Drug and alcohol

Substance-Related Disorders: Mortality Surveillance

The mortality rate in the population with SRDs (substancerelated disorders) decreased significantly over a 15-year period, from 32.4 per 1,000 in 2001-2002 to 21.6 per 1,000 in 2016-2017. A similar, but less pronounced, trend is also observable in the general population with no SRD, with the mortality rate dropping from 9.0 per 1,000 in 2001-2002 to 6.8 per 1,000 in 2016-2017.

Temporal trends in the mortality rate ratios of the population with an SRD versus the general population with no SRD shows that the risk of dying went from 3.6 times higher (in 2001-2002) to 3.2 times higher (in 2016-2017) for a person diagnosed with an SRD compared to a person with no SRD. The gap between the two populations is gradually narrowing over time.

Individuals diagnosed with an SRD are 9.4 times more likely to die by suicide than Individuals never diagnosed with an SRD. This increase in risk is statistically higher for women (18.3 times) than for men (6.5 times).

Perinatal Psychoactive Substance Use Among Indigenous Women: Social Determinants

Because of its impact on the health of families and future generations, psychoactive substance use during the perinatal period is a public health concern for the entire population. Understanding the factors that influence psychoactive substance use among Indigenous women in the perinatal period is essential to targeting prevention and health and wellness promotion strategies for First Nations and Inuit people. This synthesis analyzes the factors that emerge from the scientific literature through the lens of social determinants of health.

  • Strong family ties, social support and connection to community, traditional values and culture emerged as protective factors against psychoactive substance use during the perinatal period for Indigenous women. These factors are associated with the social environment and cultural continuity, which are social determinants of Indigenous health.
  • Difficult living conditions (job insecurity, low education level, and frequent reloc…

The non-medical cannabis regime in Québec: A public health analysis

  • This document examines, from a public health perspective, the regulatory regime governing the production, distribution, use and possession of cannabis for non-medical purposes in Québec. The analysis describes the main characteristics of this regime and examines the main public health issues it raises. Thus, the analysis identifies elements that could inform the legislative review process planned for 2021.
  • Compared to what has been put in place in other Canadian provinces and in other countries, the Québec regime has some distinctive characteristics:
  • The fully public nature of the distribution and sales system is unusual. The Société québécoise du cannabis, a not-for-profit state-owned enterprise, holds a monopoly on the purchase and sale of cannabis products for non-medical purposes to individuals in Québec. Compared to partially or fully privatized regimes, this monopoly allows for more direct control over cannabis products…

Substance-Related Disorders – Prevalence of Cases Identified Using Administrative Databases, 2001-2016

This report presents the annual and cumulative prevalence of substance-related disorders (SRDs). It demonstrates the ability of the Québec Integrated Chronic Disease Surveillance System (QICDSS) to allow for the study of SRDs based on health administrative databases. Prevalences were determined based on administrative data from April 1, 2001 to March 31, 2016, for all persons eligible for coverage by the Régie de l'assurance maladie du Québec and aged 12 and older. To be identified as having an SRD, the individual must have had at least one medical visit or hospitalization resulting in a primary or secondary diagnosis of an SRD.

  • Over a 15-year period, 40 individuals per 1,000 were diagnosed with an alcohol-related disorder and 39 per 1,000 with a drug-related disorder. Approximately 13 per 1,000 were diagnosed with both an alcohol-related and a drug-related disorder. Thus, 66 individuals per 1,000 were diagnosed with at least one SRD.
  • The annual prevalence o…

Medical competencies directory in non-cancer pain management and opioid prescribing– Update

The prescription and use of opioid drugs has increased significantly in Québec in recent years. According to studies recently published by the Institut national de santé publique du Québec – INSPQ (Gagné et al., 2013; Gagné, Dubé, Légaré and Perron, 2015), an increase in the number of deaths and the mortality rate attributable to opioid overdose was also reported in the province between 2000 and 2012, among the population aged 20 and over.

As part of an agreement with Health Canada, a project funded by the Drug Strategy Community Initiatives Fund (DSCIF) has been implemented in Québec for 2015-2017 in order to address opioid prescribing practices in chronic non-cancer pain (CNCP) management, which is often associated with the overdose trends. The grant was awarded to the INSPQ as the project coordinator, in collaboration with the Collège des médecins du Québec, the Faculty of Medicine and Health Sciences of Université de Sherbrooke, and the Centre de recherche et d’…

A Practical Guide to Support Public Health Management and Intervention in Case of Reports and Episodes of Drug Overdoses

Tools :

Drug use is a current phenomenon creating concern among public authorities and the population. It represents an important public health issue because of the significant social and health impacts associated with it. Overdose, with or without death, is a serious health consequence of drug use. Throughout North America, overdoses are on the rise. This is part…

Acute Alcohol Poisoning and Sweetened Alcoholic Beverages

Acute alcohol poisoning occurs frequently in Québec. Between January 1 and November 26, 2017, provincial emergency rooms admitted 2,332 young people age 12–24 for acute alcohol poisoning. That is equivalent to 214 cases per month, 49 cases per week, or 7 cases per day.

These cases are serious. One quarter of young people age 12–24 admitted to the emergency room at the Centre hospitalier de l’Université de Sherbrooke for alcohol-related problems had a priority level indicating that their lives were at risk.

The available data do not conclusively demonstrate that products with high alcohol and sugar content were the main cause of acute alcohol poisoning cases treated in Québec emergency rooms in 2017. Nonetheless, analysis of the data underscores a serious problem that justifies stronger preventive action.

Sales of sweetened alcoholic beverages are up in grocery and convenience stores in Québec. Products with the highest alcohol content show the highe…

Presence of Psychoactive Substances in Biological Samples From Drivers Fatally Injured in Québec From 2002 to 2013

Since 2002, the number of road traffic deaths in Québec has been falling steadily, even though the number of motor vehicles on the road – automobiles, in particular – has increased considerably. Nevertheless, the use of alcohol, drugs and medications is frequently cited as a cause of road traffic accidents by public authorities, since these psychoactive substances have the potential to impair driving.

The aim of this study is to present a profile of the psychoactive substances (i.e. alcohol, drugs and medications) examined and detected among motor vehicle and motorcycle drivers aged 16 years and over who were killed in road traffic accidents in Québec from 2002 to 2013.

The main findings are as follows:

  • The presence of psychoactive substances in the drivers of motor vehicles figured among the circumstances of death, but no assessment of a causal link between this presence and road traffic accidents was made.
  • The proportion of fatal…

Innovative Courses of Action Pertaining to “Illicit” Psychoactive Substances

This report is the result of a mandate from the Ministère de la Santé et des Services sociaux (MSSS) [Québec’s ministry of health and social services] to produce a knowledge synthesis focused on nine courses of action which pertain to “illicit” psychoactive substances and which have not been implemented, or have been implemented only on a limited scale or as a pilot project in Québec.

The nine courses of action are:

  • Education programs for overdose prevention and management with naloxone;
  • Supervised consumption services;
  • Prison syringe exchange programs;
  • Low-threshold housing programs;
  • Crack smoking equipment distribution programs;
  • Programs for prevention and substance analysis in festive environments;

Preventing Intentional OTC Drug Overdoses

  • Each year in Québec, approximately 174 people commit suicide by drug overdose, of which at least 15 are the result of over-the-counter (OTC) drug overdoses.
  • A substantial number of suicides and suicide attempts by overdose involve more than one substance.
  • The number of suicides by OTC medication is under-estimated, since in cases where several drugs have been ingested, only the substance that is presumed to have caused the death is considered when determining the most likely cause of death.
  • Acetaminophen is by far the most common drug involved in intentional OTC drug overdoses, followed by salicylates, non-steroidal anti-inflammatories, and antihistamines. Depending on the ingested drug and dose, these medications can have serious adverse health effects.
  • Unlike in a number of European countries, Canada (including Québec) has no restrictions on the maximum quantity per OTC pack sold in pharmacies, particularly for acetaminophen, ibuprofe…