Monthly Archives: June 2018


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In a new study by the Canadian Centre on Substance Use and Addiction and the Canadian Institute for Substance Use Research, it is estimated that the overall cost of substance use in Canada was $38.4 billion in 2014. That amounts to approximately $1,100 for every Canadian regardless of age.

Substance use is a significant cost to the Canadian economy.

It has a direct impact on the healthcare and criminal justice systems as well as an indirect economic impact through lost productivity illness, injury and premature death.


With a better understanding of the economic, health and social costs of substance use in Canada — supported by comparable, valid and up-to-date data — federal and provincial/territorial public health experts will be able to:

Lost Productivity

Prioritize and target relevant public policies

Create initiatives to target the harms caused by substance use
Criminal Justice

Identify information gaps, research needs and refinements to be made to national data reporting systems
Other Direct Costs

Establish a baseline for measuring changes in policy and determining the effectiveness of harm-reduction programs

Objectives of This Project

The Canadian Centre on Substance Use and Addiction (CCSA) and the Canadian Institute for Substance Use Research (CISUR)had two main objectives for the Canadian Substance Use Costs and Harms project:

Provide updated data on the costs of substance use in Canada

The Canadian Substance Use Costs and Harms report provides estimates of the costs of substance use in Canada from 2007 to 2014.


Launch an interactive data visualization tool (Coming Fall 2018).

The Tool allows for ongoing monitoring and in-depth exploration of the harms and costs of substance use over time. The methods behind this tool build on the work of CISUR’s alcohol and other drug AOD monitoring project.


Snapshot of Findings

In 2014,

  • The overall cost of substance use was $38.4 billion, which amounts to approximately $1,100 for every Canadian regardless of age.
  • Almost 70% of the total costs were due to alcohol and tobacco.
  • The four substances associated with the largest costs were:

Alcohol ($14.6 billion or 38.1% of the total cost)

Tobacco ($12.0 billion or 31.2% of the total cost)

Opioids ($3.5 billion or 9.1% of the total cost)

Cannabis ($2.8 billion or 7.3% of the total cost)
  • The distribution by cost type was as follows:
Lost Productivity

Lost productivity ($15.7 billion or 40.8% of the total cost)

Healthcare costs ($11.1 billion or 29.0% of the total cost)
Criminal Justice

Criminal justice costs ($9.0 billion or 23.3% of the total cost)
Other Direct Costs

Other Direct Costs ($2.7 billion or 7.0% of the total cost)
  • Per-person costs were highest in the three territories

Northwest TerritoriesNorthwest Territories


Between 2007 and 2014,

  • The per-person costs associated with SU increased 5.5% from $1,025 per person in 2007 to approximately $1,081 in 2014
  • The per-person costs associated with alcohol use increased by 11.6% from $369 per person to $412 per person
  • Per-person costs increased by 19.1% for cannabis ($67 to $79) and 6.8% for tobacco ($315 to $337)
  • Per-person costs decreased by 24.6% for cocaine ($84 to $63) and by 17.9% for other substances ($20 to $16)

Please click image to download full report:

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Webinar: Supporting women and families of newborns with opioid-related neonatal abstinence syndome


BSRC Webinar

Supporting women and families of newborns with opioid-related neonatal abstinence syndrome

Wednesday, July 25th, 11:00 to 12:00 (EDT)




  1. To review the prevalence of perinatal opioid use and associated factors.
  2. To describe the presentation and management of opioid-related neonatal abstinence syndrome (NAS).
  3. To review supports for women and families during pregnancy, after delivery and once baby is discharged home.
  4. To discuss the role of breastfeeding in NAS.

This webinar is free to all participants

Click here to register


A computer with speakers (or headset) and high-speed internet are required to participate in this webinar. If speakers (or headset) are not available, a telephone would be required and a toll-free number will be provided.

For further information about registration contact:

Amanda Dupupet at

The Globe And Mail: Ahead of legalization, doctors warn pregnant women of cannabis risks


With the legalization of cannabis only a few months away, one of Canada’s top medical organizations is warning women about the risks the drug poses if used during pregnancy and breastfeeding.

According to the Society of Obstetricians and Gynaecologists of Canada, marijuana use can lead to preterm birth and low birth weight, as well as lower IQ and hyperactivity after a child is born.

“We want to make sure women understand just because it’s legal doesn’t mean it’s safe,” said Jocelynn Cook, chief scientific officer with the SOGC. “The science does suggest there are effects on pregnancy and on fetal development.”


The organization is launching a social-media campaign aimed at women of childbearing age to inform them of the potential risks of cannabis use ahead of Oct. 17, the day the drug is scheduled to become legal in Canada. A YouTube video cautions that cannabis has more than 400 chemicals that can be passed to a fetus during pregnancy or breastfeeding.

Despite the warnings, many women believe marijuana is safe, even in pregnancy, Dr. Cook said. A 2015 study published in the American Journal of Obstetrics and Gynecology found 70 per cent of women surveyed believe consuming cannabis once or twice a week during pregnancy poses no, or only slight, risks. The study also found 4 per cent of pregnant women reported using cannabis in the previous month.


Last month, a study in the same journal found about 70 per cent of Colorado dispensaries recommend marijuana to pregnant women to alleviate nausea.

One of the reasons cannabis is perceived as safe is because it is a natural herb, Dr. Cook said. Public health experts have to counter those messages with facts about potential risks, she said.

The campaign to inform women about the dangers of cannabis is akin to similar campaigns from years ago about the risks of drinking alcohol during pregnancy and breastfeeding, she said.

And, much like alcohol, cannabis use during pregnancy or when breastfeeding is a difficult area to study. For instance, researchers can’t ethically give pregnant women cannabis and wait to see the effects. As a result, there is not a large scientific body of evidence and many of the studies pointing to dangers such as preterm birth or cognitive impairments were conducted a few decades ago.

Dr. Cook said agencies such as Health Canada must commit to funding cannabis research in order to properly understand the potential health risks.

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In The News, CBC: Legalization comes with risks: Doctors reminding public that health effects of cannabis use are real

Vanessa Markov says she was lethargic and anxious in the years she smoked pot daily and has had more energy and motivation since quitting, but other users have found marijuana eases their anxiety. Researchers say much work remains to be done in identifying what determines how pot will affect individual users. (Craig Chivers/CBC)


On the heels of Prime Minister Justin Trudeau’s announcement Wednesday that adults will be able to legally buy and consume recreational marijuana on Oct. 17, some doctors are reminding Canadians of potential risks from cannabis and attempting to counter some common misperceptions about the drug. 

Many people are able to consume cannabis safely, but some individuals do experience health effects, and doctors say it’s impossible to predict how any one individual will react to the drug. 

One possible risk not often associated with marijuana in the public’s perception of the drug but that has been flagged by public health experts is dependence — defined as the need for repeated doses of the drug to feel good or to avoid feeling bad. 

Vanessa Markov, 33, of Toronto knows about that risk firsthand. She started smoking marijuana at age 15. At first, it was a couple of times a week during or after school with peers. By the time she graduated from high school, she was lighting up every day.

“I lived a relatively functional life: I had good jobs, and I did well,” Markov said. “But the secret life I had was when I went home, I would just smoke pot the entire time.”

She said she now realizes that heavy use took a toll on her health.

Can aggravate anxiety for some

In her 20s, Markov started to have extreme panic attacks and high anxiety. When she went to a doctor seeking treatment for mental health issues, including depression, she initially resisted when the physician suggested she stop smoking pot but finally quit the drug three years ago.

“It’s not a solution to your anxiety, your social anxieties, your feelings,” she said. “You know it will make you feel better for a short period of time, but you will notice after a while that it’s going to start impeding on your ability to actually enjoy your life.”


Markov started smoking marijuana as a teen, pictured above, and by the time she graduated high school, she was smoking every day. (Vanessa Markov)


Aggravated anxiety is one of ways that people can react to cannabis, but there is still a lot more research and monitoring that needs to be done to quantify the incidence of this and other physical and mental health concerns among marijuana users compared with the general population.

The federal government has said it wants to continue to monitor how Canadians of all ages are using the drug after it is legalized.

 When people use is the most important thing in how it affects the brain.– Dr. Romina   Mizrahi , Centre for Addiction and Mental Health

Doctors are paying particular attention to how it’s affecting young people given that their brains are still developing up until the age of 25.

Research has shown that regular cannabis use can re-wire the brain in younger users.

Cannabis affects the brain’s frontal cortex, which is responsible for judgment and decision-making.

position statement from the Canadian Paediatric Society says the area changes rapidly in adolescence and is more vulnerable to damage from THC, the main psychoactive component of the marijuana plant. 


Cannabis use is associated with a dampening or reduction in neurochemical systems in the brain, says Romina Mizrahi, head of the Focus on Youth Psychosis Prevention Clinic at the Toronto-based Centre for Addiction and Mental Health. The brains of people younger than 25 are particularly susceptible to these effects because they are still developing. (Craig Chivers/CBC)


“When people (adults) stop using, most of these changes reverse back to normal,” said Dr. Romina Mizrahi, head of the Focus on Youth Psychosis Prevention Clinic at the Toronto-based Centre for Addiction and Mental Health. 

What’s not clear is whether that same reversal happens in adolescents.

“What we understand now is that the timing is critical. When people use is the most important thing in how it affects the brain,” Mizrahi said.

Cannabis use can disrupt the brain’s endocannabinoid system — which fine tunes communication between neurons — so it doesn’t work, or work as efficiently, Mizrahi said. 

THC and other cannabinoids in the marijuana plant interact with receptors throughout the nervous system to regulate functions such as appetite, memory and sleep.

Many factors at play when trying to track cannabis effects

Scientists are trying to understand the various ways in which cannabis can be damaging, neutral or medicinal and what determines how it will affect a particular user. But their task is complicated by the fact that the marijuana plant contains many components, varies in potency and its effects are influenced by a number of factors, including frequency of use, the complexity of the brain and its interplay with genetics. 

Mizrahi said her colleagues and other scientists have observed that cannabis is associated with a dampening or reduction in neurochemical systems, but the immediate, short- and long-term effects of that vary.

“This would explain why people feel less anxious, why people feel less activated — except for a few people who can become psychotic, and we don’t know why,” she said.


Some known effects of smoking pot include aggravation of asthma and increased wheezing, coughing and shortness of breath. (Chris Corday/CBC)


One area that both government and scientists are paying particular attention to is how cannabis use affects driving.

Here, too, misperceptions exist.

A recent Health Canada survey found that while 75 per cent of respondents believe marijuana impairs the ability to drive, when it comes to pot users specifically, only 50.2 per cent believe that to be true. And among those age 16 to 19, only 41 per cent said they believe it affects their ability to drive. 

“We know that cannabis use impairs the ability to safely drive a motor vehicle,” said Amy Porath, director of research at the Canadian Centre on Substance Use and Addiction in Ottawa. “It more than doubles the risk of being in a collision.”

There are potential health effects that Canadians should be aware of ahead of legalization, Porath said.

For example, smoking cannabis can also:

  •     Aggravate asthma.
  •     Increase wheezing, coughing and shortness of breath.
  •     Increase the risk of bronchitis.

Students perceive low risk

It’s unclear, however, whether people will start thinking differently about these and other risks when cannabis is legalized this fall. Survey data suggests that among Canadian students the perception of cannabis being a health risk has decreased even if the reality may differ.

Click to read full article

Research Alert! Alcohol and marijuana use may increase risk of condomless sex in young adults


Young persons who use alcohol and/or marijuana experience heightened likelihood of condomless sex, according to a new study published in The American Journal on Addictions. This increased likelihood was greater for women than for men on days with alcohol or marijuana use, each alone but especially when combined.

The study included 290 young adults (18-25 years of age) who reported either alcohol or marijuana use. For females, compared with days with no substance use, the estimated risk of condomless sex increased by a factor of 2.12 on alcohol use days, 1.89 on marijuana use days, and 3.39 on dual use days. Among males, the odds of condomless sex increased only slightly on alcohol use or marijuana use days, but increased by a factor of 1.71 on dual use days.

“Our goal is to identify patterns of substance use associated with heightened risk. We are excited about these findings and their public health implications,” said lead author Dr. Jumi Hayaki, of the College of the Holy Cross.

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Dual use of alcohol and marijuana and condomless sex in young adult men and women: A within‐subject day‐level analysis

First published: 20 June 2018


Background and Objectives

Unprotected sex has been linked independently to alcohol and marijuana use, but few studies have examined associations with dual use or gender differences in these associations.


This study examined day‐level associations between unprotected sex, defined as condomless vaginal sex with an opposite‐sex partner, and use of alcohol, marijuana, neither, or both substances among 290 young adults (18–25 years, 52.3% female) who reported either alcohol or marijuana use. Participants reported demographics, alcohol use, marijuana use, and at least one episode of condomless sex as defined above in the past 90 days (Timeline Follow‐Back). The likelihood of condomless sex was examined for days when alcohol, marijuana, neither, or both were used. Gender differences were also explored.


For females, compared to days with no substance use, the estimated risk of condomless sex increased by a factor of 2.12 on alcohol use days, 1.89 on marijuana use days, and 3.39 on dual use days. Among males, the odds of condomless sex increased only slightly on alcohol use (odds ratio [OR] = 1.03) or marijuana use (OR = 1.08) days, but increased by a factor of 1.71 on dual use days.

Discussion and Conclusions

Young persons who use alcohol and/or marijuana experience heightened likelihood of condomless sex. This increased likelihood is greater for women than for men on days with alcohol or marijuana use, each alone but especially when combined.

Scientific Significance

Young women may be especially susceptible to the influence of alcohol and/or marijuana use on sexual behavior. (Am J Addict 2018;XX:1–6)

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CanFASD Want To Hear From You!


One of the goals of the CanFASD blog is to build knowledge of FASD and share this knowledge across communities. They want to help all of us learn about research that is meaningful and relevant, and they are trying to do this in a couple of ways:

  • Over the years, CanFASD has written a series of issue papers to highlight particular areas of FASD research with implications for policy makers, researchers, service providers, and individuals living with FASD and their families. We have a few issue papers in the works right now, but we also want to know if there are topics you would like to see featured in the future.
  • As you know, there are new studies released every day in the FASD field, but many of these research articles are unavailable for public access. If there is a specific article that you want to see summarized on the blog, send us your request and we will do our best to share that information with you.

If there are topics or articles that you want to learn more about, send them an email at

Binge drinking during youth may impact future offspring


WASHINGTON–A rat model found preconception binge drinking may have negative consequences on future offspring’s growth, social interactions and pubertal development, according to a new study published in the Endocrine Society’s Journal of the Endocrine Society.

Binge drinking during adolescent development can have long-lasting effects in the brain, and recent data shows that these effects may directly impact first-generation offspring. These observations could have consequences for human health as more than 4.5 million Americans under the age of 21 report engaging in binge-pattern alcohol abuse.

“Our animal study demonstrates that drinking large quantities of alcohol in a ‘binge’ fashion before pregnancy can impact future offspring,” said the study’s senior author, Toni Pak, Ph.D., of Loyola University Chicago in Maywood, Ill. “Importantly, this is true for drinking behaviors of both parents, not just the mother. Our previous data supports the idea that alcohol is affecting the parental sperm and eggs to induce these modifications in the offspring, but this most recent work shows the extent of those effects on social behavior, pubertal maturation, and stress hormones as the offspring grow to adulthood.”

Researchers found that a rat model of binge-pattern drinking during puberty had several consequences for the animals’ offspring, including smaller body weight, fewer play behaviors, and decreased circulating testosterone. In addition, the parents did not pass down to the offspring any adaptive traits that allowed them to better tolerate alcohol.

“By better understanding which parental preconception behaviors impact future generations, we can do more to prevent their perpetuation,” Pak said.


Other authors of the study include: AnnaDorothea Asimes and Chun Kim of Loyola University Chicago; and Amelia Cuarenta and Anthony Auger of University of Wisconsin – Madison in Madison, Wis.

The study was supported by research grants from the National Institutes of Health.

The study, “Binge Drinking and Intergenerational Implications: Parental Preconception Alcohol Impacts Offspring Development in Rats,” will be published online.

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at

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