Illicit drug use and harms, and related interventions and policy in Canada: A narrative review of select key indicators and developments since 2000

摘要: Abstract Background By the year 2000, Canada faced high levels of illicit drug use and related harms. Simultaneously, a fundamental tension had raisen between continuing mainly repression-based versus shifting to more health-oriented policy approach. Despite wealth new data numerous individual studies that have emerged since then, no comprehensive review key indicators developments use/harm epidemiology, interventions law/policy exist; this paper seeks fill gap. Methods We searched reviewed journal publications, as well reports, government surveys, etc. reporting on information 2000. Relevant were selected extracted for inclusion, subsequently grouped narratively summarized in major topical sub-theme categories. Results Cannabis has remained principal form use; prescription opioid misuse arisen extensive phenomenon. While drug-related blood-borne-virus transmissions declined, overdose deaths increased recent years. Acceptance proliferation – local/community-based health measures (e.g., needle exchange, crack paraphernalia or naloxone distribution) aiming at high-risk users evolved, though reach access limitations persisted; Vancouver's ‘supervised injection site' attracted continued attention yet remains un-replicated elsewhere Canada. maintenance treatment utilization increased, infectious disease, psychiatric) co-morbidities among limited. Law enforcement principally focus cannabis specifically users. ‘Drug courts' introduced but shown limited effectiveness; several attempts control law reform failed, except establishment ‘medical cannabis' provisions. Conclusions federal governments reinforcing repression approach use, lower-level jurisdictions provincial/municipal levels) non-governmental organizations increasingly promoted social- intervention frameworks interventions, therefore creating an bifurcated inherently contradictory landscape reality