METHAMPHETAMINES IN ALBERTA: A Focus on Children, Youth, and Families

Transcription

FINAL REPORT
METHAMPHETAMINES IN ALBERTA:
A Focus on Children, Youth,
and Families
Authored by:
Laura Parks, BKin
Monica Jack, BComm, BSc
Methamphetamine in Alberta: A Focus on Children, Youth and Families
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Acknowledgements
The authors of this report and the Alberta Centre for Child, Family and Community Research would like to
thank the members of the Alberta Methamphetamine Inter-ministerial Working Group for functioning as
the Advisory Committee during the development of this report. Their input and feedback during this
process was invaluable. The Advisory Committee included representation from:
Alberta College of Pharmacists
Community Members
Edmonton Police Service
Government of Alberta
• Aboriginal Affairs and Northern Development
• Alberta Alcohol and Drug Abuse Commission
• Agriculture, Food and Rural Development
• Children’s Services
• Education
• Environment
• Health and Wellness
• Human Resources and Employment
• Justice and Attorney General
• Municipal Affairs
• Solicitor General and Public Security
Health Canada (Healthy Environments and Consumer Safety)
Justice Canada
Royal Canadian Mounted Police
We would also like to express our appreciation to those people who we interviewed to gather additional
information for this report. Thank you for your time and insight into the issues around methamphetamine
in Alberta. In particular, we would like to thank The Honourable Lynn Cook-Stanhope, Pam Downey,
Mary-Anne Jablonski, MLA, Lisa Luciano, David Ray, Darcy Strang, Bill Tatton, Uwe Terner, Harold
Trupish, Nina Vaughan, and those youth who so willingly shared their stories with us.
We would also like to thank Alberta Children’s Services and the Alberta Alcohol and Drug Abuse
Commission for funding the development of this report.
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Table of Contents
Acknowledgements
2
Table of Contents
3
Introduction
4
Methamphetamine in the World and in Alberta
5
The Development of This Report
5
The Scope of the Methamphetamine Problem
6
History
Who Uses Methamphetamine?
Effects of Methamphetamine
The Production of Methamphetamine
6
6
7
8
Methamphetamine Addiction ~ Not Just the Addict’s Problem
Effects of Fetal Exposure
The Effect of Addiction on the Family
Effects of Production on the Family and Community
Understanding Youth Culture
Education
Social Marketing
Designing a Message
Treatment
Youth Treatment in Alberta
Research into Youth Treatment
Moving Forward
Policy Implications
Future Research
In the End
9
10
10
11
Peer Influence
Stress
Other Factors Related to High Risk Behaviors
Prevention
9
11
12
12
12
13
15
16
17
17
18
19
19
21
23
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Introduction
Parents and community members alike worry about the impact of both legal and illegal drugs on their
children and communities. Alcohol, cigarettes, marijuana, cocaine, ecstasy, methamphetamine—these
are some of the many drugs that are impacting our society. They are addictive substances that cause
damage not only to the health of individuals who abuse these substances but to the health of our society.
People who abuse substances may face disease as a result of their addiction. They may injure someone,
intentionally or unintentionally, as a result of their substance abuse. And they may lose their family,
friends, and community as a consequence of their addiction.
Addiction has been defined in numerous ways. However, the underlying concept relates to selfadministration of a substance or product which the user knows is not in his or her best interest. To
combat addictions, then, the goal is to build healthy communities that work to reduce the likelihood of
addiction from a biochemical, environmental, and behavioral perspective. Such community development
will require strategies for prevention, treatment, and enforcement around substance abuse. Policy
makers, service providers, researchers, and others are trying to work towards solutions in these areas to
improve the health of our communities and decrease the negative influences of drugs. For more
information about methamphetamine, other drugs or AADAC services, please contact your local AADAC
office, call 1-866-332-2322 or visit www.aadac.com.
Methamphetamine is a drug that has resurfaced in North America, but this time as a more potent type
and more easily produced. As of late, the impact of methamphetamine on Alberta has become a concern.
This report was written to describe the issues around methamphetamine from a unique Alberta
perspective and focuses particularly on the impact this drug has on children, youth, families, and
communities. Opportunities for policy and research around the issue of methamphetamine are suggested
in the hopes that we can learn more about building healthy communities and put this knowledge into
practice and policy.
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Methamphetamine in the World and in Alberta
World-wide methamphetamine has become a pronounced problem in recent years, particularly among
youth. Originally methamphetamine (also known as speed, meth, crystal, crystal meth, crank, or ice)
gained popularity in Asia and the South Pacific, later working its way over to Hawaii and the West Coast
of North America. Recently its use has spread eastward across Canada and the United States.1
Amphetamine-type stimulants, the family of drugs to which methamphetamine belongs, are the most
popular illicit drug worldwide after cannabis; an estimated 0.6% of the global population used
amphetamine-type stimulants in 2003, or about 16% of drug users worldwide.2 In North America where
methamphetamine is the most common amphetamine-type stimulant, 1.1% or almost 3 million people
used amphetamine-type stimulants.2 Although the following statistics and observations are limited (e.g.
some include drugs other than methamphetamine), they suggest that Alberta has also been affected by
the wave of methamphetamine use.
•
•
•
•
•
•
In 2002, approximately 1 in every 13 high school students in Alberta reported using club drugs, like
crystal meth or ecstasy, in the past year.3
Of youth receiving services from the Alberta Alcohol and Drug Abuse Commission (AADAC) in 20032004, 25% had used amphetamines/stimulants (e.g. methamphetamine, ecstasy) in the past year and
9% were concerned about this use.4
Doctors have noticed an increase in the number of patients coming in for emergency medical
treatment relating to the use of methamphetamine although there are no readily available statistics
documenting this.5
Royal Canadian Mounted Police notice the methamphetamine being
In 2002, approximately 1 in
sold on the streets is of higher purity than in the past and there is an
every 13 high school
increase in the sheer amount of the drug available.6
students in Alberta had
The number of Schedule III drug seizures (including CNS stimulants
used club drugs, like
like ecstasy, amphetamines, and methamphetamine) in Alberta
7
crystal
meth or ecstasy, in
increased from 21 in 1998 to 252 in 2003.
(Since that time,
7,8
the past year.
methamphetamine has been reclassified as a Schedule I drug. )
The number of cases of methamphetamine trafficking has increased
from 13 in 1998 to 198 in 2002, likely reflecting both an increase in use of the drug and an increased
awareness and vigilance of law enforcers.7
The Development of This Report
This report was prepared by the Alberta Centre for Child, Family and Community Research in response to
the increasing concern about methamphetamine use among Alberta youth. The Alberta provincial
government’s Inter-ministerial Methamphetamine Working Group was enlisted to act as an expert
advisory panel. A search of academic literature was conducted using the following article databases:
MEDLINE, PsycINFO, CINAHL, PubMed, ABI Inform, and Google Scholar. Because the literature on
drug addictions spans many different sectors of research and society, these databases were selected to
cover a variety of relevant disciplines. A limited search of Internet web sites provided insight into general
information available to the public as well.
Much of the research found in the academic literature was completed outside of Alberta and Canada, so
caution should be taken in generalizing findings from such research studies to Alberta. To further
understand the nature of the methamphetamine problem in Alberta, interviews were conducted with
Alberta professionals in various sectors that handle issues involving methamphetamine. These
professionals included police and fire fighters, a Provincial Court Judge, medical professionals, treatment
and rehabilitation professionals, researchers, Alberta Children’s Services and a Member of the Legislative
Assembly of Alberta. In total, approximately 300 journal articles, reports, web resources and personal
communications were obtained, and those which were most relevant to the objectives of this report were
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included. This report is not intended to be a comprehensive or systematic review of the research
literature but highlights important issues around methamphetamine as pertains to children, youth, and
families.
The purpose of this report was to describe how the use, abuse, and manufacture of methamphetamine
may be affecting Alberta children, youth, and families. It covers the scope of the problem, including who
uses the drug, its effects, and how it is produced. Next, the impact of methamphetamine on infants,
families and the community are discussed. In keeping with a focus on youth, the youth culture is explored
as well as prevention and treatment efforts. Finally, recommendations for policy and future research are
provided.
The Scope of the Methamphetamine Problem
History
Methamphetamine, a stimulant of the central nervous system, was first synthesized in 1893 in Japan. It is
a derivative of amphetamine, which was created in Germany in 1887.1,7 Among its first uses,
methamphetamine was prescribed to treat certain medical conditions, such as asthma, obesity, and
depression, and was also used by armies during the Second World War to enhance the endurance of
soldiers.1 In the 1960s, the first illicit labs began to appear in California, producing methamphetamine or
“speed” as it was commonly known at that time.1 The dangerous properties of the drug were not fully
understood until the 1970s; subsequently, new restrictions were placed on the legal production and
distribution of the drug.1 With legal uses restricted, illegal production and use of methamphetamine
increased.1
In Canada, methamphetamine was classified as a Schedule III drug until this year, but recent legislation
in Canada has re-classified methamphetamine as a Schedule I drug. This means maximum penalties for
offences involving methamphetamine are now the same as those for offences involving cocaine or
heroin.8 If someone is caught producing, selling, importing or possessing any of these drugs, they can
face up to a life sentence in prison.
The first type of methamphetamine that was popular during the 1960s was dl-methamphetamine and
could only be injected or snorted. Starting in the 1980s, the popularity of methamphetamine grew again,
but this time the methamphetamine was a more potent type (d-methamphetamine hydrochloride). This
new type of methamphetamine can be produced using easier cooking methods and more readily
available precursor chemicals (i.e. ingredients) than in the past. It also comes in many different forms,
including pills, crystals, powder, or liquid. Although it can be taken in a variety of ways, smoking is one of
the most common ways. It is this type of methamphetamine (d-methamphetamine) that is popular today,
and it is about ten times the strength of the type of methamphetamine that was popular in the 1960s (dlmethamphetamine).
Who Uses Methamphetamine?
In the past, there were typical groups that used methamphetamine, and these groups still use the drug
today. People who typically used methamphetamine were those who felt they needed extra energy to
stay up longer, like students, people in occupations with pressure to work longer hours, and parents
balancing work outside the home with child care and housework.1,9,10 In addition, methamphetamine, or
“tina,” was, and still is, a popular drug in the homosexual club scene because it gives rise to reduced
social inhibitions and increased sexual arousal.11,12
However, young people from all walks of life are also
using methamphetamine. Street-involved youth as well
as junior and senior high school students may try the
drug, usually under the influence of their peers.13 As
The Alberta Youth Experience Survey (TAYES)
conducted by AADAC in 2002 found, 2.7% of youth in
grades 7 to 9 and 7.6% of youth in grades 10 to 12 had
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used club drugs (crystal meth or ecstasy) in the past year.3 However, this survey was administered to
Alberta youth who were in school and does not reflect the higher prevalence of methamphetamine use
among street-involved youth.13,14 As an example, three of the four people approached for in-depth
interviews at a popular youth hangout in Calgary had used or been addicted to methamphetamine.13
In the past ten years or so, the rave culture has also become
popular among youth, although some believe the growth of this
culture is now leveling off.15,16 Raves are all-night parties with
techno music and marathon dancing where drugs, like
methamphetamine and ecstasy, are widely available and
inexpensive.15,16 Drug use is generally accepted at raves although
some youth may choose not to use drugs.15,16 Data from a limited
sample of Alberta youth who attend raves suggests that although
most may believe methamphetamine and cocaine are harmful and
dirty drugs, perhaps close to half may try both drugs at least once
and about one-third may use methamphetamine on a weekly
basis.16
Of Alberta youth who attend
raves, most may believe
methamphetamine is a harmful
and dirty drug, but close to half
may try the drug at least once
and about one-third may use
methamphetamine on a weekly
basis.
Methamphetamine is sometimes referred to as “poor man’s cocaine” due to its relatively low cost
compared to cocaine and heroin.13,17 Although drugs of all kinds are prevalent on the streets (and
perhaps even in group homes according to a former resident), methamphetamine is popular with streetinvolved youth because it is inexpensive, easily available and has a long-lasting high.13,18-20
Although certain types of people may be more likely to use methamphetamine, it is important to recognize
that people may use the drug for a variety of reasons. Some of these reasons may include the following:
• To escape from boredom, sadness, or reality13
• To fit in and feel socially connected13
• To gain courage and confidence to experience things they might not have otherwise had the nerve to
do11
• To gain energy to meet the demands of life, work, or school10
• To lose weight10
If methamphetamine use progresses to addiction, the drug often becomes a barrier in life as things the
addict once valued slip away (e.g. friends, family, health, job, housing, or children), holding the user on
the outskirts of a society the drug was supposed to help them fit into.11,13,18,21
Methamphetamine is an addictive drug that can be injected, smoked, inhaled, or ingested orally and can
provide the user with up to 12 hours of increased energy, euphoria, and lowered inhibitions.1,21 When
smoked or injected, methamphetamine produces an intense “rush”, or sense of intense pleasure, lasting
a few minutes.1,21 This is then followed by the period of euphoria. Because the drug reaches the brain so
quickly after smoking or injection and produces a rush, methamphetamine is especially addictive when
smoked or injected.1,21 Methamphetamine increases the heart rate and breathing rate and can also
cause shakiness, loss of appetite, agitation, paranoia, violent behavior, and psychosis-like symptoms
(e.g. hallucinations).1,5,12,21,22 Because methamphetamine causes an increase in heart rate and blood
pressure, users may come into the emergency room complaining of chest pains or a heart attack.
Seizures and dangerously high body temperatures are other effects of high methamphetamine doses and
can be deadly.5,21 People who use methamphetamine may also have itchy skin which could lead to sores
and infection. Furthermore, methamphetamine is a highly acidic drug which causes teeth to decay at an
extremely accelerated rate, especially when combined with high soft drink and sugar consumption and
neglect of self-care or personal hygiene among those addicted to the drug.23
As use continues, people may take the drug for several days to maintain the high (i.e. binge). Particularly
on weekends, emergency rooms may encounter people on methamphetamine binges as one Calgary
doctor observed.5 These cases tend to be characterized by dehydration and exhaustion from all night
dance parties and malnutrition from not eating while on the drug.5 As users come down from the high,
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they may experience “tweaking” or out-of-control rages before they “crash”. When crashing, users usually
feel extremely exhausted and may also experience depression and irritability.11,24,25 One reason
methamphetamine users tend to use many different drugs is to control the crash after the high.18,20,26
Chronic methamphetamine users tend to develop a tolerance to the drug, which forces them to seek
larger and more frequent doses to bring on the high that was experienced at first use.21 Prolonged use of
the drug also causes changes in the brain, resulting in slower reaction times and a loss of short term
memory.27,28 Symptoms caused by long-term methamphetamine use can be like those found in
Parkinson’s disease and schizophrenia.18,29 In particular, methamphetamine abuse causes damage to
dopamine terminals in the brain, a finding similar for people with Parkinson’s disease. (Dopamine is a
chemical messenger in the brain involved in motor control.) To determine if there is a link between
methamphetamine abuse and later development of Parkinson’s disease, researchers are first trying to
see if damage to dopamine terminals caused by methamphetamine is long-lasting, or if partial recovery is
possible with lengthy periods of abstinence.27,29 At this point, the evidence is mixed as to whether the
damage is irreversible.27,29 In Japan, researchers are beginning to explore whether methamphetamine
induces the onset of schizophrenia among those who are vulnerable to developing the condition.30
The Production of Methamphetamine
Unlike cocaine and heroin, which are made in high-output production operations in foreign countries and
imported illegally to dealers in Canada, methamphetamine can be produced, or “cooked,” by a quick,
relatively simple process using readily available and legal ingredients (e.g. cold medications).7 The drug
is produced in labs which often consist of a network of rubber tubing that connects glass heating
containers and plastic storage tubs; such labs can be found anywhere from remote barns and pick-up
trucks in rural areas to bathtubs, hotel rooms and garages in the city.6,19,20,31,32 Most labs run by
individuals or small groups are small scale and generally make enough methamphetamine to support the
cook’s habit with some left over to sell.
Super labs, on the other hand, are capable of producing 10 lbs (or 4500g)1 or more of methamphetamine
within a 24-hour production cycle and are more often run by organized crime groups.20,33 At the time of
this report, there were 2 suspected large scale labs outside the Edmonton area.20 The financial lure for
organized crime groups is clear. As a former user observed, for a relatively small investment of around
$1000 for ingredients and supplies, a single cook can make about $10,000 a batch.13
Producing methamphetamine is a dangerous process because the chemicals used to make the drug and
the waste produced are corrosive, explosive, flammable, and toxic if inhaled, ingested, or absorbed
through the skin.6,19,20,34,35 Attesting to these dangers is the fact that methamphetamine labs are often
discovered when they explode.19,20,32 Detection by other means is becoming more difficult as portable
labs become more common, particularly in cities.19,20,32
In an effort to reduce the number of clandestine labs,
both the provincial and federal governments are
discussing the control of precursor chemicals used to
produce methamphetamine, namely ephedrine and
pseudoephedrine. Federal Bill C-349 proposes an
amendment of the Controlled Drugs and Substances
Act that would give Royal Canadian Mounted Police
the right to prosecute people found to be in
possession of the precursor chemicals used in the
1
A single hit of methamphetamine is 0.1g and often referred to as a ‘point’. Thus, 10 lbs of
methamphetamine would equal about 45,000 hits. As a user’s body adapts to low doses of
methamphetamine, a tolerance to the drug is built up and the user will need larger amounts of the drug to
get the same rush they initially experienced. Consequently, those addicted to methamphetamine will
often take many hits at one time, up to or even exceeding 1g.
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production of methamphetamine.36 In Alberta, Bill 204, the Precursor Limiting Act, proposes to reclassify
all products that contain ephedrine or pseudoephedrine as the main therapeutic agent (e.g. cold
medications) as Schedule II drugs, which would mean they could be sold only from behind a pharmacy
counter.37 Some stores in Canada (e.g. Shopper’s Drug Mart) and
United States (e.g. Walgreens) have already moved these products behind the counter, partly due to
increased theft.6,38 Limiting the sale of these products is hoped to impact home-based labs in the
province, but large-scale super labs likely have alternate routes to access the large amount of ephedrine
and pseudoephedrine they require. Findings on the effectiveness of controlling precursor chemicals in
the United States are unclear.39
Methamphetamine Addiction ~ Not Just the Addict’s Problem
Although there is concern about youth being addicted to methamphetamine, this is not the only way that
methamphetamine can impact children, youth, and families.
Effects of Fetal Exposure
A number of studies have been conducted on infants exposed to methamphetamine in utero (i.e. while in
the womb), but results are inconclusive about the extent of damage to the infant.40-47 This is because
many women who use methamphetamine also use alcohol, tobacco, marijuana and other drugs during
their pregnancy, making it difficult to distinguish between the direct effects of methamphetamine and the
effects of the other drugs on the fetus.40
In spite of these difficulties, some research suggests that
women who use methamphetamine throughout the
In utero exposure to methamphetamine
entire pregnancy tend to have infants of lower birth
may cause brain damage and persistent
weight and smaller head circumference compared to
behavioural problems to the child.
women who only use the drug for the first two
40
trimesters. Such growth restrictions may be caused by
methamphetamine restricting nutrients from being passed from the mother to the fetus and/or as a result
of the mother’s poor eating habits when using the drug.40,46 In addition to growth restrictions,
development of the fetal heart may be affected by methamphetamine exposure.47,48 Furthermore, case
studies suggest a possible risk of premature delivery or spontaneous abortion due to increased maternal
blood pressure from methamphetamine use.49
Other studies have looked at the childhood outcomes associated with in utero methamphetamine
exposure. A recent small-scale study found that some brain structures were smaller in children exposed
to methamphetamine in utero (but limited other drugs) compared to those who were not exposed.46
Children exposed to methamphetamine also had poorer performance than the non-exposed children in
visual motor integration, sustained attention, long-term verbal memory, and long-term spatial memory.46
Researchers think there may be link between fetal methamphetamine exposure, smaller brain structures,
and poorer learning among these children.46 A study in Sweden had followed up children who had been
exposed to methamphetamine in utero and found that at four years of age their IQs were lower than the
national average.42 At age 8, these children were found to have more aggressiveness and peer-related
problems,45 and at age 14, a higher proportion of methamphetamine-exposed children were in lower than
expected grades or receiving special lessons outside school, compared to the national average.50
However, this study included many children who had also been exposed to tobacco, alcohol, and other
drugs and could not control for changes in care (e.g. parent custody to
foster care) or unstable living environments.42,45,50
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The Effect of Addiction on the Family
Children whose parents abuse methamphetamine experience the many detrimental social effects this
drug has on families. Methamphetamine use can lead to a powerful addiction,21 and although some
parents succeed in overcoming their addictions, many are overcome by their addiction which takes
control of their life.43,51 Children of people addicted to methamphetamine are often the subjects of
neglect.22,43,45,51-53
Domestic violence and criminal activity are also common in homes where
methamphetamine is used or manufactured.45 Such living conditions could also contribute to social and
emotional problems in these children, such as low self-esteem, aggression and withdrawal from society.54
Developmental delays in speech and language have also been noticed by professionals.53 If teachers
and community members notice a child has poor hygiene, is showing up very early to school, or is coming
unprepared without a lunch or proper clothing for the season, further investigation may be required and
should consider the possibility of substance abuse in the home.22,51,53
To some extent, users may be aware of the negative impact their drug use has on their family although
the most obvious consequences may not necessarily occur to them.
Females addicted to
methamphetamine in Seattle admitted that their drug use affected their ability to parent by making them
irritable.55 However, they did not readily recognize that being “high” and drug seeking activities were also
barriers to parenting well.55
According to a representative from Children’s Services, there seems to be a growing number of drugendangered children in Alberta.51 There is current legislation and policy in place to protect children who
are found to be in danger due to chronic drug use by their guardians or caregivers.51 A court order is
given for the children to be removed from the home until it is deemed safe for them to return.20,22 In the
best case scenario, one parent may not be addicted to drugs, so Children’s Services will try to persuade
that parent to remove themselves and their children from the addicted parent until he/she is rehabilitated.
If both parents are found to be involved with drugs, Children’s Services will try to place children with an
extended family member who has been deemed a capable guardian. If these two options are not
possible, children will be placed in foster care until the parents are able to care for the children again or a
more permanent care situation can be arranged.22,51 Although parents may promise to undergo treatment
and stay off drugs to regain custody of their children, it may be a condition of the court that parents are
randomly screened for drug use to make sure they remain clean.22 If parents are committed to take
immediate action to break their addiction and provide a better life for their children, Children’s Services
may allow the child to remain with their parents, but again a court-ordered monitoring system would be in
place.22,51
As a sign of how powerful this addiction can be, parents may give up their children when
forced to choose between their addiction and their children.20
As with other drug addictions, methamphetamine addictions within families put costly demands on the
social system required to care for drug-endangered children. Most importantly, it creates an unstable
living environments for affected children—sometimes including changes in custody—and also hinders the
optimal development of these children. Many times an addiction to methamphetamine will also lead to
involvement in the production of methamphetamine, which adds to the negative impact on children in the
home as described below.13
Effects of Production on the Family and Community
As stated before, producing methamphetamine is a dangerous process because the chemicals used to
make the drug and the waste produced are corrosive, explosive, flammable, and toxic if inhaled, ingested,
or absorbed through the skin. 6,19,20,34,35 Thus, illegal methamphetamine labs pose a health risk to those
who may come into contact with the lab and its chemicals.35,56 This may include the following people:
• people involved in the cooking process
• children living in a home where methamphetamine is produced
• professionals who first respond to the scene of a discovered lab
• people who are in the general area of the lab.
Respiratory irritation, headaches, dizziness, nausea, eye irritation, and burns are effects found among
people exposed to methamphetamine labs.35,53,56 Liver and kidney disease, cancer, anemia, risk of
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infection, and severe lung disease have also been reported by those exposed to methamphetamine
labs.53 There are no known published studies that have specifically looked at the effects of
methamphetamine labs on the long-term health and development of children. However, it is clear that
children in homes where methamphetamine is produced are in danger. Not only are they exposed to
toxic chemicals, but there is the potential for these children to accidentally or intentionally take
methamphetamine.53 Methamphetamine labs pose significant
health and safety risks to all who are exposed, however, children
It is clear that children in homes
are particularly vulnerable.
Proposed legislation is being
where methamphetamine is
developed in Alberta to ensure that children can be apprehended
produced are in danger.
from guardians or caregivers who have exposed children to
clandestine drug labs or grow operations. This proposed
legislation may be passed as early as Spring 2006.
Methamphetamine labs pose a danger to the general public as well. For instance, there was a case in
Alberta in 2002 where unsuspecting neighbours and housekeeping staff in an apartment building suffered
from side effects from exposure to phosphine gas produced by a methamphetamine lab in an apartment
unit.6,56-58 At high concentrations, phosphine gas can induce coma or even cause death, as with three
men who died in a methamphetamine lab they had set up in a California hotel room.58 Thus,
methamphetamine labs pose a risk to the safety and well-being of those who knowingly and unknowingly
come into contact with the ingredients and by-products.
Understanding Youth Culture
Turning again to focus on youth methamphetamine use, it is important to first of all consider the youth
culture. Adolescence is a time of hormonal and developmental changes, a changing social environment,
and transitions from childhood to adulthood.59 As part of these changes, adolescents will try many new
things for the first time, from driving a car and getting their first
job to behaviors that are considered high risk. Risk-taking
If a youth is involved with a peer
behaviour is closely associated with the adolescent maturation
59
group
who has easy access to and
process. In fact, compared with other age groups, teenagers
uses drugs, that youth is much
participate in higher amounts of reckless, risk-taking and
sensation-seeking behaviours.59
more likely to use drugs.
Peer Influence
During adolescence, peer influence and social interaction gain primary importance as youth seek the
independence required for adulthood.59,60 Social influences are believed to be a primary reason young
people start using drugs.61 Indeed, girls may start taking methamphetamine to control their weight, and
teens will try drugs at parties to not feel left out.13,55,62,63 The rave culture, where drugs are widely used, is
also popular among youth because everyone is accepted in this culture and social interactions seem
easier for people.16 From junior high to high school, the amount of high-risk peer behaviours increases
drastically,60 and if a youth is involved with a peer group who has easy access to drugs and uses drugs,
that youth is much more likely to use drugs.3,16
Some youth end up on the streets as a result of their drug use,
running away or being asked to leave their homes; underlying
factors may include poverty, abuse, and family dysfunction.64
Sometimes young people, particularly those from high
socioeconomic status may be drawn to the streets by the
perceived excitement and challenge of surviving in the “urban
wild”.64 When living on the streets, youth connect with a new
peer group where drug use is prevalent. On the street, some
consider it more safe to sleep during the day and stay up all
night, so youth will use methamphetamine to get them through
the night and help make it more fun.13,18,19
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Stress
For adolescents, it is likely both daily hassles and major life events that contribute to the stress
encountered during this time of physical, mental and social change.59,65 In response to stress, some
adolescents may experience depressed moods and anxiety—perhaps more so than their adult
counterparts.59 Adolescents may search for new, “mature” ways to cope with all the stress in their lives.59
Some youth may turn to drugs as a way to manage problems and stress.59 To an adolescent,
methamphetamine may at first seem like a drug that could help solve problems, like being overweight,
being shy, not fitting in, difficulty keeping up with school, or feeling down. Level of stress does appear to
be a factor related to drug use and abuse. 59 Although drug use itself may directly or indirectly cause
stress, researchers are also exploring the possibility that stress may affect the decision-making abilities of
youth, including decisions related to drug use.59
Other Factors Related to High Risk Behaviors
Although peer group and stress are related to drug use, there are some other factors related to high-risk
behaviors.
• Adolescents who have experienced physical or sexual abuse are more likely to abuse alcohol or
drugs.66
• Adolescents with families who have had alcohol problems or used drugs are more likely to abuse
these substances themselves.66
• Adolescents engaging in other high-risk behaviors, such as alcohol, tobacco, and marijuana use, and
early sexual activity may be more likely to use methamphetamine.9
• Adolescents not living with both natural parents may have higher incidences of hard drug use (e.g.
cocaine, methamphetamine).3
• Adolescents without a close family relationship may be more likely to use methamphetamine.9
• The likelihood of high-risk behaviours may increase with each tattoo or body piercing, and multiple
body piercings are related to a higher incidence of hard drug use.67
• Youth who attend alternative high schools (schools for students whose needs are not addressed in
regular schools) also have a higher incidence of high-risk behaviours (average of 5.4 high risk
behaviours compared to 3.6 among students attending a traditional high school).68 This is not to say
that attending an alternative high school will cause students to engage in high-risk behaviours; it may
well be that such schools attract at-risk youth.
Although the above factors may be related to high-risk behaviors, they will not necessarily lead to highrisk behaviors. These factors may indicate an opportunity for further discussion with youth about drug
use and other high-risk behaviors, but it is important to remember that youth in general are at risk for
engaging in high risk behaviours.59 However, these factors can help policy makers decide which youth
are more likely to engage in high-risk behaviors and thus which should be targeted more intensely with
prevention efforts.
Prevention
A moderate amount of risk-taking behavior is considered adaptive by some professionals as it may help
youth explore adult life and behavior and help them acquire the skills they will need once they reach
adulthood—if they can avoid long-term negative consequences of certain behaviors.59 The reality,
though, is that drug use is potentially even more dangerous for teenagers, as the time from initial drug
exposure to substance dependency is often shorter in adolescents than in adults.69 However, youth may
not recognize the negative consequences of using a particular drug, like methamphetamine. Perhaps
youth have never heard of the drug and its effects, have been misinformed, or feel invincible despite
everything they have been told about the drug.70 Or perhaps youth have grown up in environments where
drug use occurred and are consequently more likely to develop an addiction.66 Whatever the case may
be, it is clear that initiatives to prevent youth from using methamphetamine and other drugs are needed—
ones that target risk factors, build resiliency, and promote healthy development in youth.
Page 12 of 31
Education
Judges, law enforcement officials, medical staff, social service personnel, and recovered
methamphetamine addicts agree that more education to youth and to the general public is needed in
order to prevent the use, sale and production of methamphetamine.6,13,18-20,22,51
Programs in North America
Drug Abuse Resistance Education (DARE) has been one of the most popular in-school drug education
programs in North America.71,72 However, the original version of the program has been shown in multiple
studies to be ineffective at changing drug use behavior in the long term.72-77 Modifications to the DARE
program, such as including a peer-led component and developing extracurricular activities, may show
some promise in changing actual student behaviors.73 Exclusively school-based programs alone are
limited in their effectiveness to keep students away from drugs. Longer-lasting effects and impressions
are made when classroom-based drug education is partnered with community-wide initiatives and multicomponent education programs.61,73
Many prevention programs have been evaluating outcomes to determine if they are effective at
preventing risk behaviors. In fact, the Centers for Disease Control and Prevention in the United States
has compiled a list of “Registries of Programs Effective in Reducing Youth Risk Behaviors”.78 This is a list
of federal agencies in the United States who have developed registries for research-based prevention
programs that have been found to be effective or promising. Considering that some of these registries
contain numerous programs, Substance Abuse and Mental Health Services Administration (SAMHSA)
outlined the essential elements of programs registered with their organization that have been found to be
effective.79 According to SAMHSA, programs that were effective:
• focused on generic life skills rather than knowledge and skills related to substances only
• allowed students to practice using these skills and information
• were school-based, delivered over short time periods, and usually involved weekly sessions
• had a consistent message delivered through many channels, including those outside the school
• addressed factors that put youth at risk for substance use
• were integrated into naturally occurring social contexts (e.g. schools, churches)
• focused on strengths of youth and families
• adhered to the program curriculum
• trained facilitators
• used credible facilitators known to the students
• used peers to deliver some content
• involved parents by developing parenting skills and increasing involvement in their children’s lives.79
Some particularly notable programs in the SAMHSA registry appear to reduce youth substance use for
three years after the program: Across Ages, LifeSkills Training, Project SUCCESS, and Project Toward
No Drug Abuse.79 A more extensive review of these programs and the methods used to evaluate them
would be required before using such programs to further develop drug prevention strategies in Alberta. In
terms of Canadian programs currently in use and considered exemplary, outcome evaluations will help
determine how effective these programs are in changing youth behavior.80 One program that is currently
being researched for its effectiveness is The Fourth R, developed by David Wolfe and his team from the
University of Toronto. The Fourth R includes many of the essential elements noted by SAMHSA and
particularly emphasizes the development of relationship skills and decision-making skills.81 This program
is currently being evaluated in 20 Ontario schools through a randomized controlled trial and when
completed will provide useful information for Canadian strategies to prevent or reduce high-risk
behaviors.
Page 13 of 31
Programs Used in Alberta
Two programs currently used in Alberta for preventing risk taking behaviours and injuries are the
Preventing Alcohol and Risk-Related Trauma in Youth (PARTY) Program (developed in Toronto in 1986)
and the Heroes Program (developed by SmartRisk in Alberta in 1986).
Ù PARTY is a full day program in a hospital setting where students attend talks and presentations about
traumatic injuries resulting from high-risk behavior. A brain injury survivor also tells his or her story
and answers students’ questions.82,83
Ù Heroes takes place in the school, is an hour long, and uses multimedia presentations. It too includes
a presentation from a survivor followed by a question period.82,84
An evaluation of Heroes showed that the program may have an influence on the immediate decisions that
teens make but likely has no longer terms effects.85 An evaluation of the PARTY program could not be
located, but other research also indicates that single intervention programs, like PARTY or Heroes, will
not have a major long-term impact on behaviour or attitudes even though they may increase knowledge
and awareness.79,82 It is possible, however, that integrating such units into a program delivered over
many sessions may have more long-lasting effects. AADAC has also developed a school-based
curriculum for grades 3 to 7, 9, and 11.86 Evaluating the effectiveness of this curriculum on changing
youth behaviors would allow for further development of prevention initiatives in Alberta.
Educating Youth Outside of the School System
As a note of caution, although schools provide a natural way to target youth, homeless youth are at a
particularly high risk of adverse health practices and outcomes and are often an overlooked population in
health promotion and health care.64,87 As an Alberta Member of the Legislative Assembly aptly stated,
society cannot overlook the problems of a particular group of people because these problems will
inevitably grow to affect those outside of the group.88 Thus, prevention efforts should be directed at youth
who are in school and those who are not.
Along the same line, it is also important to remember that keeping teens in school and engaged in school
programs is fundamental to keeping them off the streets and hopefully off of drugs.13,19 Certainly, some
children are not inclined in the traditional academic sense, but options with a more direct-to-career focus,
such as home economics, industrial arts, art and design, etc. may keep these students in school.
Research suggests that participation in high school art and/or athletics programs may be related to a
lower drop-out rate.89
Community Education
Drug education is not just for youth; the whole community benefits from awareness and knowledge about
this problem.61,79,90
In particular, the general public needs information about drugs, like
methamphetamine, that are not well known or understood. Some stakeholders feel that if the general
public is informed about what methamphetamine is, its effects, and how it is produced, they can watch for
signs of a problem in their own community.6,20,51
By informing the public about this drug, various segments of the population can work together to prevent
use and abuse of methamphetamine. Some police services have already started running education
sessions about methamphetamine production with stores and businesses around the city, so owners and
staff can watch for suspicious purchases of precursor chemicals and report any irregular activity to the
police.19 Some policy makers are also calling for new regulations around precursor chemicals in
Alberta.37 Judges in the Canadian justice system may require more information about the dangers of
methamphetamine and its production, to help in planning appropriate sentences people who are found
guilty of producing methamphetamine.57 Furthermore, many parents may be unaware of the prevalence
of methamphetamine among their local adolescent population, making them less likely to understand its
threat to their community.91 Thus, it is important that prevention efforts include a community education
component targeting various segments that may be indirectly affected by methamphetamine use in
Alberta.
Page 14 of 31
Social Marketing
Some youth may only require information (i.e. education) to make healthy lifestyle choices.92 Others,
however, require motivation (i.e. marketing) to choose a particular behaviour.92 The power of marketing is
clear. Corporations would not spend billions on advertising if they did not believe that it influences buying
behaviour. As a case in point, the United States spends $333 million on nutrition education in a year.93
However, compared to the $2.8 billion spent in 1997 on ads for breakfast cereals, candy, gum, beer, and
pop, it is not surprising that elaborate, high priced and well-researched marketing schemes aimed at
children and youth have more of an impact than education campaigns promoting healthy choices.93,94
Offering an Alternative Product
Marketing can motivate youths to choose a particular behavior by providing something of value in return
for this choice, but all too often social marketing initiatives lack this exchange.92 If no clear product is
offered in a social marketing initiative, youths will not know what to “buy” and the opportunity to change
their behaviour is limited.72,92 Although social marketing strategies can complement education strategies
in a drug prevention program, a social marketing strategy can only be effective if it promotes an
alternative behaviour or “product”. For example, if the social marketing message is simply “don’t do
drugs” and youth are not provided with a choice of other activities they should be doing instead, there is
limited change in behaviour. This is a significant consideration in the fight against drugs because if youth
spend more time engaging in an alternative activity, they have less time to devote to experimentation and
possible abuse of drugs. Alternative activities should be developed and marketed to youth, but these
activities must also provide immediate benefits that youth value. Immediate and short-term benefits that
appeal to youth are more likely to change their behaviour than vague long-term benefits (e.g. living longer
and good health).95,96
A social marketing effort that demonstrates how to offer an alternative “product” is a binge drinking
prevention program at the University of Wisconsin.97 This effort focused on developing alternative
activities that were alcohol-free and strategically offered on evenings when binge drinking typically
occurred.97 This approach represents a radical shift from the typical “information only” strategies most
commonly associated with social marketing. The strength in this approach may be reflected in the
change in binge drinking patterns at the University of Wisconsin. Since 1999 when 67% of students at the
university reported binge drinking in the past two weeks, there has been a decreasing trend in binge
drinking with 59% who reported the same in 2004.98
The Importance of Planning and Research
Because social marketing is consumer-oriented, social marketing efforts
following planning and research:
• consumer research – identifying (a) the needs, values, and desired
benefits of the youth population; (b) barriers or costs to changing
behaviour; and (c) when and where benefits could be offered
• competitive analysis – identifying (a) other choices youth have and
(b) social, environmental, and economic forces that may influence
behaviour
• segmentation – developing groups of youth based on similarities in
demographics and psychological or behavioral factors
• targeted programs – programs that meet the unique needs of each
segment identified.97
aimed at youth require the
Immediate and short-term
benefits that appeal to
youth are more likely to
change behaviour than
vague long-term benefits,
like living longer and good
health.
Successful social marketing strategies also design promotion strategies and use media channels that will
reach the intended group and convey the intended message.96 It is important to consider lifestyle habits
of the target group. For instance, on average Canadian children and teenagers spend over an hour each
day on the Internet and about 2 hours per day watching television.99,100 More details, such as which
television programs are watched and which web sites are visited, would be valuable in ensuring the target
group is reached with promotional messages that “sell” a particular type of behavior or activity. The
importance of selecting the appropriate media is emphasized by a couple of examples. First of all, when
smoking is shown in movies, youths are perhaps more likely to report an intent to smoke in the future
Page 15 of 31
although anti-smoking advertisements shown before the movie may combat this tendency.101 Another
example is the case of 4-H in the United States. Although textbook covers, rulers, stickers and posters
are used successfully by food advertisers, such modes of communication did not prove effective for
recruiting new 4-H members.94,102 Instead, the Internet and word-of-mouth were most influential for
achieving this 4-H objective.
Although social marketing initiatives may influence behaviour, they cannot control for other forces in the
environment and thus any change in behaviour could potentially be explained by social marketing as well
as other forces (e.g. law enforcement).97 Even so, one of the most important elements of a social
marketing strategy is measuring outcomes to help determine if the strategy met its objectives. A good
example of measuring outcomes comes from the National Highway Traffic Safety Administration and the
Wisconsin Department of Transportation, which undertook a project to reduce driving after excessive
drinking. SafeRide is a social marketing effort that provided an alternative way of getting home after
drinking and resulted in an estimated cost savings of almost $1 million because of alcohol-related crashes
that were avoided.103 However, few social marketing efforts are evaluated to determine if they meet their
objectives.96 In the same way that corporations measure outcomes that could be attributed to advertising
efforts (e.g. revenue), social marketing initiatives should also measure outcomes (e.g. behaviour change)
that could be attributed to its efforts.
Designing a Message
Often public service campaigns tend to focus only on the negative aspect of drug use and use
emotionally charged messages.96 The use of such scare tactics has been widely criticized by many
prevention scientists, and it is generally agreed to be an ineffective method of prevention.96,104-106 There
may be many reasons why scare tactics appear to be ineffective:
• If teens know of someone who is using the drug and the user does not experience all the effects that
have been emphasized, the information may seem overstated and less credible.106
• Fear of drugs may be rated low among reasons why teens choose not to use drugs.107
• Continual negative reinforcement may actually make a behaviour seem more attractive instead of
discouraging its practice, as appears to be the case with warnings about violence on television
programs.108
A balanced approach to drug education that presents both the positive and negative aspects of the drug
is thought to be more effective.13,106 In reality, methamphetamine use leads to a euphoric state, which
means many people find the initial experience pleasurable. On the other hand, youth also need to know
that repeated use of the drug may quickly lead to an addiction and eventually land the person either in
jail, the hospital or the morgue.88 An effective prevention program would also explain why some people
choose to use methamphetamine and teach youth skills to make healthier decisions in light of this.79
Presenting the drug simply as a bad choice without information about its positive and negative effects
may make students question the reliability of the information.61
According to focus groups and youth who were formerly addicted to methamphetamine, prevention
messages should also be relevant and capture the attention of the youth.13,95,109 Sharing the shocking
realities of drug use and abuse may capture the attention of youth, as long as they also present a
balanced story.13,22,109 Real-life stories from people who youth can relate to and have dealt with issues
youth can relate to are thought to provide more salient messages.13,95,109 Some of the following ideas
were given by people who were addicted to methamphetamine in the past:
• taking classes to a treatment facility to see a detoxification13
• taking classes to see an overdose at the hospital13
• taking classes to the homeless shelter to see what kind of life drug abuse can lead to13
• having an ex-dealer talk about how they tricked kids into using their products.110
Also, some youth who were addicted to methamphetamine in the past write poetry as part of their healing
and recovery process, often writing about the drug and their experiences with it.62 Perhaps these poems
or experiences could be communicated to youth. However, to our knowlege no research has looked at
the effectiveness of prevention efforts that use recovered addicts to communicate to youth.
Page 16 of 31
Another aspect to consider is the messenger. Some youth consider police officers to be credible sources
for drug information, but other youth, particularly those most at risk for drug abuse, may not.13,22,111
Furthermore, although youth may consider a messenger to be credible, the level of influence of the
messenger among youth, including those most at risk for drug abuse, should be considered when
designing education or marketing strategies.
Treatment
Treatment of adolescent drug addictions is a difficult process because the drug has essentially taken over
the life of the youth and prevented their normal maturation and development. Some believe that
treatment of adolescents should be looked at not as rehabilitation, but as an initial habilitation.22,112 In
particular, overcoming a methamphetamine addiction often involves a lengthy detoxification period and
relapse is common.21,113,114
Youth Treatment in Alberta
In Alberta, a few different treatment services are available for drug addictions in general. Alberta Alcohol
and Drug Abuse Commission (AADAC) has been the province’s primary treatment resource since
1951.115 Youth outpatient services are offered free of charge by 37 AADAC offices and 15 services
funded by AADAC across Alberta.116 Youth clients go to AADAC offices seeking help for their addictions,
which shows they have recognized they have a problem by the time they arrive at AADAC. Based on an
assessment, AADAC clients are matched up with the appropriate treatment options, which could include
information sessions and counseling in one-to-one, group and family settings. Clients may also be
referred to a self-help group specific to their addiction and are encouraged to participate in 12 step
programs such as Alcoholics Anonymous or Narcotics Anonymous both during and after their
treatment.115 The philosophy at AADAC is to focus is on the person, not the drug.115
AADAC has also opened two provincial youth detoxification and residential programs—one in the Calgary
region and one in the Edmonton region. These services provide a total of 24 additional treatment beds,
with four detoxification beds and eight residential treatment beds in each city, for youth ages 12 to 17
years. There are two different types of residential programs being offered. The Edmonton site is an
urban-based model while the Calgary-based location provides a wilderness adventure therapy program.
Both programs include individual and group therapy, family centred programming, on-site school and
extensive recreational activities to promote group co-operation and constructive use of leisure time. The
programs are designed to teach the youth skills to stay clean and sober, to improve their interpersonal
skills, and to educate the youth on how alcohol and other drugs affect the users and people around them.
AADAC has developed a crystal methamphetamine treatment protocol designed specifically for youth
experiencing crystal methamphetamine abuse problems. This protocol allows for the capacity to provide
flexible individualized treatment response within the detoxification or residential setting. With the addition
of youth detox and residential programs, AADAC is able to offer the full spectrum of voluntary treatment
services to Alberta youth and their families.
Plans to expand the number of AADAC’s youth detox and residential beds throughout the province are in
progress. For more information on youth treatment services offered by AADAC, please visit
www.aadac.com.
Another program offered in Alberta through The Alberta Adolescent Recovery Centre (AARC) is
specifically for youth under 21 years of age and is considered innovative in its approach. AARC mainly
deals with youth who are at late stage addiction and will use any available drug to achieve a high.18,112
One of AARC’s central beliefs is that a youth’s drug addiction affects the whole family, so the whole family
must be involved in the recovery process.112 As such, the program is an intensive, structured, long-term
program that incorporates the following elements:
• Twelve Step Recovery Model, like Alcoholics Anonymous or Narcotics Anonymous;
• Positive peer influence, including the use of peer counselors;
Page 17 of 31
•
•
Group, family, and individual therapy; and
Use of “recovery homes,” where new participants stay in the home of another participant who is
farther along in the program and their family.
A treatment program in the United States similar to AARC recently found that 25% of all its clients
(including those who did not complete treatment) had not used drugs or alcohol since completing
treatment and 51% had not returned to their former level of use.117 In particular, the AARC program and
others that use peer counselors believe this is helpful in the recovery of adolescents who are addicted to
drugs. Having been in the same position of recovery themselves, peer counsellors cannot be deceived as
easily by the youth undergoing recovery and may also be able to relate more readily.106,112 In light of
funding pressures that many drug treatment programs experience, one or two psychologists and
psychiatrists supervising a team of peer counselors, while providing fewer one-on-one sessions
themselves, could present a financially viable method of treatment.88
Policy makers are hoping
Youth treatment of drugs addictions is also changing in Alberta. In April
that 5 days of mandatory
2005, Bill 202, the Protection of Children Abusing Drugs Act, was
118
detoxification will provide
passed.
When this Bill comes into force in July 2006, parents can
apply to the Provincial Court to have their child placed in a mandatory
an
opportunity for some of
five day detoxification program.118 Although some experts believe that
these
youth to realize they
detoxification can take up to 45 days,113 policy makers are hoping that 5
need help.
days will provide an opportunity for some of these youth to realize they
need help; perhaps for some this will be a first step in treatment by preparing youths to engage in the rest
of the recovery process.22,88 Though some express concern about the freedoms of youth under this Bill,
as one Member of the Legislative Assembly of Alberta stated, “Addiction is an abdication of one’s
autonomy. By being addicted, one has already surrendered control over his or her life to someone or
something else, in this case a chemical substance and the people who provide it or urge the use of it”.119
Currently, there is no known research comparing the effectiveness of mandatory and voluntary drug
treatment among youth and thus no basis to argue their relative effectiveness among youth. Among
adults addicted to methamphetamine, one study to date suggests that mandatory treatment may be as
effective as voluntary treatment over the long term although early relapse may be an area of concern.120
In the absence of such research involving youth, Bill 202 provides an opportunity to evaluate the
effectiveness of mandatory detoxification among youth.
Research into Youth Treatment
Overall, there is a lack of research into the treatment of drug addictions among adolescents, especially
when compared to the amount of addictions research involving adults.121 With a lack of research, there is
no evidence to date about which treatments are most effective for which type of youth.121 However, there
is some indication that outpatient family based treatments for youth may be more effective than other
types of outpatient treatments.121,122 There is also some general addictions research that, if found
promising, could be tested with youth addictions. Some researchers are investigating the potential use of
drug therapy in the treatment of methamphetamine addictions.123 Other research in Vancouver, British
Columbia, is exploring the use of acupuncture to reduce drug cravings and withdrawal symptoms, which
may prove to be useful during detoxification. 124 Such treatment approaches would need to be integrated
with psychosocial approaches for long-term recovery. Research in Taiwan suggests that social pressure
to use methamphetamine may be the main reason that adolescents relapse and use methamphetamine
again.114 This indicates the impact that peer relationships can have on youth and how important it may be
for them to develop skills to cope with social pressure. Treatment outcomes in adolescents may also be
affected by psychiatric disorders, so treating youths with substance use and psychiatrics disorders is
another area for further research.125 Although there is limited research into the general treatment of drug
addictions among youth, there is even less research into the treatment of methamphetamine addictions
among youth. All in all, further research is required to determine which treatments are most effective for
which types of youth and which types of addictions.
Page 18 of 31
Moving Forward
Policy Implications
Policy makers in the province of Alberta are concerned about the spread of methamphetamine in Alberta.
This April, the Protection of Children Abusing Drugs Act was passed in the Alberta Legislature.118 It was
the first private members bill in Alberta Legislature history to gain unanimous consent to move the bill
ahead to the Committee of the Whole and the third reading while waiving the usual proceedings of the
legislature.88 Members of the Legislative Assembly were in agreement that some sort of action must be
taken to protect children, youth and families from the effects of methamphetamine. However, further
planning and policies around this issue are necessary.
Policy Principles
•
Approach the problem of methamphetamine in Alberta holistically.
Policies around methamphetamine will be most effective if together they reflect the scope of the
problem. Methamphetamine is not just a youth addictions issue. Adult addictions may also impact
infants, children, youth, and the community. Thus, multi-pronged strategies aimed at helping youth
and adults addicted to methamphetamine as well as children, families, and communities affected by
the addiction will address the problem more comprehensively.
•
Balance Alberta policy between prevention, enforcement, treatment, and harm reduction.
Canada’s Drug Strategy emphasizes a need to approach to the issue of harmful substance use with a
balance between prevention, enforcement, treatment, and harm reduction efforts.126 Recently, many
proposed policies have focused on enforcement issues. For instance, there has been a change in
federal policy regarding the penalties for offences involving methamphetamine, and there is debate
provincially and federally on how to best control precursor chemicals used in the production of
methamphetamine. Although such enforcement is necessary, prevention, treatment and harm
reduction are other policy areas worth exploring further. The call for a balanced approach to the
methamphetamine issue was also reinforced by participants at the Alberta Workshop on
Methamphetamine: An Environmental Scan , that took place in September 2004 in Red Deer, Alberta.
Stakeholders who completed a pre-workshop survey believed that “resources should be relatively
evenly split between activities related to prevention and education (about 40% of available
resources), treatment (30% of available resources), and enforcement (30% of available
resources)”.127
•
Work towards integrating various Alberta systems that encounter people involved with
methamphetamine.
Systems that methamphetamine users often come in contact with operate as fairly separate entities.
If someone turns up at the hospital for treatment of a methamphetamine-related problem, they are
treated for that specific problem and released.5 Sometimes they are given information about
available detoxification and drug addiction resources, but this is not standard practice and there is no
follow-up with the patient after they have left the hospital. Consequently, many methamphetamine
addicts are repeat patients in the emergency room.5 In the law enforcement sector, a similar scenario
exists. Anyone caught with methamphetamine is released almost immediately until their court date.20
It is not police policy to inform their clients of any treatment or counseling options although some
officers choose to do so.20 Once in court, the judge can order an individual to get treatment but
cannot order anyone to pay for the treatment, so treatment is only ordered in cases where there is
someone willing to pay.22 Government funding for court-ordered treatment (ranging from $65-$85 per
session for up to 10 sessions) is insufficient to cover the time needed to overcome a
methamphetamine addiction.18,20,22 Evidently, there is a need for greater collaboration among the law
enforcement, judicial, medical, social services and rehabilitation sectors to more readily address the
Page 19 of 31
issues related to methamphetamine production and usage.5,19,20,22 The need to develop a
“coordinated provincial response“ was also recognized in 2004 by participants in the Alberta
Workshop on Methamphetamine: An Environmental Scan.127
•
Engage youth, families, and communities in identifying strategic directions in program and
policy development.
Youth, families and community members have ground level perspective on the issues around
methamphetamine use and production. Perspective from these groups must be gathered and used to
develop effective strategic directions.
Prevention
•
Ensure prevention efforts in Alberta aim to reduce the use of drugs overall, with the reduction
of methamphetamine use contributing to this goal.
Although methamphetamine is a drug that can be powerfully addictive, it is one drug among many
that are affecting Alberta’s children, youth and families. Furthermore, an addiction to one drug puts a
person at risk for developing an addiction to another drug. A goal to reduce drug use overall then
encompasses a reduction in methamphetamine use.
•
Ensure prevention efforts target all relevant segments.
Many segments of society can make a unique contribution to reducing overall drug use if they are
targeted in prevention efforts. For instance, prevention efforts aimed solely at youth in school miss
those youth who are not in school (i.e. street-involved youth). However, youth not in school are at a
particularly high risk of drug abuse and are often overlooked in health promotion strategies.64,87 Also,
communicating with various community segments (e.g. parents, store owners, etc.) about drug abuse
and drugs that are not well-known, like methamphetamine, may develop partners who watch for and
respond to signs of a problem in their own community.
•
Support the development of more comprehensive prevention programs for students in
Alberta.
Research has shown that single intervention drug prevention programs, like many that exist in
Alberta, will not have a major long-term impact on behaviour or attitudes.79,82 Longer-lasting effects
and impressions are made when classroom-based drug education is partnered with community-wide
initiatives and multi-component education programs.61,73 Thus, advocating for the development of
more comprehensive programs, even ones that perhaps build on the single intervention drug
prevention programs currently in use, would mean advocating for a longer-lasting impact on youth. To
maximize effectiveness, programs will also consider the level of influence among youth of the people
who deliver the program. A comprehensive program will involve numerous strategies beyond
traditional methods for delivering its message and achieving behavior change.
•
Support the development of alternative activities for youth and the development social
marketing strategies that may be required to promote these alternative “products”.
Youth need a reason to avoid drugs.13,19 Adolescents who have something of value in their life – a
passion for a sport, art or drama, strong family ties, established beliefs or values - are less likely to
trade that for drugs like methamphetamine. This is why it is important to develop alternative activities,
choices, or “products” that have immediate and valued benefits to youth. For instance, research has
shown that participation in high school art and/or athletics programs is related to a lower drop-out
rate.89 At present, with more of a focus on sending young adults to university and school board
budget difficulties, these programs are slowly losing funding and being eliminated.128,129 Those youth
who placed value on coming to school for non-traditional classes and programs will be more likely to
drop out if those classes and programs are no longer offered; if they are not in school, they will be
Page 20 of 31
more inclined to turn to drugs as a way to fill their extra time.13 Thus, funding programs that help
engage students in the school experience or funding alternative social events may be just as
important as formal drug education programs. Social marketing expertise could aid in the
development and success of these alternative “products”.
Treatment
•
Ensure outcomes of the Protection of Children Abusing Drugs Act are evaluated and use
these results to inform future policy.
Before the passing of the Protection of Children Abusing Drugs Act,
Evaluating outcomes of
parents could do little to stop their child from using drugs except wait
88,119
for him or her to get arrested and have the Court get involved.
the mandatory five-day
This Act provides a new way that parents can try to help their children.
detoxification will
Evaluating outcomes of the mandatory five-day detoxification will
provide insight into how
provide insight into how this legislation is reducing the drug abuse
this legislation is
behaviours of youth and will contribute to a base of research into the
reducing
the drug abuse
effectiveness of mandatory detoxification among youth. Such evidence
will be particularly informative as policy for the next steps in treatment
behaviours of youth.
of drug addictions are considered (e.g. mandatory treatment program
for youth following the five days of detoxification or mandatory detoxification of addicts over 18 years
of age).88
•
Ensure a continuum of treatment options are available for addicted youth.
It is important, for example, that outpatient treatment be available to youth as well as residential
treatment, as some may find this more effective as a first option versus residential treatment. As well,
outpatient treatment should be available to provide support after discharge from residential treatment
programs.
•
Support the development of research into youth drug addictions.
To date, there has not been enough research conducted to determine which treatments are most
effective for which types of youth and which types of drug addictions. However, such research is
critical to obtain maximum levels of success of treatment, which is why it is important that policy
makers support the development of research in the area of youth drug addictions.
Future Research
Research into issues involving methamphetamine and youth will help to inform policy and practice around
the prevention and treatment of addictions to this drug.
•
Gain a better understanding of the effects of methamphetamine exposure during pregnancy
on fetal development and child development.
Research has been fairly conclusive as to the short- and long-term effects of using methamphetamine
on the adult brain and body.21,27,29,130,131 However, the short- and long-term effects on a
methamphetamine-exposed fetus are difficult to discern, and there are also few long-term follow-up
studies of school-aged children who have been exposed to methamphetamine in utero. Further
research in this area is merited to work towards identifying such children and developing appropriate
interventions.
•
Research possible links between methamphetamine and the development of later
medical/psychological conditions.
Page 21 of 31
Symptoms caused by long-term methamphetamine use can be like those found in Parkinson’s
disease and schizophrenia. Although research is starting to explore a possible link between
methamphetamine addiction and the development of later medical/psychological conditions,
exploratory research should be followed to determine if this is an area that requires further study.
Prevention
•
Improve estimates of the proportion of methamphetamine use in various segments as well as
understanding of the risk factors and reasons for using drugs and/or methamphetamine.
It is difficult to estimate the prevalence of methamphetamine use among various segments of the
population, though this data is important in planning a strategy to counter the spread of
methamphetamine. Good, reliable surveillance data is necessary to track the trend of
methamphetamine use and identify risk factors and reasons for use among Alberta youth. AADAC will
be conducting another survey of students to follow-up The Alberta Youth Experience Survey in 2002,
which will assist in monitoring drug use trends among youth in school. Estimating the proportion of
Alberta youth not in school who use and/or abuse methamphetamine remains a potential, albeit
challenging, area of research.5,22 Other data is also needed. For instance, one emergency room
doctor hypothesizes that some methamphetamine users are probably not detected by medical
personnel if they come in with a complaint not related to drugs. Data about the use of emergency
rooms by methamphetamine addicts are not readily available although research using a rapid urine
test might be able to help estimate prevalence among emergency room patients.5,9
•
Review research-based prevention programs that have evidence of effectiveness to provide
insight into the development of more comprehensive programs in Alberta.
Research has shown that single intervention drug prevention programs, like many that exist in
Alberta, will not have a major long-term impact on behaviour or attitudes.79,82 Longer-lasting effects
occur when classroom-based drug education is partnered with community-wide initiatives and multicomponent education programs.61,73 Currently, most Alberta initiatives are classroom-based. A
review of research-based prevention programs that appear to be effective, including Across Ages,
LifeSkills Training, Project SUCCESS, Project Toward No Drug Abuse, and The Fourth R, would be
worthwhile. Reviewing the research conducted on these and other programs would provide
information for the development of comprehensive programs in Alberta that perhaps expand on the
strengths of existing programs in the province. In addition, evaluating the effectiveness of the recently
developed AADAC school curriculum will be informative.
•
Research the potential effectiveness of developing and promoting alternative activities for
youth using social marketing methods.
Because some youth may require motivation rather than education to choose not to take drugs,
research investigating the effectiveness of using social marketing to develop and promote alternative
activities for youth will help determine how social marketing may be able to contribute to prevention
efforts.
Treatment
•
Evaluate the outcomes of the Protection of Children Abusing Drugs Act.
As mentioned previously, evaluating the effectiveness of the Protection of Children Abusing Drugs
Act will help determine its potential impact on drug addictions in youth. Research into the
effectiveness of longer-term mandatory treatment programs for youth would also be informative as
policy makers consider the next steps in policy.88
•
Develop much-needed research comparing various forms of drug addiction treatment among
youth.
Page 22 of 31
Research into the treatment of drug addictions among adolescents is critical given the lack of
evidence to date about which treatments are most effective for which type of youth and which types of
addiction. Based on limited research, some methods of treatment for youth, like outpatient family
based treatments, may be more effective than other types, but further research is required to more
confidently determine their effectiveness among youth. Drug therapy in the treatment of
methamphetamine addictions and alternative therapies, like acupuncture, are currently being
explored and may present other areas of exploratory research. Relapse in methamphetamine
addictions and the general impact of psychiatric disorders on drug addictions treatment are other
areas to be considered in such research.
In the End
Methamphetamine is the latest in a long line of addiction problems in Alberta as well as other parts of
Canada and the world. It has been criticized by many as being the next “drug-du-jour,” a phase among
drug users that will go by the wayside in a few years time. Certainly, illicit drug use shows trends based
on what drug is popular. Methamphetamine was popular once before, but this time it has surfaced as a
more potent type (d-methamphetamine) that is also much easier to produce and can be taken in a variety
of ways, signaling that methamphetamine may be a bigger and longer-lasting problem this time around.
The ideal situation would be a world which was free from the harms of substance use and abuse. People
of influence, such as educators, law makers and enforcers, medical personnel and researchers, as well
as communities share a duty to take measures to control the use, production, and sale of
methamphetamine and other drugs to work towards this vision. Great care and initiative in the areas of
policy, research, and practice must be taken to help children, youths and families affected by
methamphetamine addictions and to empower youth to resist the drug’s temptations.
Page 23 of 31
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METHAMPHETAMINES IN ALBERTA: A Focus on Children, Youth, and Families

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