Student drug use in Ontario, Canada, at historic lows but new concerns over fentanyl emerge

By almost every measure, students in grades 7 through 12 in Ontario, Canada are drinking, smoking, and using drugs at the lowest rates since the Ontario Student Drug Use and Health Survey (OSDUHS) began in 1977. This according to new numbers released today by the Centre for Addiction and Mental Health (CAMH).

But new data on fentanyl use, included for the first time in this survey, is raising concerns given the health risks of this potent opioid drug.

The Ontario-wide survey of 11,435 students is Canada's longest-running systematic study of drug use among youth, and one of the longest-running in the world.

In most categories, drug, alcohol use at the lowest levels ever recorded

Over the past 40 years, the OSDUHS has shown similar trends in student drug use, with use peaking in the late 1970s, followed by a gradual decline through the 1980s and early 1990s, a second peak in the late 1990s, and then another gradual decline to the current low levels.

Since the most recent peak almost 20 years ago, consumption of the most commonly-used drugs has gone down substantially, including:

• ALCOHOL: from 66 per cent to 42.5 per cent
• CANNABIS: from 28 per cent to 19 per cent
• TOBACCO CIGARETTES: from 28.4 per cent to 7 per cent
• DRINKING AND DRIVING: from 14 per cent to 4.2 per cent

Non-medical use of prescription opioids, which has only been monitored since 2007, has dropped from 20.6 per cent to 10.6 per cent amongst this population during that time.

The general decline in drug use over the past two decades has occurred for both males and female students. "These long-term declines are very positive findings, and point to the success of efforts by parents, educators, public health and government - and the students themselves - to address substance use and the problems it can create," said CAMH Independent Scientist Dr. Hayley Hamilton, co-lead of the survey. "Nevertheless, we must remember that substance use among students can quickly begin to increase, as we have seen in the past, so a long-term and continued commitment to public health goals is necessary."

Increasing numbers of Ontario students are reporting abstaining from any use of drugs, alcohol, cigarettes and other smoking devices. For example, in 1999, just over one in four students (27 per cent) abstained from drug use in the previous year. That number now approaches one in two students (44 per cent).

Exceptions to long-term decline in student drug use

The non-medical use of ADHD drugs (Ritalin, Adderall, etc.) has increased significantly since monitoring first began a decade ago, more than doubling from 1 per cent to 2.3 per cent.

Non-medical use of over-the-counter cough and cold medicine has increased since the last survey in 2015, from 6.4 to 9.2 per cent. The increase in use was evident among males (from 6.7 per cent in 2015 to 11.2 per cent in 2017), but not females.

While driving after cannabis use is down from its peak of up to 20 per cent in the 2000s, the current rate of 9 per cent has been stable for a few years, and is about twice the proportion of students who report driving after drinking (4 per cent).

"While we have seen important declines in substance use and risk behaviours, some of them, like driving after cannabis use, driving after drinking, and tobacco use appear to have reached plateaus where no further declines have been seen recently," says CAMH Senior Scientist Dr. Robert Mann, co-lead of the survey. "Under these circumstances it is important to consider how we might make further progress in these areas."

Fentanyl and opioids

Given concerns about fentanyl, researchers included a new question to assess student use of the drug. While just under 1 per cent of high school students report past-year use, that figure represents about 5,800 grades 9 to 12 students using fentanyl, which has become synonymous with the opioid crisis.

"Fentanyl is a very dangerous opioid, and any proportion of students using this hazardous drug is alarming," said Dr. Hamilton.

Cannabis use and views on legalization

Cannabis remains the most commonly used illicit drug among Ontario students, as 19 per cent of students in grades 7-12 report past year use (about 172,200 students). Prevalence of cannabis use does not differ between males and females, and use increases up to about 37 per cent among 12th graders.

With cannabis set to become legal in Canada in July 2018, students were asked for the first time about their views on legalization. Students were equally divided on being in favour of legalization (35 per cent), opposed to it (33 per cent), or being unsure (32 per cent).

Just under two-thirds of students (62 per cent) said they do not intend to use cannabis when it is legalized for adults. Eight per cent said they would try cannabis when it becomes legal. Of those consuming cannabis now, 4 per cent said they intend to use it more often when it becomes legal.

Electronic cigarette use continues to surpass tobacco cigarettes

The 2017 survey continued to show that more students use electronic cigarettes than tobacco cigarettes, as 11 per cent of students (about 80,800 in grades 7-12 in Ontario) use e-cigarettes compared with 7 per cent who smoke tobacco cigarettes (about 63,800 students). Males are more likely than females to use both types of cigarettes. Use of e-cigarettes has been stable since 2015, when monitoring first began. Cigarette smoking, while currently lower than decades ago, has remained stable for the past few years.