Survey reveals increase in drinking, cannabis use and psychological distress

The latest survey of Ontario adults from the Centre for Addiction and Mental Health (CAMH) shows increasing rates of daily drinking and cannabis use and high levels of psychological distress. The results of the 2009 CAMH Monitor survey, the longest running survey tracking mental health and addiction indicators among adults in Ontario, were published today.

The proportion of adults reporting daily drinking increased from 5.3% in 2002 to over 9% in 2009. The average number of drinks consumed weekly among drinkers has also increased from 3 drinks to 4.6 drinks, and the proportion of adults exceeding low-risk drinking guidelines remains at elevated levels (22%). However, there were also some encouraging findings: there was a significant decline in binge drinking from 12.6% in 2006 to 7.1% in 2009, and the decline was evident especially among young adults, from 24% to 11.5%.

Although driving within an hour of consuming two or more drinks has shown a steady decline in the past years, from 13.1% in 1996 to 6.9% in 2009, there is evidence that this trend has reversed among young adults. Driving after drinking posted a significant increase among 18 to 29 year olds, from 7.7% in 2005 to 12.8% in 2009.

"The data tell us that while the number of people who drink alcohol has not changed, the way they are drinking has -- people are drinking more often and may be consuming more alcohol when they do drink, although there may be fewer binge occasions," said Dr. Robert Mann, CAMH Senior Scientist and lead investigator on the study. "We know that the more access people have to alcohol, the more people will drink, leading to more instances of drinking and driving. Measures such as Random Breath Testing and lowering legal limits to .05% can reduce drunk driving deaths. The implementation of .05% legislation in British Columbia appears to have resulted in a 50% decrease in drinking and driving deaths in that province."

The prevalence of cannabis use has been steadily increasing from 8.7% in 1996 to 13.3% in 2009, for both men and women and among all age groups. Along with this, there was almost a 2-fold increase in cannabis use among those aged 18-29, from 18.3% to 35.8%.

"These increases are of concern to us," stated Dr. Mann. "We know that cannabis use may increase the risk of psychosis for people who are predisposed to schizophrenia, and may worsen the symptoms of other mental illnesses." Another noticeable change was the large increase in use of cannabis among older adults. Use by those aged 50 years and older increased more than 3-fold from 1.4% to 4.7% between 1996 and 2009 and, among past year cannabis users, the proportion of users aged 50 years and older increased from 1.9% to 13.9% during the same time period.

Some positive findings are that the percentage of adult Ontarians reporting smoking cigarettes declined from 19.7% in 2008 to 18.6% in 2009. Though 14% of Ontarians still report daily smoking, it is a positive sign that cigarette smoking has steadily declined since 1996, from 26.8% to 18.6% in 2009. Dr. Mann notes that the provincial government's commitment to anti- smoking legislation through smoke-free Ontario probably played an important role in the decrease in smoking rates.

One in seven Ontario adults (14.7%), representing 1,400,000 people, reported symptoms of elevated psychological distress, and almost 6% reported that their overall mental health was poor. Those aged 30-39 were the most likely to report poor mental health, and those over age 65 reported the lowest rates of poor mental health. Mental health was strongly correlated with education. Those who had not graduated high school reported higher levels of poor mental health, and those who had graduated from university reported lower rates. "These results suggest that the social determinants of health, such as income, play as important a role in mental health as they do in physical health," said Mann.

The use of anti-anxiety medication has remained stable over the past few years, but trend data shows that over the past 10 years, use of these medications has risen from 4.5% to nearly 7% of Ontario adults. The same pattern can also be seen in the use of antidepressant medication, which has trended upward from 3.6% in 1999 to the current rate of 6.6%. Added Dr. Mann, "Though these are marked increases, they may also be showing that more people experiencing mental health problems are seeking and receiving help, which is a positive step."

Despite several differences, there was no strong dominant pattern in regional differences. Those from Northern Ontario were the most likely to be current smokers and to smoke daily; those from Toronto were the least likely to drink alcohol; those from the South West region of the province reported the highest average number of drinks consumed per week; and driving after drinking was most likely in the South West and in the Central South regions.

The Centre for Addiction and Mental Health's CAMH Monitor is the longest ongoing representative survey of adult substance use in Canada. The study, which now spans 32 years, is based on 24 random surveys conducted between 1977 and 2009. The 2009 cycle of the CAMH Monitor is based on telephone interviews with 2,037 adults aged 18 and older across Ontario This report also describes changes in substance use and related harms since 1977.