2. Spring 2011 Molly Bell, Colleen Dell, and Randy Duncan Emerging Trends in Alcohol and Drug Use in Saskatoon: Highlights

3. Project background Prevalence Enforcement Treatment Morbidity Mortality AIDS/HIV/HepC IDU Needle exchange Drug & alcohol indicators Canadian Community Epidemiology Network on Drug Use (CCENDU): http://www.ccsa.ca/Eng/Priorities/Research/CCENDU/Pages/default.aspx

4. Methodology 114-item questionnaire completed by 51 key informants during Winter/Spring 2011 Additional respondents were identified by the research team and key informants Respondents included emergency room physicians, public health nurses, emergency medical (or ambulance) technicians, addictions counselors, pharmacists, mental health specialists, drug enforcement officers, social workers, drug users Interpretation panel to verify the questionnaire findings Existing sources of quantitative data also reported on

5. Saskatoon: Demographics Largest city in Saskatchewan ~ 250,000 residents ~ 17,600 individuals of Registered Indian Status ~17,000 immigrants Agriculture and mining are large industries The Saskatoon Health Region & University of Saskatchewan are large employers 2010 unemployment rate was 4.3% Saskatoon

6. Social determinants of health The social determinants of health are the economic and social conditions under which people live and influence their health. A 2009 Saskatoon Health Region report identified significant health disparities between affluent and low-income residents in the city. A large proportion of Saskatoon’s First Nations and Métis populations live in low-income neighborhoods, and face poorer health status in comparison to the rest of the city’s population.

7. Problematic substance use

8. Cocaine/crack

9. Cocaine/crack: Typical users

10. Cannabis

11. Cannabis: Typical users

12. Opioid prescription drugs

13. Opioid prescription drugs: Typical users

14. Alcohol

15. Alcohol: Typical users

16. Prevalence: Additional information Geographic distribution of problematic substance use Cocaine/crack, methadone and non-potable substances a particular concern for lower-income neighborhoods. Alcohol, cannabis, opioid and non-opioid prescription drugs, amphetamines, and ecstasy were identified a city-wide problems Heroin, hallucinogens, steroids and solvents were not identified as problematic. Other substances of concern Energy drinks and salvia

17. Enforcement

18. Increased trafficking in nearly all substances in Saskatoon, and especially cocaine/crack, cannabis, opioids and ecstasy. Factors cited as causes for the increase: demand from consumers availability from suppliers poverty lack of affordable housing difficulty accessing treatment programs Saskatoon’s healthy economy

19. Treatment: Demographics

20. Treatment Key informants indicated an increase in individuals seeking treatment in the past year. Substances most frequently cited are alcohol, cocaine/crack, cannabis and opioids. Contributing factors: Decreased health and wellness Lack of affordable housing Poverty Typical treatment seekers were males and females 49 years of age and under.

21. Morbidity Key informants identified an increase in individuals seeking medical care due to alcohol and drug use over the past year Substances most frequently cited were alcohol, cocaine/crack, cannabis, and opioids Poverty was the most frequently identified cause All age groups identified as seeking care, with males and females 49 and under cited most frequently

22. Mortality Key informants identified an increase in substance-related deaths over the past year in Saskatoon. Substances most frequently cited are alcohol, cocaine/crack, opioids and illicit methadone. Males and females age 19 to 49 were the most frequently cited as suffering drug-related deaths. All age groups were identified for alcohol-related deaths.

23. HIV/AIDS/Hepatitis C Injection Drug Use (IDU) In 2009/2010, 14% of treatment admissions in Saskatoon reported IDU in the past month. Cocaine and morphine were the most frequently injected drugs reported, followed by Ritalin© and Concerta©. In 2009, 11,216 loose needles were recovered in Saskatoon neighborhoods One-third of key informants identified an increase in IDU in Saskatoon over the past year. Cocaine/crack were identified most frequently, followed far behind by heroin and methadone. Typical injection drug users were identified as males and females 19-29, followed by individuals 30 to 49 and youth under 19. 35% of informants believe there has been an increase in IDU associated risky behaviours (e.g., needle sharing/reuse, unprotected sex) over the past 12 months in Saskatoon, placing individuals at increased risk of contracting HIV/AIDS & Hepatitis C.

24. Pregnancy In 2009/2010, 4% of women admitted to drug and alcohol treatment services in Saskatoon were pregnant. Key informants identified an increase in the number of women who use substances during pregnancy. Key respondents also identified an increase in pregnant women accessing treatment, requiring medical care, being involved with the law, and being HIV and Hepatitis C infected.

25. Future Directions Question: What does this means for your work? How can we address this? Early detection and surveillance network established in Saskatoon: Google® group created to enhance information sharing and communication among drug and alcohol use-related sectors Contact Molly Bell at molly.bell@shaw.ca to joinmolly.bell@shaw.ca Saskatoon CCENDU report available at: http://www.addictionresearchchair.com/disseminating-knowledge/ccendu/

26. References Needle Safe Saskatoon. (2010). 2010 Newsletter. Retrieved from: http://www.aidssaskatoon.ca/web/sites/default/files/NSS%202010%20Newsletter%20FINAL.pdf http://www.aidssaskatoon.ca/web/sites/default/files/NSS%202010%20Newsletter%20FINAL.pdf Opondo J. (2010). Saskatoon: Updated information on an HIV epidemic in the prairies. PowerPoint Presentation. Saskatoon. Saskatchewan Government Insurance. (2011). 2009 Saskatchewan traffic accident facts. Regina. Retrieved from: https://www.sgi.sk.ca/sgi_pub/road_safety/trafficcollisionstats/pdf/2009/TAIS2009section10.pdf https://www.sgi.sk.ca/sgi_pub/road_safety/trafficcollisionstats/pdf/2009/TAIS2009section10.pdf Saskatchewan Ministry of Health. (nd). Saskatchewan’s HIV strategy: 2010-2014. Regina: Ministry of Health. Retrieved from: http://www.allnationshope.ca/Documents/hiv-strategy-2010-2014.pdf Saskatchewan Ministry of Health. (2011). Community Care Branch, Community Program Profile 2009-10, unpublished. Regina: Ministry of Health. http://www.allnationshope.ca/Documents/hiv-strategy-2010-2014.pdf Saskatoon Health Region. (2009). 2009-2010 Annual Report to The Minister of Health. Saskatoon: SHR. Retrieved from: http://www.saskatoonhealthregion.ca/about_us/documents/shr_annual_report_2009_10.pdf http://www.saskatoonhealthregion.ca/about_us/documents/shr_annual_report_2009_10.pdf Saskatoon Health Region. (unpub). Preliminary results from the 2009 Enhanced Street Youth Survey. Saskatoon Police Service. (2010). Month-end and year-end crime statistics. Retrieved from: http://www.police.saskatoon.sk.ca/pdf/Dec_Monthend_Detail.pdf http://www.police.saskatoon.sk.ca/pdf/Dec_Monthend_Detail.pdf Saskatoon Regional Economic Development Authority. (2011). Business statistics. Retrieved from: http://www.sreda.com/en/pages/354/business_statistics.html http://www.sreda.com/en/pages/354/business_statistics.html Statistics Canada. (2007). Saskatoon, Saskatchewan (Code4711066) (table). 2006 Community Profiles. 2006 Census. Statistics Canada Catalogue no. 92-591-XWE. Ottawa. Retrieved from: http://www12.statcan.ca/census-recensement/2006/dp- pd/prof/92-591/index.cfm?Lang=Ehttp://www12.statcan.ca/census-recensement/2006/dp- pd/prof/92-591/index.cfm?Lang=E Statistics Canada. (2010). Labour Force Information. Catalogue no. 71-001-X. Ottawa. Retrieved from: http://www.statcan.gc.ca/pub/71-001-x/71-001-x201003_eng.html http://www.statcan.gc.ca/pub/71-001-x/71-001-x201003_eng.html