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Canadian Drug Strategies

By Mykayla McGowan

Are Canadian Drug Strategies Out of Commission?

Substance use is the fuel that keeps the dumpster fire of Canada’s criminal justice complex and health care system ablaze. With 1 in 5 Canadians experiencing a substance use disorder in their lifetime, it is no wonder that the country we call home harbours the fastest-growing rate of overdose mortality globally.

The current Drugs and Substances strategy is failing Canadians and requires immediate modification.

Canada’s Current Situation

Approximately 6 million Canadians meet the criteria for a substance use disorder during their lifetime. Potential harms from such use have heightened amid Canada’s opioid crisis, as supplies have become increasingly contaminated with synthetic opioids like fentanyl.

Canada’s Drugs and Substances Strategy emphasizes four key pillars to prevent and treat problematic substance use. The pillars are:

  • Prevention: educate the public about the risks of substance use
  • Treatment: support treatment and rehabilitation services
  • Harm reduction: reduce the negative effects of substance use on individuals and communities
  • Enforcement: address production, trafficking and diversion of drugs

What’s Not Clicking in Canada?

National Inconsistency

The current Canadian system unloads enforcement and harm reduction responsibilities onto provinces and territories to deal with individually. The lack of a cohesive, national strategy focused on reducing problematic drug use and overdose has set Canada and its citizens up for failure.

Research, Evidence, and Evaluation Issues

The government fails to ground its substance use policy in evidence. The country does not have a central organization for data collection and analysis on substance use issues, as exists elsewhere, such as in Australia and the United States.

If things do not change, Canadians will start to feel the consequences of the inaction taken by our federal government.

Is Anyone Doing it Right?

Although it is easy to critic drug strategies across the globe for one reason or another, some countries are doing it right.

Take Portugal, for example. As of 2001, the Portuguese federal government decriminalized the personal possession of all drugs as a part of a push to treat substance use as an issue of public health rather than public order in response to high rates of HIV linked to injection drug use.

Portugal’s strategy acts as a cohesive, nationwide plan that enforces policies on a case-by-case basis. Problematic drug use is addressed by dissuasion committees rather than the criminal justice system, where sanctions, charges, or voluntary treatment referrals are imposed instead of jail time.

As a result, Portugal has enjoyed various benefits, including:

  • Reduced problematic drug use and incidences of HIV/AIDS
  • Increased number of citizens utilizing treatment facilities
  • Fewer drug-induced deaths
  • Overall social costs of drug misuse declined

Why it Works for Portugal

The Portuguese drug strategy is informed by evidence and research conducted within the country. Portugal identified the issues they wanted to address and approached them in a culturally and socially informed manner.

So What?

This blog has two purposes:

  • Criticize the Canadian federal government’s approach to drug use (which is well deserved)
  • Identify a need for change

Imagine that the Canadian federal government wants to adopt an effective strategy to reduce problematic substance use. They would need to:

  • Accept contextual factors facing Canadians
  • Be open to innovation
  • Situate any intervention within an evidence-informed continuum of prevention, harm reduction, and treatment
    • An evidence-informed continuum supports the collection and monitoring of data and is required to evaluate the success of any policy-based approach to substance use. This continuum allows for corrections to be made easily, as they are grounded in evidence and account for changes in external factors, such as trends in drug consumption or overdose rates

A great place to start would be forming a national organization for data collection and analysis on substance use issues.

Creating such an organization will allow the government to self-reflect and identify the most pressing problems that require immediate attention, such as the opioid crisis. Only once the key issues are pinpointed, the organization could conduct research to find the most effective solutions for our countries problems.

Perhaps this imaginary organization could take notes on the drug policy of Portugal as a starting point.

Obesity in Canada… The way forward

By: Victoria Ekunnusi

Multiple Variables of Obesity

Obesity has many factors: Personal, Behavioral, and Environmental. Personal predisposing variables include genetics and ethical background. Behavioural variables are practices (sedentary lifestyle and food choice) that turn into habits over time. Finally, environmental variables are the living conditions and the overarching social determinants of health. Often, obesity is a result of a combination of these variables.

Obesity- A chronic health condition

Obesity is considered to be a chronic disease by organizations like Obesity Canada, Canadian Medical Association and the World Health Organization because obesity is the leading cause of type 2 diabetes, high blood pressure, heart disease, stroke, arthritis, cancer and other health problems, it can cause a significant strain on individuals, families, and the health care system. 

Despite public health prevention strategies, obesity continues to persist, and the rate has tripled over the past three decades in Canada, and now, about one in four Canadians is obese.

Cost of Obesity 

The annual direct health care cost of obesity which includes physician, hospitalization, and medication cost, is currently estimated to be between $5 to $7 billion. This cost is projected to rise to about $9 billion by 2021. The economic and psychological costs of obesity will continue to increase without comprehensive, evidence-based, and people-centred strategies. Thus, addressing the prevalence of obesity in Canada should be an utmost priority.

Addressing Obesity at the early stage of life

Recently, the Canadian government has created policies by placing taxes on unhealthy meals, banning certain fatty food, and providing open spaces to encourage physical activities. However, these interventions have not yielded the desired outcomes. 

Obesity and weight gain develop over a lifetime. Therefore, the impact of obesity points to the importance of prevention through healthy behaviours, including increased physical activity and a healthy nutritional diet, beginning at an early stage, and continuing through all the stages of life.

The federal government should encourage addressing Obesity from early childhood. For example, countries like Japan and Finland were able to reduce obesity issues by adopting the “health in all policies approach” (Addressing Obesity at the early life), where the health department worked with schools, childcare providers, and parents to create a healthier environment at the early life.

Considering the increasing rate of obesity, a possible way for the government to truly eradicate or at least reduce the prevalence of obesity is to address it at the early stage of life by adopting some guidelines (listed below) that could help reduce the national burden of obesity.

Guidelines

Here are the guidelines that should be followed to reduce obesity:

  • Young children should be educated on the importance of healthy eating and engaging in physical activities.
  • Young married couples should be encouraged to initiate healthy meals for their children early in life so that it becomes part of their lifestyle.
  • The government could subsidize the cost of healthy food and gym membership for low- and middle-income families to facilitate involvement in healthy lifestyle choices.
  • There should be an ongoing evaluation strategy to identify and monitor areas of improvement.

Awakening Call

The quality of life of Canadians should be at the forefront of the government priorities to ensure all citizens live a healthy life. Addressing Obesity at the early stage of life is the way forward that can help reduce the burden of chronic health issues over time, significantly increasing Canadian’s quality of life and reducing the huge medical cost of obesity

Strategies to prevent obesity need to address all phases and places in life, starting from birth to make sure we are living healthy lives through healthy eating and physical activity.

Evaluating the 2021 Federal Election Projections

With the final seat tally now official, it is possible to evaluate the prediction results. For this analysis, CBC Canada Votes 2021 at 8:00 am on September 25, 2021, is being used. The analysis examines six websites that aggregate polls from the polling firms and then create a model to predict the election are examined (338Canada, Calculated Politics, CBC Poll Tracker, Lean Toss Up, Too Close to Call, and The Signal), three projection websites using their own models (Election Prediction Project, Election Atlas, and Advanced Symbolics) and four polling firms which use their own data to predict the election (Ekos, Forum, Innovative Research, and Mainstreet).

The results show the Liberals with 159 seats, the Conservatives with 119, the NDP with 25, the Bloc with 33 and the Greens with two. Most projections underestimated Liberal support. Mainstreet was predicted exactly 159 seats. The average estimates were missed by five seats. The Conservative support was very close with a mean of 118. Six projections overestimated Conservative support, seven underestimated Conservative support, and the CBC Poll Tracker had exactly 119 seats. The average estimates were very close only missing by one seat. NDP support was overestimated by every projection by an average of seven seats. The Bloc seats were overestimated in ten projections and underestimated in four. The mean of Bloc support was only off by two seats. Seven projections accurately predicted the Greens would win two seats and the average projection was two seats. Five projections predicted the Greens would win three seats and two predicted one seat. Three projections incorrectly predicted the PPC would win one seat.

To evaluate the overall accuracy of the different projections the projection for each party is subtracted from the actual seats won. The absolute value is then taken (i.e. if it is negative it is turned positive) and these values are added together. This gives a value of the error of each projection. (A more accurate method would be to look at each individual riding and see what percentage of the ridings were accurately predicted. This information is not readily available for each of the projections).

The average projection error was 24. The most accurate projection was by Mainstreet who only missed by 12. Mainstreet also had the most accurate projection in 2019. The poll aggregates as a group were the most accurate. Five poll aggregator projections (Calculated Politics, CBC Poll Tracker, Lean Toss Up, Too Close to Call, and @politicstacan) had an error of 14. The most accurate other projection method was Election Atlas with a projection error of 16. Ekos also had an error of 16.

Part of the accuracy of the models used to predict the vote share of each party in the election is due to the accuracy of the projection of the vote share of each party. The next comparison examines how accurate the vote share was projected. The average error is calculated in the same way as the previous analysis, with the absolute value of the difference taken for each party.

The average error was 10.1 percentage points. The most accurate projection was from The Signal with an error of 6.2 percentage points. Too Close to Call was just behind at 6.5 percentage points off. All but one of the aggregators had better projections than each polling firm. Calculated politics had the same tracking error as Mainstreet at 10.7 percentage points. Mainstreet was the most accurate polling firm once again. On average, the projections underestimated the Liberal, Conservative, and Bloc party support were underestimated. The NDP, Green, and PPC support was overestimated by the projections.

Every projection accurately predicted a Liberal minority government with the Conservative party in second place. Seat projections for the Bloc, Greens, and PPC were also reasonably accurate. The NDP seat projections were the biggest miss with every projection overestimating the projected seat total with an average error of seven seats. The Liberal party support on average was overestimated by five seats on average. A post-election analysis of why the NDP was down in the projected vote and seat count is warranted to improve future projections. Overall, the projections were very accurate, and the projection modellers should be satisfied with their predictions.