A Canadian Community Epidemiology Network on Drug Use (CCENDU) Report Regina and Area 2004 Report June 2006 Prepared by: Addictions Services Regina Qu’Appelle Health Region TABLE OF CONTENTS FOREWARD................................................................................. 3 REPORT PREPARATION .............................................................. 4 ABOUT THE REGINA QU’APPELLE HEALTH REGION (RQHR)........ 5 ACKNOWLEDGMENTS.................................................................. 7 SOURCES .................................................................................... 7 LIMITATIONS OF THE REPORT ................................................... 9 EXECUTIVE SUMMARY .............................................................. 11 PREVALENCE ............................................................................ 16 A L C O H O L .................................................................................... 16 C A N N A B I S ................................................................................. 17 C O C A I N E .................................................................................... 17 H E R O I N , M O R P H I N E A N D O T H E R N A R C O T I C S ............ 17 M E T H A M P H E T A M I N E ............................................................... 17 MORBIDITY .............................................................................. 18 A L C O H O L .................................................................................... 18 C A N N A B I S ................................................................................. 18 C O C A I N E .................................................................................... 18 H E R O I N , M O R P H I N E A N D O T H E R N A R C O T I C S ............ 18 O T H E R D R U G S ......................................................................... 18 MORTALITY .............................................................................. 20 A L C O H O L .................................................................................... 20 C A N N A B I S ............................................................................... 21 C O C A I N E .................................................................................. 21 H E R O I N , M O R P H I N E A N D O T H E R N A R C O T I C S ............ 21 O T H E R D R U G S ....................................................................... 21 ENFORCEMENT ......................................................................... 25 A L C O H O L .................................................................................. 25 C A N N A B I S ............................................................................... 27 C O C A I N E .................................................................................. 28 H E R O I N , M O R P H I N E A N D O T H E R N A R C O T I C S ............ 30 TREATMENT .............................................................................. 33 A L C O H O L .................................................................................. 33 C A N N A B I S ............................................................................... 33 C O C A I N E .................................................................................. 33 H E R O I N , M O R P H I N E A N D O T H E R N A R C O T I C S ............ 34 O T H E R D R U G S ....................................................................... 34 YOUTH ...................................................................................... 38 INJECTION DRUG USE .............................................................. 40 HIV/AIDS AND HEPATITIS C .................................................... 44 NEEDLE EXCHANGE................................................................... 46 THE REGINA AND AREA DRUG STRATEGY ................................. 47 APPENDIX A ............................................................................. 50 GLOSSARY OF TERMS ............................................................... 52 FOREWARD The Canadian Community Epidemiology Network on Drug Use (CCENDU) http://www.ccsa.ca/ccendu is guided by a steering committee that ensures collaboration between federal, provincial and community agencies is maintained. Intersecting interests in drug use, such as health and legal consequences of use, treatment, and law enforcement, bind these agencies together in an effort to provide an early warning system that aids in the identification of potentially dangerous drug trends as well as improved methods of response. There are currently twelve CCENDU sites, with additional sites under development. Each local site collects, collates, and interprets data and information in eight major drug use areas: Alcohol Cocaine Cannabis Heroin Sedative-hypnotics and tranquillizers Hallucinogens other than cannabis Stimulants other than cocaine Inhalants As well, six indicator areas are used to gather data to produce local reports: Prevalence of drug use Law enforcement Treatment Morbidity Mortality HIV/AIDS and Hepatitis C (includes injection drug use and needle exchange information) REPORT PREPARATION Depending on the availability of resources, a final report is developed for each year by all of the twelve CCENDU sites. The 2004 report for the Regina site was developed and organized by various team members from the area. Regular meetings were conducted throughout the year to ensure the reports creation and successful dissemination. The Regina site team includes: Co-ordinator: Mr. Brian Danyliw, Program Manager Addiction Services, Regina Qu’Appelle Health Region Dr. Zahid Abbas Epidemiologist Population and Public Health Services Regina Qu’Appelle Health Region Ms. Kathy Lloyd, Supervisor Population and Public Health Services, Communicable Disease Control Regina Qu’Appelle Health Region Mr. John McCallum, Program Consultant Community Care Branch, Saskatchewan Health S/Sergeant Rick Bourassa, Planning and Research Analyst Regina Police Service Mr. Kent Silzer, Information Consultant Mental Health & Addiction Services, Regina Qu’Appelle Health Region Sergeant Dave Henry, Combined Forces Special Enforcement Unit Royal Canadian Mounted Police Mr. Ron Thurlow, Addiction Counsellor Addiction Services Regina Qu’Appelle Health Region ABOUT THE REGINA QU’APPELLE HEALTH REGION (RQHR) The Regina Qu’Appelle Health Region encompasses an area of 26,663 square kilometres, and has a population of approximately 246,478. The City of Regina is the largest populated centre with 187,772 (Saskatchewan Health, Covered population, 2005) persons. 25% of the population live in rural communities or in one of the 17 First Nations Communities within the health region. In 2005, 13.4% of the population was over the age of 65. The growing Registered Indian population made up approximately 9% of the total population. The population in the RQHR is expected to remain relatively stable over the next 15 years. ACKNOWLEDGMENTS Throughout the year, many individuals work diligently to compile the information needed to complete the CCENDU report for Regina and area. The Regina CCENDU committee would sincerely like to thank all the individuals and organizations that contributed information to be used in the 2004 Regina report. A very special "thank you" to Ron Thurlow, for all of his efforts in the development of our report. SOURCES AIDS Programs South Saskatchewan Regina Qu’Appelle Health Region, Addiction Services Regina Qu’Appelle Health Region, Harm Reduction Methadone Clinic Regina Qu’Appelle Health Region, Health Information Management Services Regina Qu’Appelle Health Region, Population and Public Health Services, Communicable Disease Control Regina Police Service Royal Canadian Mounted Police Saskatchewan Government Insurance Saskatchewan Health, Corporate Information and Technology Branch Saskatchewan Justice, Coroners Branch Saskatchewan Liquor and Gaming Authority The Parliament Methadone Clinic The Regina Health District Injection Drug Use Strategy Report The Regina and Area Drug Strategy Report LIMITATIONS OF THE REPORT 1. This report has attempted to collect data on the prevalence of alcohol and drug usage and the incidence of alcohol and drug related health and social problems in the Regina Qu’Appelle Health Region (RQHR). In a number of instances, however, information has only been available for the area within City of Regina boundaries. Therefore, caution needs to be used when trying to compare information from these differing sources. Due to population differences, results should not be generalized. 2. There are differences in the time periods for data provided by the various agencies. Some data represents the calendar year; other data is reported on a fiscal year (ending March 31) basis. Some of the data reported is current (2004/05) while other information reported relates to earlier years. As such, caution should be taken when interpreting the presented data due to time period fluctuations. Data is presented in absolute numbers and is not expressed as rates. 3. Addiction Services (ADS) treatment information is taken from the Saskatchewan Health Management Information System database. It reports individual admissions to treatment service, not individual clients. The number of discrete individuals is not recorded. As well, treatment data often represents the availability of treatment services rather than the true incidence or prevalence of disease. 4. The Coroners Branch, Saskatchewan Justice keeps a record of alcohol and drug related deaths that are investigated through its office; however the full extent to which alcohol and drug use is implicated in deaths is not known. Drug related deaths are likely underestimated. 5. Enforcement data may be influenced by factors other than the incidence of alcohol and drug related crime. Reports from the Integrated Drug Unit, which is a co-operative effort of the Regina Police Service and the Royal Canadian Mounted Police may include a duplication of some statistical data. EXECUTIVE SUMMARY The Canadian Community Epidemiology Network on Drug Use (CCENDU) reports help to provide a snapshot of drug and alcohol use nation wide. As in many centers located across Canada, Regina and the surrounding communities that comprise the Regina Qu’Appelle Health Region (RQHR) are challenged by addictions. The CCENDU report developed for Regina and area assists health practitioners, law enforcement and various community agencies in the identification of emerging trends in drug and alcohol use. Difficulties and consequences related to addiction affect both the individual and the community. Often, serious health, social and economic consequences affect people dealing with addiction. Moreover, those consequences have the potential to compromise the lives of those around them including the family and the community. In 2004, alcohol continues to be the chemical of choice for many users located within the RQHR. However, alcohol-involved collisions, including personal injury, property damage and fatalities remained relatively steady in the RQHR, and did not significantly increase. Saskatchewan has traditionally suffered higher per capita rates of impaired driving than many other comparable jurisdictions in Canada. In 2004, 817 clients were referred for assessment under the Safe Driving legislation for offences related primarily to drinking and driving, a decrease of 22 percent from 2003. 2004/2005 indicated substantial alcohol related problems amongst individuals that reside within the RQHR. A total of 4680 treatment episodes were recorded by Addictions Services, RQHR for alcohol dependency, which is a slight increase from 2003/2004 statistics. Of these clients, 72% identified that their use of alcoholic beverages was causing a problem. Moreover, 2100 alcohol related diagnosis from hospital separations (in-patient and emergency room data) were recorded for the 2004/2005 year. This number is consistent with 2003/2004 data, increasing only by 76 diagnoses in the RQHR. As in years past, alcohol continues to be a primary choice for Regina’s youth. Addiction Service counsellors in Regina maintain that alcohol continues to be the number one chemical of choice among youth in our city. Illicit drugs are common amongst Regina and area citizens. In 2004, cocaine related diagnoses rose for a third year, increasing 40%. In fact, morbidity data also indicated moderate increases in diagnoses for cannabis, morphine and other narcotics, and other drugs. Cocaine violations increased slightly in 2004. However, the 10% increase seems relatively minor to the 142% increase noted in 2003. It should be noted, however, that because these violations had recorded very small numbers in previous years, the large increase in percent did not indicate significant alarm. Recorded violations under the Controlled Drug and Substances Act showed a 12% decrease in total reported cannabis violations in 2004. Heroin, morphine and other narcotics violations did display an increase of 63 % in the number of total violations recorded in 2004. These violations were mainly pertaining to narcotics other than heroin, which in Regina would be morphine, Demerol or Ritalin. Violations for heroin possession and trafficking remained steady, with only one (1) violation noted. An eight-year trend analysis of all illicit drug violations within the city of Regina indicates that cannabis infractions continue to be more prevalent than other drug offences. This trend is consistent with data collected in 2003. Statistics gathered from individuals receiving treatment from the RQHR’s Addiction Services agencies recorded 2563 treatment episodes wherein clients identified with using cannabis. This is an increase of approximately 12% over 2003. Increases were also noted for clients identifying the use of cocaine and narcotics. Selfreport data collected by Addiction Services for 2004/2005 showed an increase of 40% for cocaine use. Narcotics use increased by only 8% in the same time period. Alcohol and marijuana continue to be the most commonly used chemicals, however cocaine is usage has continued to increase, with no apparent levelling in usage. Despite an influx of crystal methamphetamine use (commonly referred to as “crystal meth”), in other parts of Saskatchewan, in the RQHR alcohol continues to be the number one choice by youth, followed by marijuana at a close second. Addiction counsellors are seeing some methamphetamine use but it remained relatively small in 2004/05. However, with a client base of 30 or more youth receiving treatment for crystal meth use, counsellors are showing concern. As such, there has been a significant increase in requests for public information on crystal meth by both the community and the education system. According to Addiction counsellors, cocaine use amongst youth is becoming more apparent and is being “tried” by more youth. The prevalence of injection drug use has also remained consistent in the RQHR. Unlike previous years where morphine/Demerol, Talwin and Ritalin (T’s and R’s) topped the list of the most commonly injected drugs, 2004/2005 statistics identified cocaine as the most injected drug, followed by morphine/Demerol and finally Talwin & Ritalin. The decline in the use of T’s and R’s remains consistent in the last two years, going from the most injected drug in 2002/2003, to the third most injected drug. More significantly, although IV drug use by both male and female clients aged 19 years and older has increase by approximately 17% in 2004, IV drug use by females 18 and under increased by 79% in the same period. The number of clients accessing Methadone services in the RQHR rose nearly 10% in 2004/2005. However, it should be noted that a small number of these clients were prescribed methadone for pain relief purposes only. HIV/AIDS has continued to be present within the RQHR. Although the annual number of newly diagnosed cases has been small over the past five years, there has been consistent growth in the number of individuals diagnosed with HIV/AIDS. In 2004, 15 newly diagnosed cases of HIV were recorded. This number is up 25% when compared to the 12 newly diagnosed cases recorded in previous year. HIV transmission and risk is primarily prevalent across Canada through both injection drug use and sex trade work. A total of 60 hospital separations for people with HIV/AIDS were recorded within the region in 2003/2004. This total represents a decrease in both inpatient and emergency room admissions. These numbers do not confirm the number of different individuals who received care, or in which health region they resided in. The Regina Qu’Appelle Health Region is only one of the two health regions in Saskatchewan that offer infectious disease medical specialist services, and as such, persons residing out of the region may have made some of the visits. In 2004, 211 individuals were diagnosed with Hepatitis C. This number is up slightly, representing a 10% increase since 2003. Initiatives are in place in Regina to help decrease the risk of blood borne and sexually transmitted diseases in persons who participate in ‘at risk’ behaviours. The program, known as “The Street Project”, exchanges clean needles, sharps containers, and provides other related supplies. In 2004/2005, the RQHR recorded a total of 1,656,382 needles exchanged through the program. In 2004, the Regina and Area Drug Strategy continued to make progress in planning addiction treatment services for the RQHR. The Steering Committee and seven working groups held meetings regularly and started to develop work plans and identify priorities. These included plans for a Brief Detox and Homelessness Shelter, a Youth Stabilization Program and a Drug Treatment Court. As well, consultants were hired to develop an evaluation process to ensure progress within the mandate of the Drug Strategy. PREVALENCE ALCOHOL In 2003/2004 annual report compiled by the Saskatchewan Liquor and Gaming Authority (SLGA) indicated a total revenue of $66,137,000.00 generated from sales of liquor from outlets in the Regina Qu’Appelle Health Region. Additional data collected by SLGA notes an increase of approximately 5% in the volume of sales of absolute alcohol in the 2004/2005 year when compared to 2003/2004 sales. Sales of wines and coolers, and spirits showed significant increases in sales in 2004/2005. Sales of beer decreased by nearly 10% in fiscal 2004. The table below shows a 5-year history of the volume of alcohol sales in Saskatchewan. (000’s of litres) Year Spirits Wines and Coolers Beer Absolute Alcohol 2000 5,387 5,303 59,019 5,530 2001 5,383 5,841 61,060 5,649 2002 5,229 6,089 60,234 5,496 2003 5,330 6,346 62,615 5,302 58,729 5,544 2004 5,630 6,845 Source: Saskatchewan Liquor and Gaming Authority The table below summarizes data provided by Saskatchewan Government Insurance that represents the total number of alcoholinvolved collisions occurring between 2000 and 2004 within the Regina Qu’Appelle Health Region. Property damage, personal injury, and fatalities remained relatively consistent. The number of persons injured in alcohol-involved collisions increased slightly. Fatalities decreased in 2004. Year Property damage Personal Injury Fatal Number Injured Number Killed 2000 217 165 5 268 5 2001 217 115 6 195 7 2002 221 133 7 204 7 2003 200 133 7 210 8 5 217 5 2004 188 142 Source: Saskatchewan Government Insurance CANNABIS Cannabis substances are readily accessible within the city of Regina and the RQHR. Unfortunately, there is no statistical data available to indicate the prevalence of the drug within these areas. COCAINE Cocaine, and “crack” are quite accessible within the RQHR. Currently, however, data is not available, beyond anecdotal sources, to confirm accurate prevalence information. HEROIN, MORPHINE AND OTHER NARCOTICS Morphine and other narcotics, including heroin, are available and readily sold on the streets of Regina as well as in rural communities that fall within the RQHR. As with other substances that are commonly used in the community, data is not available to indicate the actual number of people using, selling or partaking in activities related to these drugs. METHAMPHETAMINE Methamphetamine, which is gaining a strong foothold in the other regions of Saskatchewan, have not been as prevalent within the RQHR. Once again, hard data are not available to support the anecdotal information that is currently available. MORBIDITY * ALCOHOL The RQHR recorded 2100 alcohol related diagnosis in the 2004/2005 year. This number is slightly elevated, showing an increase of 76 cases over 2003/2004. 67% of the alcohol- related diagnoses were for emergency room visits. 28% were for individuals aged 36 to 45 years, nearly twice the number for any other age group. CANNABIS In 2004/2005 there were 396 cannabis-related diagnoses made in the RQHR. Cannabis related diagnoses have increased slightly, reporting 55 more than recorded in 2003/2004. Approximately 45% of the cannabisrelated diagnoses involved individuals aged 18 to 25 years and required inpatient services. COCAINE The RQHR recorded an increase in cocaine related diagnoses in 2004/2005, rising to 343 from 290 diagnoses in 2003/2004. 88% of cocaine-related diagnoses were spread relatively evenly over the 18 to 25, 29 to 35 and 36 to 45 age groups. HEROIN, MORPHINE AND OTHER NARCOTICS In 2004/2005, 366 opiate-related diagnoses were recorded within the region. An increase was also noted in this area, rising from 308 diagnoses in 2003/2004. 59% were females, with 30% of these being between 18 and 25 years of age. OTHER DRUGS “Other Drugs” include substances such as sedatives/hypnotics, stimulants other than cocaine, such as methamphetamine, as well as solvents. In 2004/2005, The RQHR recorded 295 sedative/hypnotic drug related diagnoses. This number has increased only slightly from 2003/2004, noting 21 additional diagnoses. Conversely, in 2004/2005, 140 stimulant related diagnoses were recorded, a 65% increase from the 91 diagnoses in 2003/2004. Solvent related diagnoses dropped by 50%, from 83 in 2003/2004 to 42 diagnoses recorded for 2004/2005. The multiple/unspecified drugs diagnoses rose by 11% in 2004/2005, from 317 to 352. * The International Statistical Classification of Diseases and Related Health Problems -ICD-10 is used to code the underlying cause of Morbidity. The ICD-10 codes used in this report are attached as Appendix 'A'. The following graphs display the annual variation for drug-related hospital separations in the past 3 years. Data are divided into emergency room visits and inpatient visits. Data provided by R.Q.H.R. Hospital Information Systems. Drug-related Emergency Room Visits 1 ,6 0 0 1 ,4 0 0 1 ,2 0 0 1 ,0 0 0 F2002 F2003 800 F2004 600 400 200 nt /U s* ns 3 pe ci f ie d* 3 So lv e ul an ts H al Se da tiv M ul t ip le es /H St im lu ci no ge ns pi at es yp no tic s *2 O an na bi s C C A lc oc ai ne oh ol 0 Drug-related Inpatient Visits 900 800 700 600 500 F2002 400 F2003 F2004 300 200 100 3 fie d* /U ns p ec i en t s* 3 s St im ul an t in og en s tic s *2 H al lu c So lv M ul tip le Se da t iv es /H yp no O pi at es C an na bi s C oc ai ne Al co h ol 0 **2 ‐ NOTE: Commencing 2002, with the implementation of ICD‐10, the sedative stats include ʺPoisoning by psychotropic drugsʺ which was not included in previous years stats (accounts for significant increase) *3 ‐ NOTE: In 2002, RQHR implemented ICD10 diagnostic coding. This may impact code groupings. MORTALITY ALCOHOL In 2004, the Coroners Branch, Saskatchewan Justice investigated a total of 41 deaths that occurred within the RQHR where alcohol was present. That number is down considerably from 2003, where 64 deceased persons had consumed alcohol. The chart below provides a breakdown of the cause of death recorded. It should be noted that deaths investigated by the Coroner’s Branch are not representative of all deaths that occur within the RQHR. Number of Deceased Saskatchewan Coroners Branch - Alcohol Present at Death 21 25 20 15 10 5 0 tu Na 9 6 3 2 ra s au lC es Ac en cid ta l i Su cid e m Ho ici de U e nd te rm in e. .. Classification of Death Blood alcohol readings ranged from 0.01 mg to 0.55 mg per 100 m CANNABIS Data collected by the Coroners Branch, Saskatchewan Justice in 2004 indicated 4 deaths wherein THC, or Cannabis, was present. COCAINE In 2004, five deaths were investigated by the Coroner’s Branch that involved the presence of cocaine in the deceased. Interestingly, three of these deaths also involved the use of Methadone. HEROIN, MORPHINE AND OTHER NARCOTICS In 2004, the Coroner’s Branch confirmed that a total of 20 deaths were investigated where opiates/methadone were present in the deceased. It should be noted that since many of these were accidental deaths and natural deaths, it is reasonable to assume that in some cases morphine may have been administered by medical personal attending the person. OTHER DRUGS In total, the Coroners Branch, Saskatchewan Justice investigated 74 deaths in 2004 that found drugs to be present within the deceased. This number is up slightly from 2003, wherein 69 deaths were investigated. Deaths are categorized by incident, inclusive of accidental, suicide, natural and homicidal deaths. The graph below illustrates the breakdown of deaths as they relate to each category. Number of Deceased Saskatchewan Coroners Branch - Drug Present at Death 46 50 40 30 20 10 0 16 9 2 1 t Na al ur t en d i c Ac al e cid i Su de ici m Ho d Un Classification of Death Source: Coroner’s Branch - Saskatchewan Justice et ed in m er C s se u a Hospital Information Systems provides data related to the number of drug-related deaths that occurred in the hospitals in Regina. Some of this information may be duplicated in the data reflected by the Coroner’s Branch. The following table shows the number of deaths in 2004 as recorded by Hospital Information Systems, for emergency visits and inpatient visits. 34 35 30 25 20 Emergency 15 10 5 6 1 0 2 0 2 3 1 0 1 0 0 0 0 01 Inpatient 1 Al co ho l C oc ai ne C an na bi s Se da O pi ti v at e es /H yp no tic H al s lu ci no ge ns St im ul an ts M ul So tip lv le en /U ts ns pe ci fie d 0 NOTE: The cause of death may or not be attributable to the substance abuse; these statistics represent only the disposition code of ʺDeath on or after arrivalʺ for these cases. ENFORCEMENT ALCOHOL As in other regions and provinces, the RQHR deals with the difficulty of impaired driving. Unfortunately, Saskatchewan has dealt with higher rates of impaired driving per capita than other jurisdictions in Canada. In 2004/2005, 788 individuals were referred for assessment under the Safe Driving legislation for offences primarily related to drinking and driving. 778 of these individuals were referred directly from Saskatchewan Government Insurance for Driving While Under the Influence (DUI). The numbers indicate an 18% reduction from 2003. Of the DUI referrals, 83% were male, while 17% were female. The Safe Driving legislation provides an opportunity for early intervention that individuals may not otherwise be aware of or utilize. Drinking and Driving Convictions – Regina Qu’Appelle Health Region 1999 to 2004 1999 2000 2001 2002 2003 2004 Impaired driving 178 179 195 216 212 162 Fail to Comply with a Demand Over 80% mgs. Alcohol in Blood Impaired Driving Causing Bodily Harm Impaired Driving Causing Death Total 29 36 35 47 43 31 579 617 695 788 732 616 5 10 13 14 8 8 1 1 1 0 0 0 792 843 938 1065 995 817 Source: Saskatchewan Government Insurance Alcohol related infractions, as identified by the Alcohol and Gaming Regulation Act, Provincial Statues, are tracked by the Regina Police Service. Data collected for 2004 is illustrated in the charts below identifying drinking and driving convictions within the RQHR as well as charges laid for various alcohol-related infractions that occurred within the city of Regina. It should be noted that most of the statistics in the chart below are enforcement-driven. Incidents tracked can be officer-initiated through drinking and driving spot checks, and therefore should not be interpreted literally as a measure of prevalence. 2000 2001 2002 2003 2004 Alcohol and Gaming Regulation Act Provincial Statutes Having Alcohol in Public Place - Charged - Guilty not charged 117 4 166 4 90 3 65 3 34 1 Having Alcohol in Auto - Charged - Guilty not charged 184 0 184 0 132 0 167 1 132 1 Intoxicated in a Public Place - Charged - Guilty not charged 221 1462 120 715 183 1424 241 1518 198 1221 Criminal Code Alcohol Related Offences Impaired Operation of a Motor Vehicle - Causing Death - Causing Injury - Impaired Driving - Exceed .08 2 31 724 621 2 23 629 516 0 27 509 399 0 21 526 416 0 19 399 325 Source: Regina Police Service The reduction in impaired driving offences has been partially attributed to the Enforcement Overdrive project, a partnership between Saskatchewan Government Insurance and the Regina Police Service. This partnership has provided the resources to conduct high visibility roadside check stops at strategically selected locations. The objective was to reduce the incidence of impaired driving and make the streets of Regina safer. This program has been credited with successfully reducing alcohol– related traffic collisions by 30% and has increased public awareness of an increased risk of being stopped by 31%. CANNABIS The Regina Police Service records reported violations of the Controlled Drug and Substances Act throughout the year. The charts and table below are representative of reported violations pertaining to cannabis over the last 8 years within the city of Regina. Year 1997 1998 1999 2000 2001 2002 2003 2004 Possession Cannabis Poss. For The Purpose of Trafficking 87 93 113 104 129 164 171 150 9 26 35 10 6 1 n/a n/a Trafficking Cannabis 16 91 67 24 23 14 37 36 Importation of Cannabis 0 1 0 6 5 0 4 2 Cultivation 6 14 13 6 4 13 15 12 Total Violations 118 225 228 150 167 192 227 200 Source: Regina Police Service Reported Violations Controlled Drug & Substances Act Possession Cannabis Number of Violations 250 Poss. For The Purpose of Trafficking 200 150 Trafficking Cannabis 100 Importation of Cannabis 50 0 Cultivation 1997 1998 1999 2000 2001 2002 2003 2004 Year Total Violations Source: Regina Police Service In 2004, total reported cannabis violations decreased by 12% when compared to data collected in 2003. In fact, all forms of violations related to cannabis decreased slightly in 2004. COCAINE The graph and table below illustrate the number of cocaine related violations that occurred in Regina from 1997 to 2004, according to statistics compiled by the Regina Police Service. 40 35 30 Possession of Cocaine 25 20 Trafficking Cocaine 15 Poss. for the Purpose of Trafficking Total Violations 10 5 0 1997 1998 1999 Year Possession of Cocaine Trafficking Cocaine Poss. For The Purpose of Trafficking Total Violations 2000 2001 2002 2003 2004 1997 1998 1999 2000 2001 2002 2003 2004 1 8 2 9 11 11 16 18 1 11 3 7 8 3 18 19 1 3 2 21 11 16 4 20 0 19 0 14 0 34 0 37 Source: Regina Police Service 2004 statistics infer that total violations for cocaine have remained fairly consistent with violations in 2003. . HEROIN, MORPHINE AND OTHER NARCOTICS The total number of charges for heroin and other narcotics violations increased by 58% in Regina in 2004. The table below provides a breakdown of specific violations with corresponding number of violations reported. An eight-year trend for total reported violations for heroin and NCA violations within Regina is also provided. Year Possession of Heroin Possession of other NCA Trafficking Heroin Trafficking other NCA Importation of Heroin Importation of NCA Total 1997 0 1998 0 1999 0 2000 0 2001 0 2002 0 2003 0 2004 0 26 19 29 27 13 31 19 34 0 0 1 0 2 0 1 1 17 18 8 8 11 5 12 18 0 0 0 2 0 0 0 0 0 3 1 0 2 0 1 1 43 40 39 37 28 36 33 54 Source: Regina Police Service Total Reported Violations - Controlled Drug & Substances Act Number of Violations 70 60 50 40 30 20 10 0 1997 1998 1999 2000 2001 Year Source: Regina Police Service 2002 2003 2004 An eight-year analysis of total violations within the city of Regina indicates that cannabis infractions continue to be more prevalent than other drug offences. This trend is consistent with 2003 data. However, in 2004, heroin and other NCA offences showed a 64% increase over the previous year, while cocaine violations increased by 10 %. Trends in Cannabis, Cocaine, Heroin and Other NCA Violations in Regina Number of Violations 250 200 Cannabis Cocaine Heroin and Other NCA 150 100 50 0 1997 1998 1999 2000 2001 2002 2003 2004 Year Source: Regina Police Service Despite the notable fluctuations within the data presented under the law enforcement portion of the report, increases and decreases in violations are not necessarily indicative of the prevalence of substances within the community. The data collected may be a reflection of an existing police focus and/or investigative cycles at a particular time, which may explain some of the spikes and dips in enforcement statistics. In addition to enforcement provided by the Regina Police Service, The Royal Canadian Mounted Police (RCMP) collect information on violations that occur outside the city of Regina. The violations include charges related to the possession and trafficking of various substances, including cannabis and cocaine. Unfortunately, data from the RCMP is unavailable for inclusion in this report. TREATMENT In 2004/2005 the reported number of clients receiving treatment within the RQHR, for alcohol and cannabis problems, increased by 8% and 12% respectively. The most dramatic change was registered for people using cocaine, showing an increase of 40% over the previous year. ALCOHOL In 2004/2005, a total of 4680 treatment episodes were recorded by Addictions Services, Regina Qu’Appelle Health Region for alcohol dependency. Of these clients, 72% identified that their use of alcoholic beverages was causing a problem. Additionally, nearly 2% of clients receiving treatment identified with drinking Lysol and other nonbeverage sources of alcohol. CANNABIS A total of 2563 treatment episodes were recorded by Addictions Services that identified clients using cannabis, 12% more than in 2003/04. 67% of these clients reported that their use of cannabis was problematic. COCAINE Addictions Services recorded a total of 1825 treatment episodes wherein clients were being treated for cocaine use in 2004/2005. This is a 40% increase over the previous year. Of these clients, 87% (1591) acknowledged that their use of cocaine was causing problems in their lives. HEROIN, MORPHINE AND OTHER NARCOTICS Clients engaging in narcotic use that are being treated within drug and alcohol treatment agencies do not have their specific chemical usage directly tracked. Rather, information is collected under the factions of prescription and non-prescription narcotic use. In 2004/2005, 1192 clients reported using prescription narcotics. 70% identified their use as problematic. Likewise, 1111 clients reported using non-prescription narcotics, 67% recognized their use to be causing problems in their lives. OTHER DRUGS Upon admission into a treatment program for drug and alcohol use, clients are asked to complete a self-report questionnaire. The RQHR uses the information provided to gain a better understanding of how drugs, alcohol and various mood-altering chemicals are perceived to be impacting the lives of clients. The graphs below display self-reported client information for both males and females. Clients responded to the type of chemical used as well as the potential problems the chemical(s) can cause in their daily lives. Chemicals used by MALE clients in the RQHR 4000 3500 Number of clients 3000 2500 2000 1500 1000 500 Ly H al so lu l c An in og tien D ep s re ss C an ra ts ck /C oc M ar ai ne iju an a/ H as Tr an h qu iliz Pr er s es N N c r ic on ip ot tio -P in n re e N sc a rip rc ot tio ic n s N ar co tic Se s St im da ul tiv an es ts /H yp no tic s St er oi ds Al co ho l So lv en ts 0 NOT USING YES, NOT CREATING PROBLEMS Source: Saskatchewan Health Information Products Group YES, CREATING PROBLEMS Chemical used by FEMALE clients in the RQHR 4000 Number of clients 3500 NOT USING 3000 2500 YES, NOT CREATING PROBLEMS 2000 1500 YES, CREATING PROBLEMS 1000 500 So Al co ho l lv en ts Ly H al so l An l u c i no ti ge D ep ns re ss C an ra ck ts /C M oc ar ai i ju ne an a/ H Tr as an h qu iliz Pr er es s N cr N on ip i c tio ot -P in n re e N sc ar rip co ti o tic n s N ar co tic Se St s da im tiv u l es an /H ts yp no tic s St er oi ds 0 Self-report data collected by the RQHR for 2004/2005 is consistent with past usage trends. Alcohol, nicotine and marijuana continue to be the most commonly used chemicals. However, since 2003/2004, reported nicotine usage has dropped slightly while cocaine has dramatically increased. Most common drug use of MALE & FEMALE clients combined 100% 836 977 90% 832 1591 1709 80% Clients 70% 3284 60% 50% 40% 30% 20% 10% 0% Alcohol NOT USING Marijuana Nicotine Cocaine YES, NOT CREATING PROBLEMS Prescription Narcotics Stimulants YES, CREATING PROBLEMS Source: Saskatchewan Health Information Products Group YOUTH The Regina and Area Drug Strategy (June 2003) identified gaps in services to youth who are experiencing harmful involvement with alcohol and drugs. The Healing Continuum working group has begun the task of developing strategies to bridge the identified gaps in service. (Ref: Regina and Area Drug Strategy section of this report - page 37). A higher degree of integration of services for youth has been developing within the RQHR. This is especially true for high-risk youth who require a more varied services (health, social services and justice). This integration of services was one starting point to close these ‘in-between’ areas, where youth were becoming lost in the system. The expected increase in the use of ‘crystal meth’ waned to some degree within the RQHR and the number of youth referred to addiction counsellors dropped off significantly. The demand for information on crystal methamphetamine continued to be high and has played a significant role in raising the communities awareness of this drug and the consequences of use. Alcohol and marijuana continue to be the primary drugs of choice among the youth in Regina and area. The use of ecstasy and other club drugs continues to be part of the rave scene and has not shown a significant increase in usage. Cocaine use is increasing and although it is mainly an “occasional use” drug, it appears to be reaching more youth and at a younger age. Addiction Services’ Parent Information Groups and Parent Support Groups continue to be an important community resource for parents in gaining an understanding of the impact alcohol and drug use has on their lives, as well as on the lives of their affected children. INJECTION DRUG USE The prevalence of drug use, as identified by clients within the RQHR, had been consistent in the past, whereby Talwin & Ritalin (commonly know as T’s and R’s) topped the list of preferred injected drugs, followed by cocaine and Morphine/Demerol. Starting in 2002, data indicated a change of preference among users. In 2004/2005 cocaine continues as the most injected drug, followed by Morphine/Demerol and finally Talwin & Ritalin. In je c tio n D r u g U s e r e p o r te d b y c lie n ts in 2 0 0 4 /2 0 0 5 500 450 450 M ost In je c te d 400 350 296 300 250 2nd M ost In je c te d 219 200 181 173 166 150 88 22 11 11 21 20 22 14 1 2 3 26 13 St im ul an ts Tr an qu illi ze rs oc ai ne H al lu ci no ge ns C M H or er ph oi in n e/ D em er ol Ta lw in /R ita lin 0 O th er 3 rd M o s t In je c te d 61 2 0 6 0 0 0 2 6 2 St er oi iv es ds /H yp no tic s 50 65 Se da t 100 Source: Saskatchewan Health Information Products Group To better understand the population of intravenous drug users, statistics were compiled by the RQHR based on clients receiving treatment. Data was gathered and collated by age, sex, cultural heritage and drug preferences of IV drug users. The two charts below illustrate the prevalence of IV drug use in 2004 amongst both males and females in accordance to their age range. Both males and females 19 years and older used IV drugs significantly more often when compared to males and females under the age of 18 within and prior to the last 12 months. Females accounted for 76% of the IV drug use for clients under the age of 18 years. Male and female IV drug use by clients, 19 years and older, has increased approximately 17% when compared to data collected in 2003. Males that have used in the last 12 months increased 22%, while females in the same category jumped 5%. Number of Clients IV Drug Use By Age For Male RQHR Clients 2,312 2500 2000 18 Years and Under 19 Years and Over 1500 1000 565 365 500 18 337 248 10 4 0 Used in Last 12 Months Used Prior to Last 12 Months Both None Use Source: Saskatchewan Health Information Products Group IV Drug Use By Age For Female RQHR Clients Number of Clients 2500 2000 1500 920 1000 428 500 240 49 22 21 183 201 0 Used in Last 12 Months Used Prior to Last 12 Months Both None Use Source: Saskatchewan Health Information Products Group 18 Years and Under 19 Years and Over The chart below displays IV drug use as identified by clients who disclosed their Aboriginal Status. The numbers indicate the high prevalence of IV drug use within the First Nations clients that utilize the addiction services within the RQHR. These numbers support the need for culturally appropriate treatment services within our health region. 2500 2000 1500 Used in Last 12 Months 1000 Used Prior to Last 12 Months 500 0 In N ui on t -A bo rig in al et is M N on -S ta tu s Both St at us Number of Clients IV Drug Use by Aboriginal Status None Aboriginal Status Source: Saskatchewan Health Information Products Group To moderate the impact of injection drug use, the RQHR has various methadone services within the community. In 2004/2005, 945 active Methadone Program clients were recorded within the region. This number has increased from the 856 active methadone clients recorded in 2003/2004. Although these numbers provide an indication of those who participate in the methadone programs, accurate information regarding the number of clients involved in Regina is difficult to obtain due to several factors. Clients may be registered with a clinic and then discontinue services, only to return at a later date or they may move from the area without notifying the program co-ordinators. As well, clients are able to get Methadone prescribed by an approved physician without having to be involved with the clinic’s counselling staff. There are currently 11 clients within the RQHR who are prescribed Methadone for pain relief purposes only. HIV/AIDS AND HEPATITIS C The RQHR reported 15 newly diagnosed cases of HIV in 2004. Additionally, 211 new cases of Hepatitis C were reported. HIV transmission and risk is primarily prevalent across Canada through both injection drug use and sex trade work. A large portion of HIV infections seen within the RQHR are considered to be chronic, having been acquired in years past. A considerable portion of these individuals received testing while present in a drug and alcohol rehabilitation program. In 2004/2005, the RQHR recorded a total of 117 hospital separations for people with HIV/AIDS. Hospital separations refer to the number of patients admitted to a Regina hospital through either inpatient admission or emergency room admission. This year, 65 inpatient admissions and 52 emergency room admissions are a 95% increase when compared to 2003/2004 data. The graph below represents a 5-year trend of the inpatient and emergency room admissions (hospital separations) for patients known to have HIV/AIDS. Only hospitals located within Regina are included. Regina Hospital Seperations - 5 Year Trend 70 Admissions 60 50 40 Hospital Visits Emergency Room Visits 30 20 10 0 2000/2001 2001/2002 2002/2003 2003/2004 2004/2005 Year NEEDLE EXCHANGE The goal of Needle Exchange Program that exists within the RQHR is to reduce the spread of HIV/AIDS and other blood borne diseases such as Hepatitis A, B and C through needle sharing.. This program is part of RQHR’s harm reduction strategy that aids in the recovery of dirty needles through program that provides them with clean needles, sharp containers and other related supplies to injection drug users in exchange for used or dirty needles. There are three centres located throughout the city of Regina including the Carmichael Outreach Centre, AIDS Programs South Saskatchewan and the RQHR Street Project. In 2004/2005, the three centres provided a total of 1,656,382 needles that were exchanged through the program. The following graph indicates the growth of the Needle Exchange program in Regina in the last 12 years. Total Number of Needles Distributed 1992-2004 1800000 Number of Needles Distributed 1600000 1400000 1200000 1000000 800000 600000 400000 200000 0 APSS CARMICHAEL STREET 1992 1993 1994 1995 1996 1997 1998 1999 2000 0 0 0 0 0 0 0 0 0 218,973 361,145 422,201 624,235 0 0 0 0 0 0 0 65,928 218,401 403,452 452,069 0 0 191 7787 2001 2002 2003 2004 22,374 34,982 74,491 115,248 197,008 332,706 500,397 543,095 529,510 543,850 580,078 Year Source: RQHR Population and Public Health THE REGINA AND AREA DRUG STRATEGY Throughout 2004, the Regina and Area Drug Strategy (RADS) working groups continued to meet on a regular basis in an effort to develop work plans to address the priority projects that were identified from the report. The multi-agency nature of the membership of each group allowed for the strong connections that had developed in the initial stages of the RADS to continue. With a community-wide initiative such as the RADS, project evaluation was one of the major issues addressed. In 2004, the Steering Committee contracted INNOVA Learning of Regina to develop an evaluation plan. Representatives of INNOVA met with each working group to develop the Evaluation Framework, which was presented in October 2004. The Evaluation Framework is available for viewing online at: http://www.reginadrugstrategy.ca/report.shtml Following is a listing of the working groups and a list of the projects that have been the focus of each group and the progress to date. By having all the community partners involved in identifying the main priority issues, the working groups were assured that the issues were important, not only in the service organizations but also within the community. Prevention To develop current and relevant curriculum for schools. To develop a peer support network. To develop of a series of ‘user-friendly’ pamphlets for youth, parents and community resources. To develop a telephone hotline for information and referrals related to addiction issues. These were addressed initially by developing a proposal and securing funding to develop these resources and programs. Included were plans to develop a ‘speakers bureau’ of youth that had experiences with addiction and recovery to share. Healing Continuum To review existing pathways and treatment services. To initiate a meeting between addiction treatment centres. To develop resources for youth, including stabilization and other program components. To more closely monitor the increased use of methadone and the subsequent impacts on births and deaths. The review of existing treatment services and pathways led to a decision to focus on services for youth, which were noted to be lacking within the RQHR. At the workgroup’s request, one of it’s members completed a series of youth focus groups, interviews with community service providers and a review best practice literature to identify gaps in services. The report filed in November of 2004 identified several gaps in services and as a result the workgroup were able to develop several recommendations specific to youth treatment services. Harm Reduction To develop a ‘Brief Detox and Homelessness Shelter’ in Regina. To improve access to services for pregnant women not presently accessing pre-natal care. To continue to assess the Harm Reduction services available in Regina. The development of a Brief Detox and Homelessness Shelter was initiated by hiring consultants to develop a business case and investigate funding sources for this initiative. The report, entitled “The Crossroads - A Rehabilitation Centre for Homeless, Substance Dependent and Dual Diagnosed Individuals”, was submitted in December 2004. Plans to develop this centre continued through yearend. Assessing and improving access to services was initiated by holding consultations with identified at risk women. This led to expanded services at identified community health care centres in central Regina and expanded out-reach services within the community. Plans to evaluate and design a comprehensive model of Harm Reduction in Regina continue to progress by researching services models that could hold some benefit to the community. Community Justice To assess the critical pathway to treatment currently in place for offenders as they move through the Criminal Justice System. To ensuring appropriate substance abuse programming for offenders both in the community and incarcerated. To assess the feasibility of developing a Drug Treatment Court in Regina. To assess inconsistencies and related concerns with Methadone services for criminal offenders. The group determined that funding sources were available for developing a Drug Treatment Court for Regina and proceeded to develop a proposal for the “Regina and Area Drug Treatment Court”. The group consisted of individuals from Justice, Health, the RQHR, the Regina Police Service, the RCMP and other addiction services in the Regina area. The proposal was submitted in January 2005 and project planning continues. Work on the other projects continued with regular meetings to continue to assess the critical pathway to treatment and determine gaps in the system. The group determined that addiction-related programming within the Regina Correctional Centre could be expanded. This project also continues. Capacity Building To develop an inventory of Human Services providers within the RQHR. To develop a research project regarding ‘volunteerism’ in addictions treatment. To research and develop an inventory of available ‘funding sources’. To strengthen the network of community partners and continue to develop programs within the community. The Capacity Building committee continued to build on the project’s communication strategy by developing and expanding the Regina and Area Drug Strategy website. Many projects were initiated within the RQHR to continue to build on the foundations that were laid in the first full year of the RADS. With community development being one of the goals of the RADS, the committee has continued to encourage and support multiple organizations in developing projects within the community. Planning and development continued through out the year. APPENDIX A ICD-10 Diagnostic Codes for Substance Related Hospital Cases ALCOHOL I42.6 Mental and behavioural disorders due to use of alcohol Alcoholic cardiomyopathy K29.2 Alcoholic gastritis K700,1,2,3,4,9 Alcoholic liver disease R78.0 Finding of alcohol in blood T510,1,2,3,8,9 Toxic effect of alcohol Z50.2 Alcohol rehabilitation Z71.4 Alcohol abuse counselling and surveillance F100,1,2,3,4,5,6,7,8,9 COCAINE R78.2 Mental and behavioural disorders due to use of cocaine Finding of cocaine in blood T40.5 Poisoning by cocaine F140,1,2,3,4,5,6,7,8,9 CANNABIS F120,1,2,3,4,5,6,7,8,9 T40.7 Mental and behavioural disorders due to use of cannabinoids Poisoning by cannabis (derivatives) OPIATES F110,1,2,3,4,5,6,7,8,9 T400,1,2,3,4,6 R78.1 Mental and behavioural disorders due to use of opioids Poisoning by opium, heroin, other opioids, methadone, other synthetic narcotics, other and unspecified narcotics Finding of opiate drug in blood SEDATIVES/HYPNOTICS/TRANQUILIZERS F130,1,2,3,4,5,6,7,8,9 T42.3 T430,1,2,3,4,5,6,8,9 R78.5 Mental and behavioural disorders due to use of sedatives or hypnotics Poisoning by barbiturates Poisoning by psychotropic drugs, not elsewhere classified Finding of psychotropic drug in blood HALLUCINOGENS F160, 1,2,3,4,5,6,7,8,9 Mental and behavioural disorders due to use of hallucinogens Poisoning by lysergide [LSD], other and unspecified T408,9 psychodysleptics [hallucinogens] Finding of hallucinogen in blood R78.3 STIMULANTS F150,1,2,3,4,5,6,7,8,9 T43.6 Mental and behavioural disorders due to use of other stimulants, including caffeine Poisoning by psychostimulants w/ abuse potential SOLVENTS F180, 1,2,3,4,5,6,7,8,9 Mental and behavioural disorders due to use of volatile solvents Toxic effect of organic solvents T520,1,2,3,4,8,9 MULTIPLE/UNSPECIFIED DRUG USE F190, 1,2,3,4,5,6,7,8,9 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances Finding of other drugs of addictive potential in blood R78.4 Z50.3 Drug rehabilitation Z71.5 Drug abuse counselling and surveillance HIV/AIDS B24 Human immunodeficiency virus [HIV] disease R75 Laboratory evidence of human immunodeficiency virus [HIV] Contact with and exposure to human immunodeficiency virus [HIV] Asymptomatic human immunodeficiency virus [HIV] infection status Z20.6 Z21 GLOSSARY OF TERMS ADS AIDS Anti-Depressant Canadian Addiction Survey Cannabis CCENDU CCSA Cocaine Controlled Drugs and Substances Act Crack DWI Ecstasy Gamma Hydroxybutyrate (GHB) Addiction Services Acquired Immune Deficiency Syndrome (AIDS) is the most serious outcome of Human Immunodeficiency Virus (HIV) infection. It is a serious (often fatal) disease of the immune system transmitted through blood products especially by sexual contact or contaminated needles. A major classification of drugs used medically to improve mood in severely depressed patients. A national Canadian survey that reports on prevalence and harmful effects of substance abuse. Formal Latin name for marijuana, cannabis is the most commonly used illicit drug; considered a soft drug, it consists of the dried leaves of the hemp plant; smoked or chewed for euphoric effect. Canadian Community Epidemiology Network on Drug Use Canadian Centre on Substance Abuse A highly addictive stimulant drug derived from the cocoa plant that produces profound feelings of pleasure. An Act respecting the control of certain drugs, their precursors and other substances and to amend certain other Acts and repeal the Narcotic Control Act in consequence thereof A purified and potent form of cocaine that is smoked rather than snorted Driving while intoxicated, or driving while impaired. General term used to describe the criminal action of operating a vehicle while intoxicated, impaired or under the influence of alcohol or other drugs. Drugs used for their euphoric effects A powerful, rapidly acting central nervous system depressant. It is typically abused for its ability to produce euphoric and hallucinogenic states and for its alleged function as a growth hormone that releases agents to stimulate muscle growth HEP-C RADS A viral hepatitis clinically indistinguishable from hepatitis B but caused by a single-stranded RNA virus; usually transmitted by parenteral means (as injection of an illicit drug or blood transfusion or exposure to blood or blood products). A strong narcotic analgesic drug derived for the opium poppy. It is a narcotic that is considered a hard drug; a highly addictive morphine derivative; intravenous injection provides the fastest and most intense rush. Human Immunodeficiency Virus, the virus that causes AIDS. Intravenous Injection. The fastest route into the blood stream. Traditionally used as a cleaning product, a nonalcoholic beverage that is consumed by individuals, often causing an intoxicated state, including behavioural and psychological changes. Information regarding hospital inpatient and emergency clients that present with various ailments. The most potent natural opiate compound produced by the opium poppy, classified as a narcotic drug extracted which has powerful, habit-forming properties used to relieve pain. Information regarding the cause of death of an individual. A class of drugs (e.g., heroin, codeine, methadone) that are derived from the opium poppy plant, contain opium, or are produced synthetically and have opium-like effects. Opioid drugs relieve pain, dull the senses and induce sleep. Narcotic Control Act. Non Government Organization Narcotics obtained without a doctors prescription such as over the counter or off the street narcotics. Narcotics obtained by the client through a doctor’s prescription. The number of people in a given population affected with a particular disease or condition at a given time. The Regina and Area Drug Strategy RQHR Regina Qu’Appelle Health Region Heroin HIV IV Lysol Morbidity Morphine Mortality Narcotic NCA NGO Non-prescription drug Prescription drug Prevalence Safe Driving Legislation Legislation passed in 1996, that requires drivers convicted of various impaired driving charges to attend addiction assessments and follow through on resulting referrals prior to reinstatement. Sedatives/Hypnotics A group of drugs used to produce sedation (calmness). Sedatives include sleeping medications and anti-anxiety drugs. SLGA Saskatchewan Liquor and Gaming Authority Solvent Fluids used to dissolve or dilute oil paints and their mediums, such as Turpentine. This substance can be used to achieve a “high” by breathing in the fumes of the chemical. STD Sexually Transmitted Disease. Steroids (Also called "Anabolic Steroids") Prescription drugs derived from growth-stimulating male testosterone. Though long taken by some professional and amateur body builders -- and other athletes -- to increase muscle size and endurance, there are side effects (including liver and heart damage, and mental problems) associated with the use of some steroids. Stimulants Drugs that stimulate or speed up central nervous system functioning. Stimulants include caffeine, nicotine, amphetamines (Speed) and cocaine. THC Tetrahydrocannabinol. The primary psychoactive compound present in cannabinoids (marijuana, hashish and hashish oil). Trafficking Buying and selling illegally; For the purpose of this report, it refers to the acquisition, transfer and disposal of drugs. Tranquilizers (major) Drugs used to relieve symptoms of severe psychosis (for example, Thorazine); (minor) Psychoactive drugs with sedative and anti-anxiety effect; also used as anticonvulsants and muscle relaxants (an example is Valium).
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