Health Policy Analysis: National Anti-Drug Strategy - Research Paper Example

Health Policy Analysis: National Anti-Drug Strategy Abstract: The paper review’s Canada’s National Anti-Drug Strategy, which is the successor of National Drug Strategy of Canada, as part of the health policy. The policy focuses on use and abuse of illicit drugs among the population, and tackles it through its action plan of prevention, treatment and action. More attention is paid to control the production and distribution of drugs as part of the criminal code than the health aspect that involved harm-reducing approach. It has been successful in reducing the drug use over the years that proves its effectiveness as policy. However, issue of substance abuse must be considered in general rather than aiming on illicit drugs only. Health Policy Review: National Anti-Drug Strategy Introduction: Substance abuse in Canada is a problematic issue with far-reaching impacts on individuals, families and communities in legal, economic and most importantly, health-related dimensions. It can be defined as any use of substance that causes physical or social damage. These can be medical, for example prescription drugs, or non-medical and legal or illegal, like alcohol or tobacco compared to marijuana or cocaine. The most abused among these are psychotropic drugs that manipulate a person’s thoughts, feelings and actions. Some of these are available on prescription in Canada to relieve pain or help to sleep, others like nicotine can be bought easily in altered forms like cigarettes, while the more dangerous ones like cocaine and cannabis are prohibited and can only be accessed illegally (Chenier, 2006). Estimates from a recent study reveal that the total social costs (death, illness and economic cost) of substance abuse in Canada amounted to $39.8 billion in 2002, out of which alcohol accounted for 36.6% ($14.6 billion), tobacco accounted for 42.7% ($17 billion) and illegal drugs for 20.7% ($8.2 billion) of the total estimates (Parliamentary Information and Research Service, 2006). Canada has historically attempted to manage the drug issue, initiating with the federal policy of the National Drug Strategy (NDS) in 1987, which focused on substance use and abuse in general under Health Canada as the lead department (Chenier, 2006). However, following the change of Canadian government in 2005 brought about changes in the country’s drug policies and focus shifted from treating it mainly as a health issue to enforcement issue in the ensuing the new National Anti-Drug Policy with leadership shifting to Department of Justice (Thomas, 2009). The paper examines the Policy from the health sector’s perspective and determines its relevance and effectiveness as a health policy. (intro ends) The National Anti-Drug Strategy (NADS/ Strategy) is a focused initiative launched by the Canadian Federal Government in October 2007 that contributes in development of a healthy society by reducing the demand and supply for illicit drugs, along with tackling the crimes associated with it (National Anti-Drug Implementation and Evaluation, 2010). It aims to achieve this through three action plans: prevention of illicit drug use, treatment of those depending on it and effective enforcement of laws to combat their production and distribution (Thomas, 2009). It focuses particularly on the use of illicit drugs as compared to substance use and abuse that its predecessor policy, CDS, centred on. This exclusive focus on the illicit drugs left observers thinking over the status of the licit substances like alcohol which comprise of social costs higher than those of illicit ones. Also, the policy does not mention harm-reduction not provides does it any funding for it. While previously, the issue was treated primarily as that of health and administered mainly by Health Canada, the revisions in 2007 regard it as more of enforcement issue with the Department of Justice acting as its new leading agency. The Strategy is significantly intertwined with other federal policy initiatives, namely the agendas for Tackling Crime and Healthy and Safe Communities. Government of Canada announced $111 million over five years in new and ongoing funding for critical drug treatment initiatives to treat drug addicts in provinces and territories from First Nation, Inuit and part of drug gangs (Department of Justice, 2008). Evidence however, indicates that at a holistic approach is being adopted at provincial and territorial levels; instead of focusing completely on the issue of illicit drugs, they choose to tackle with substance abuse in general and support harm reduction, hence reverting to part of the old Canada Drug Strategy which paid attention to the health factor than NADS did. Illicit drugs are an issue of concern both nationally and internationally and a coordinated strategy like NADS is essential to tackle with it. Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) in 2008 showed that 11% of Canadians had used cannabis in the previous year, while the percentage among the youth- NADS’ key target population was considerably higher at 33%. This is also because Canada has become a major player for producing and trafficking methamphetamine, ecstasy, marijuana and other such prohibited drugs. The case above represents enforcement concerns related to drugs more than of health in general. Research on the costs of substance abuse in Canada estimated that alcohol abuse accounted for $14.6 billion in social costs in 2002 compared to $8.2 billion for drugs (Parliamentary Information and Research Service, 2006). Stakeholders therefore suggest that policy should widen scope to solve problem of substance abuse, which does not merely comprise of illicit drugs. The intervention is hence, not entirely effective in respect to health as substance abuse continues to be committed by the target population, which is the whole population in general, through use and abuse of licit drugs like nicotine and alcohol. Also, as the statistics show, the policy has not even been able to control narcotics use as it stays accessible to the population (National Anti-Drug Implementation and Evaluation, 2010). The policy proposes to cover the use of illicit drugs as described under Controlled Drugs and Substance Act (CDSA) that includes street drugs like cocaine, marijuana, cannabis and heroine, and synthetics like LSD, ecstasy and pharmaceuticals. Evidence from evaluation revealed that most federal and provincial stakeholders operate on the assumption that the definition excludes pharmaceuticals, which may not be illegal in all situations, but might be obtained and used illegally by abusers. For instance, in September 2008, the Centre for Addiction and Mental Health (CAMH), in pushing the Strategy to attend to the problematic use of pharmaceuticals, made a point that currently it “addresses only illicit drugs such as cannabis, cocaine, and heroin. This suggests that the policy is being evaluated effectively, in light of which need is discovered to through clearly communicate to stakeholders that policy covers the use of all controlled substances including pharmaceuticals. Evaluations also revealed that most of the projects funded under NADS address the issue of substance abuse in general rather than particularly illicit drugs; the objective of the Treatment Action Plan to “support effective treatment and rehabilitation systems” as such is rightfully recognized in broader perspective. Analysis of a recent mapping study examining all projects funded under this Plan as of March 1, 2009, showed that 51.7% addressed substance use in general, while 47.4% addressed illicit drugs (National Anti-Drug Implementation and Evaluation, 2010). Progress in consistent under the National Anti-Drug Strategy. Among its many measures, the Government of Canada has, till now, has introduced laws to ensure that serious drug crimes are severely penalized, launched a prevention-focused awareness operation to discourage illicit drug use, declare $111 million for funding over five years in new and critical drug treatment initiatives in progress at provincial and territorial ranks (Department of Justice Canada, 2008). The evaluation found the National Anti-Drug Strategy to be implemented quite efficiently. Almost all workings of the Strategy have been put into practice, with the exception of some elements particularly those that are part of the Prevention and Treatment Action Plans, which have faced delays and other impediments, and are behind schedule in implementation. The main barriers have been circumstances that are beyond the control of Strategy partners like the delays in 2008 federal elections due to disruptions in internal processes; concerns on human resource, for example some components were implemented late because it took time to ensure that new employees met all security and training requisites; and the need to reorganize its ongoing programs, for instance the relaunch of the existing Drug Strategy Community Initiatives Fund (HC) was postponed due to receipt of around 300 proposals that had to be assessed and hence consumed time. Consequently, about one-third of the funds allocated to the Strategy were left unspent in the initial two years. Altogether, nearly $55 million of total allocations in the Strategy were either re-profiled into future fiscal years or retrograded in the process. Implications of this might be hindrance in the pace of advancement toward required and expected consequences. As a result of the problems faced in execution of the Strategy, nearly 32% of the funds allocated for the two fiscal years ending 2008 and 2009 remain unspent. Although adequacy of the policy resources in implementation can only be fully measured after all the components are in action, some areas where insufficiency has been appraised, which include its international component. Several associated NADS partners for international component that include Health Canada and Department of Justice failed to receive new funds like those of Operation and Maintenance under the Strategy. This has resulted in augmented resource related ordeals as Canada faces international demands to tackle world wide drug related issues, including to the upcoming problems of synthetic drugs and diversion of precursor chemicals. Department of Justice is also seen too under sourced to carry out its lead role in the policy matters that involve its development, reporting and evaluation as well as coordination among partners. Although as a lead department, it received extra funds, the division relied to some extent on external borrowing to fulfil its key role (National Anti-Drug Implementation and Evaluation, 2010). The policy is effective as it has managed to achieve its goals to the extent it majorly focused on; the use of illicit drugs as per common interpretation, that is limited to street types, reduced fairly. According to surveys by CANDUM, the incidence of past-year cannabis use among population aged 15 or older decreased from 14.1% in 2004 to 10.6% in 2009, whereas the alcohol use decreased from 79.3% in 2004 to 76.5% in 2009 in the same age range. Consumption of at least one of five illicit drugs, namely cocaine, speed, hallucinogens, ecstasy, and heroin between ages 15 to 24 years, fell from 11.3% in 2004 to 5.5% in 2009. The results for use and abuse of psychoactive, pharmaceutical drugs however remain unchanged over time (Health Canada, 2009). This might be because of lack of recognition of such as also a focus of NADS. It is thereby recommended that the Department of Justice, as the leading agency, coordinate with other partners in National Anti-Drug Strategy to clarify the definition and objective of the policy to all stakeholders, to make known that it also aims to tackle abuse of licit drugs rather than only those that are illicit. The policy should be developed to focus more on health aspect of the policy rather than legislative and enforcement aspect dealing with drug production, consumption and distribution. NADS is effective hence; in managing drug abuse, but not substance abuse in general because definition of its goals as per Controlled Drugs and Substances Act lack general understanding. It is a significant move by Canadian authorities owing to the deteriorating conditions of the matter as is evident from surveys. However, the policy enactment is more in line with the Criminal Code Act the Drugs Act, which reduces its relevance as a health policy. Its impact on health sector though, should not be underestimated as improvement in its treatment and prevention is also clear the statistics. References: Canada’s Journal of Ideas (2009, July 22). A Frank Analysis of Canada's Newest Drug Policy Approach. Retrieved November 11, 2010 from http://www.c2cjournal.ca/blog-articles/view/a-frank-analysis-of-canadas-newest-drug-policy-approach CBS News (2007, January 15). Canada's anti-drug strategy a failure, study suggests. Retrieved November 11, 2010 from http://www.cbc.ca/canada/story/2007/01/15/drug-strategy.html Chenier, N., M. (2001, January 23) Substance and Public Policy Retrieved November 10, 2010 from http://dsp-psd.pwgsc.gc.ca/Collection-R/LoPBdP/CIR/942-e.htm#SELECTIVE CHRONOLOGY(txt) DeBeck,K., Wood E., Montaner, J. & Kerr, T. (2009, March) Canada's new federal ‘National Anti-Drug Strategy’: An informal audit of reported funding allocation. International Journal of Drug Policy, 20,188-191 Department of Justice Canada (2008, August) Backgrounder: National Anti-Drug Strategy. Retrieved Nover 12, 2010 from http://www.justice.gc.ca/eng/news-nouv/nr-cp/2008/doc_32285.html Department of Justice Canada (2010, January). National Anti-Drug Policy: Implementation and Evaluation. Retrieved November 11, 2010 from http://www.justice.gc.ca/eng/pi/eval/rep-rap/10/nasie-snaef/nasie.pdf Health Canada (2009) Major findings from the Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) 2009. Retrieved November 12, 2010 from http://www.hc-sc.gc.ca/hc-ps/drugs-drogues/stat/index-eng.php M2PressWIRE (2007, October 10). International Task Force on Strategic Drug Policy Says Canadas New Anti-Drug Strategy Is a Step in the Right Direction for Canada and Other Countries. Retrieved November 11, 2010 from Newspaper Source database. Parliamentary Information and Research Service (2006, April 3). Substance Abuse and Public Policy in Canada. Retrieved November 9, 2010 from http://www2.parl.gc.ca/content/lop/researchpublications/prb0605-e.pdf Statistics Canada (2009, May) Trends in police-reported drug offences in Canada. Retrieved November 12, 2010 from http://www.statcan.gc.ca/pub/85-002-x/2009002/article/10847-eng.htm Read More