over the last decade and currently is involved in the management or coordination of the following:

Some Committee members expressed concerns over the proliferation of virtual and non-virtual research networks currently being coordinated by the CCSA. Unfortunately, the Committee did not have the opportunity to assess the effectiveness of these research and knowledge networks and services. The Committee believes that under a renewed Canada’s Drug Strategy, all components of the strategy should be subject to comprehensive evaluations to ensure effectiveness, increase accountability and avoid duplication of services. Furthermore, the mandate of the proposed Canadian Drug Commissioner will ensure that federal dollars and resources will be appropriately allocated and reallocated if need be.

According to published documents and testimony before the Committee, here are some examples of activities undertaken by research and knowledge management networks currently being coordinated and/or managed by the CCSA.

(i) National Clearinghouse on Substance Abuse

Since 1991, the National Clearinghouse on Substance Abuse has been providing information to a variety of stakeholders, agencies, governments and anyone interested in learning more about the issues related to the use and harmful use of substances. The clearinghouse “complements the work of the Canadian Substance Abuse Information Network (CSAIN), and responds mainly to requests that are national in scope.”¹¹⁵ The clearinghouse offers two information services: the General Reference Service, and the FAS/FAE Information Service. In order to respond to information requests and to enhance dissemination of Canadian resources, the clearinghouse has “a very extensive collection of what they call fugitive or grey literature, which is literature that has not been published in peer-reviewed journals. They are difficult-to-obtain documents that researchers typically like to look at and draw from, as they go about their research.”¹¹⁶ The FAS/FAE information service, funded in part by the Brewers Association of Canada and the Association of Canadian Distillers, provides a toll-free telephone line to an information specialist and access to “a special collection, bibliographies, a Web site, and links to support groups, prevention projects, resource centres and experts on FAS/FAE.”¹¹⁷

The clearinghouse has been at the forefront in making information available on the Internet through the CCSA Web site, since January 1995. The Web site offers access to numerous databases including a national bibliographic database of Canadian publications dealing with the harmful use of substances, a number of directories of addiction organizations and agencies, a database of addictions researchers in Canada as well as a topical database on Hepatitis C and injection drug use. Finally, the Web site also offers access to a series of research publications published by the CCSA on a multitude of issues related to the use and harmful use of substances.

(ii) The Virtual Clearinghouse on Alcohol, Tobacco, and Other Drugs (VCATOD)

The Virtual Clearinghouse on Alcohol, Tobacco and Other Drugs, funded by the Department of Foreign Affairs and International Trade, is a trilingual Internet site (English, French and Spanish), which offers a single portal to worldwide research produced by recognized organizations that provide credible information related to the use and harmful use of substances. The Virtual Clearinghouse also provides a mechanism for online exchanges of information called “threaded” discussions such as discussions on high-risk youth, the state of marijuana research or the state of knowledge about ecstasy which all took place online in 2000-2001.¹¹⁸

(iii) Canadian Community Epidemiology Network on Drug Use (CCENDU)

The Canadian Community Epidemiology Network on Drug Use (CCENDU) was established in 1995 as a Canada-wide surveillance system on substance use. It is a counterpart of the Community Epidemiology Working Group in the United States, which has been around for 25 years. According to its own description, CCENDU is “a collaborative project involving federal, provincial, and community agencies, with intersecting interests in drug use, health and legal consequences of use, treatment, and law enforcement.”¹²⁰ Its stated goals are “to coordinate and facilitate the collection, organization, and dissemination of qualitative and quantitative information on drug use, among the Canadian population at the local, provincial, and national level” and “to foster networking among key multi-sectoral partners, to improve the quality of data being gathered, and to serve as an early warning system concerning emerging trends.”¹²¹

Essentially, CCENDU’s vision is a partnership to monitor drug trends and associated factors. There are two parts to that vision. One, which I think really captures CCENDU, is the idea of partnership. As I just said, there’s partnership at the local, national and international levels. The other part is to monitor drug trends and associated factors, and that’s essentially the data part.¹²²

There are currently 12 CCENDU sites across Canada, which are at different levels of development. They all collect data on an annual basis and some submit reports that provide information on the use and harmful use of some substances in a particular region of Canada. These substances are: alcohol, cocaine, cannabis, heroin, sedative-hypnotics and tranquilizers, hallucinogens, stimulants and licit drugs. Information from the sites’ reports is incorporated in an overview report, which provides gender specific data on prevalence, treatment, law enforcement activities, morbidity, mortality, HIV/AIDS and Hepatitis C. The network plans to establish five new sites every year in rural and urban settings. CCENDU is also looking at the feasibility of on-reserve data collection, which would fill a huge gap in data on the use and harmful use of substances among the First Nations people.

An evaluation of CCENDU was completed in 1999 by Alan Ogborne of the Centre for Addiction and Mental Health, on behalf of the Canadian Centre on Substance Abuse, and funded by Health Canada. The evaluation showed that “good progress has been made toward the original objectives, particularly in regard to the establishment of a national framework; the development of local networks involving policy developers; the routine gathering, processing and dissemination of various types of data; and, increasing awareness of the limitations of existing data”.¹²³ The main concerns were the quality of the data available to CCENDU, the need for greater consistency in data sources, as well as the need for more rapid dissemination. The evaluation report concluded:

CCENDU has the potential to ensure that alcohol and drug-related policies and programs are reality-base and effective. Reports from CCENDU could be of use to all those with an interest in alcohol and drug-related problems, including local and national policy-makers, the general public and those most affected by these problems. CCENDU addresses a widely held concern for better information on health issues and programs. CCENDU can also enhance Canada’s capacity to respond to requests from the World Health Organization, the UN Commission on Narcotic Drugs and other international agencies concerned with alcohol and drug problems.¹²⁴

The evaluation report recommended the continuation of CCENDU as a national project with further evaluation after three more years and federal financial support for the national coordination function through the Canadian Centre on Substance Abuse.

CCENDU has made progress toward addressing the main concerns raised in the 1999 evaluation. They are currently working with their partners to establish standardized data sources and collection techniques, which will increase comparability of data across Canada. Timeliness of reporting remains an obstacle but CCENDU is addressing this issue by proceeding with the development of a Web-based format for regular reports and an online community where site coordinators will be able to share information. While CCENDU continues to face difficulties regarding funding of their network, the CCSA has given it a high priority and has recently hired a national research advisor to provide leadership to the network.

(iv) Health, Education and Enforcement in Partnership

The CCSA also coordinates the Health, Education and Enforcement in Partnership (HEP) network since its establishment in 1994. According to its own description, HEP is a network of key stakeholders from the health, education and enforcement fields committed to the development of collaborative initiatives to address issues related to substance use and abuse.

HEP is led by a Steering Committee, which includes representatives from the Canadian Centre on Substance Abuse, Health Canada, Correctional Service Canada, the Canadian Association of Chiefs of Police, the Department of the Solicitor General (Secretariat and RCMP), the Department of Justice (including the National Crime Prevention Centre), the National Parole Board, the Federation of Canadian Municipalities, Alcohol and Drug Concerns,¹²⁶ the Canadian Association of Principals and the Student Life Education Company (BACCHUS). The Steering Committee hosts an annual meeting, which brings together members of the Federal/Provincial/Territorial Committee on Alcohol and Other Drug Issues, the Canadian Association of Chiefs of Police, the RCMP Drug Awareness Service and others, to exchange information, learn from one another and develop networks to pursue informal relationships throughout the year.

Activities of the HEP network include:

According to the background information available on the HEP Web site, the HEP network is rooted in the concept of seeking a balanced approach between supply reduction and demand reduction when addressing the numerous issues related to substance use and abuse. Its objectives are to promote better cooperation between stakeholders in the public health, education and enforcement fields, better sharing of information, better use of resources by preventing duplication and encouraging partnerships, and to contribute to policy and programming in the substance abuse field.

(v) National Working Group on Addictions Policy

The CCSA National Working Group on Addictions Policy was established in 1992 to monitor policy issues, develop policy documents and help coordinate policy development across Canada. It brings together representatives from key governmental and non-governmental organizations in the addictions field, as well as academia, research, and policy.¹²⁷ Michel Perron, Chief Executive Director of the CCSA, told the Committee that the working group takes on particularly controversial or difficult issues, those which perhaps a particular federal department or provincial government might not want to address on their own.

The working group meets twice a year and members participate at their own expense. Policy discussion documents have been prepared on a variety of subjects, including guiding principles for policy development, syringe exchange, harm reduction, cannabis policy, problem gambling, drug courts and the impact of smoking on drug treatment.

(vi) Canadian Executive Council on Addictions (CECA)

The Canadian Executive Council on Addictions (CECA) was recently established (2002) to provide a forum for leaders in the field of addictions in Canada to influence public policy related to the harmful use of substances, and dependence. Its membership includes senior executives of addiction agencies operating in Canada under a legislated federal or provincial mandate, or a recognized provincial authority, as approved by the board of directors. Current members represent British Columbia, Alberta, Manitoba, and Ontario. The chief executive officer of the Canadian Centre on Substance Abuse sits on the Council as a representative of that organization.

(vii) Conclusion

The Canadian Centre on Substance Abuse has demonstrated dedication to the fulfillment of its mandate, roles and responsibilities throughout the past 14 years despite major cutbacks in its core funding from the federal government. The Centre has managed through the commitment of its personnel, its own revenue-generating efforts, its capacity to leverage scarce resources into successful initiatives, its ability to form partnerships, and its focus on innovation to establish itself as the lead Canadian agency in the field of addictions.

When the CCSA was established in 1988 it received $2 million from the federal government as initial funding with an understanding that to fully meet the mandate it was given by Act of Parliament, monies would be required beyond this minimum base. Initial funding was also meant to leverage monies from other orders of government and non-governmental agencies involved in the field of addictions. However, with the effective sunset of Canada’s Drug Strategy in 1997, federal funding for the Centre was reduced by 75% to $500,000 per year. Its mandate remained the same and demands for CCSA services continued to increase. The recent increase in federal funding to $1.5 million per year does not even bring the CCSA back to its initial 1988 funding.

The Committee acknowledges the work that has been done by the CCSA with very limited resources and recognizes that, given appropriate funding, the Centre has the ability to play an expanded role under a renewed federal drug strategy and to clearly establish itself as the lead agency, both domestically and abroad, on the use and harmful use of substances in Canada. In an attempt to determine a reasonable amount of annual core funding, the Committee determined that, taking inflation into consideration, the initial annual core funding of $2 million promised by the federal government in 1988 would amount to $2,820,755 in 2002 dollars. The Committee further recognizes that the landscape has significantly changed in the last 14 years and that the demands for CCSA services have increased and will continue to do so under a renewed federal drug strategy as this report recommends an expansion of its mandate. The Committee thus recommends that federal funding for the Canadian Centre on Substance Abuse be immediately increased to $3 million so as to ensure that the CCSA has the necessary resources to continue its work and undertake the design of a new federal drug strategy.

(b) The Canadian Institutes of Health Research (CIHR) - Institute of Neurosciences, Mental Health and Addiction (INMHA)

Currently, the Institute of Neurosciences, Mental Health and Addiction (INMHA)¹³⁰ is the main institute of the Canadian Institutes of Health Research (CIHR), which allocates research funds to address issues related to the harmful use of substances and dependence. The INMHA allocates funds for a vast array of health concerns that currently include mental health, neurological health, vision, hearing and cognitive functioning. The Institute also supports research to reduce the burden of related disorders through prevention strategies, screening, diagnosis, treatment, support systems and palliation. Addiction prevention policies and strategies is thus one research area among many others that the institute supports.

For example, the CIHR funds a large interdisciplinary health research team comprised of 15 investigators from across Canada, under the lead of Dr. Benedikt Fischer (University of Toronto and Centre for Addiction and Mental Health), to conduct a multi-site cohort study with untreated illicit opiate users in five Canadian cities (Vancouver, Edmonton, Toronto, Montreal and Québec).¹³¹ This team of researchers endeavours to improve illicit opiate research, treatment and policy in Canada. The Committee acknowledges that this type of research is desperately needed and should be encouraged through financial support.

The INMHA, in partnership with the Institute of Aboriginal People’s Health, also supported the creation of a National Network for Aboriginal Mental Health Research (NNAMHR). The NNAMHR has received funding from the CIHR for a four-year period to conduct research in partnership with Aboriginal communities and academic researchers and develop research capacity to address the pressing mental health needs and concerns of Aboriginal people in rural and urban settings. This network has the potential to produce much-needed data on the use and harmful use of substances, and dependence, among Aboriginal people. However, the results will not be seen for many years.

Notwithstanding these efforts, many witnesses appearing before the Committee argued that the exceedingly broad mandate given to the INMHA results in a lack of focus on addictions research.

The CIHR institute I’m on the board of — neuroscience, mental health, and addiction — is making a very sincere effort to address all these terrible problems of the current research situation regarding addictions. They have a large mandate. They also have to cover mental health, neuroscience, vision problems, and hearing problems. I’m the only member in the substance abuse area on the 15-person board. I’m surrounded by neuroscientists and mental health people. We have to give them a period of time, see how much they accomplish, and then revisit the idea.

I still haven’t given up the idea that maybe at some point, not far in the future, the next time they decide to rearrange the makeup of the CIHR institutes they will consider a stand-alone institute on addictions. I think the scope of the social and health problems associated with substance abuse alone merits that. It’s the approximate cause of one in five deaths in Canada, and it’s the reason why many of the underlying determinants of health relate to low levels of population health.¹³²

Given the scope and consequences of problems related to the harmful use of substances in Canada, the Committee believes that the current INMHA should increase its focus on addictions research.

(c) Other Federal Initiatives

The Addictions Research Centre (ARC) was established in November 1999 and officially opened on 18 May 2001. The Centre is responsible for all addictions research and development activities within the mandate of Correctional Service Canada (CSC). It is fully funded by the CSC. Its role is:

The ARC has adopted the following goals:

Since its opening in 2001, the Centre has conducted research in a number of areas including the unique needs of Aboriginal offenders in relation to the harmful use of substances; special needs of women and gender specific patterns of use and harmful use of substances; fetal alcohol syndrome; evaluation of the effectiveness of intensive support units within correctional institutions; effectiveness of a methadone maintenance program; effectiveness of random and mandatory urine analysis programs; and updating assessments tools used in correctional facilities to determine levels of substance abuse of offenders.¹³³

In 2002, the ARC also organized an international forum to discuss research and development priorities related to the use and harmful use of substances within the correctional environment. The Forum was co-sponsored by the Canadian Centre on Substance Abuse and the Centre international de criminologie comparée at the Université de Montréal. It brought together 160 delegates (researchers, correctional managers, program delivery staff and individuals working in the field of substance abuse at the community level) from ten countries.

Finally, there are other federal initiatives supporting research, surveillance and knowledge dissemination related to predictive factors and prevalence of use and harmful use of substances. The Canadian Strategy on HIV/AIDS supports research related to injection drug use as a risk factor for Hepatitis C and HIV/AIDS. The Fetal Alcohol Syndrome/Fetal Alcohol Effects initiative supports the development and dissemination of research and knowledge as it relates to this particular area. For example, the initiative has launched a review of best practices and a situational analysis of research, policies, practices and programs and co-funded a national information service on FAS/FAE through the CCSA National Clearinghouse on Substance Abuse.

3. SETTING RESEARCH PRIORITIES AND RESOURCES

The Committee acknowledges the on-going research activities and the work currently being done with respect to information and knowledge management. However, the Committee observed that there are important gaps in knowledge related to the use and harmful use of substances, that coordination of current activities needs improvement, and that resources allocated to research are inadequate. The Committee concludes that there is a need to increase and better coordinate Canada’s research capacity on the use and harmful use of substances and dependence.

Research priorities for evidence-based policy development on the use and harmful use of substances and clear national indicators¹³⁴ against which all governmental and non-governmental stakeholders can agree to collect data annually should be set by Health Canada in consultation with the CCSA and other key stakeholders, including users of substances. Resources must be allocated to addictions research if Canada is to meet the challenges brought forth by these complex social and health issues.

4. COMMITTEE OBSERVATIONS - RESEARCH AND KNOWLEDGE

The Committee observed the following:

There is an alarming lack of information on the nature, prevalence and patterns of use and harmful use of substances and dependence, as well as a lack of coordination of research, data and best practices in Canada.

United States and Europe invest a substantial amount of resources into addictions research. In Canada, the investment in research pales in comparison. In fact, in recent years the United States government has awarded six times as much money as the Canadian government to support addictions research being conducted in Canada. Furthermore, we should be utilizing world research studies where appropriate.

Innovative, outcome-based research on the use and harmful use of substances and dependence, requires sustained, dedicated resources to achieve real breakthroughs in our understanding of substance use in Canada and to design policies and programs that will make meaningful differences in the lives of Canadians, their families and communities.

An early warning system must be set up to ensure that when a new synthetic drug or substance is identified on the streets, we have access to information on its production, traffic and use without delay.

RECOMMENDATION 6

The Committee recommends that biennial cross-Canada surveys be undertaken as part of a renewed Canada’s Drug Strategy to determine the nature, prevalence and trends of all substance use in Canada.

RECOMMENDATION 7

Considering the urgent need for Canada-wide data on the use and harmful use of substances and dependence, and the costs and benefits of using a regular health survey to gather such data, the Committee recommends serious consideration be given to integrating questions on licit and illicit substances in every cycle of the Canadian Community Health Survey, every two years.

RECOMMENDATION 8

The Committee recommends that the Government of Canada’s contribution to the Canadian Centre on Substance Abuse (CCSA) be immediately increased to $3 million, with subsequent annual increases to be determined based on the recommendations of the Canadian Drug Commissioner following an annual review and audit of the needs and activities of the CCSA.

RECOMMENDATION 9

The Committee recommends that the Institute of Neurosciences, Mental Health and Addiction increase its focus on addictions research.

RECOMMENDATION 10

The Committee recommends that the Government of Canada, under a renewed Canada’s Drug Strategy, provide Health Canada with dedicated research funds to:

RECOMMENDATION 11

The Committee recommends that Health Canada, in consultation with the Canadian Centre on Substance Abuse and key stakeholders, including substance users, identify research priorities to be supported by dedicated research funds under a renewed Canada’s Drug Strategy.