Regulatory Policies and
Legal Controls
Head: Dr. Louis Gliksman
The Regulatory Policies and Legal Controls Unit focuses primarily
on assessing the impact of policy and legal control initiatives and on
conducting research on potential policy options for various levels of
government. The majority of the policy research currently under investi-gation
falls within the framework of harm reduction, an approach that has been
endorsed by CAMH. Our focus is on alcohol, tobacco and other drugs, although
mental health issues are beginning to be integrated into the research
as well. Investigators in this unit represent a variety of disciplines,
including psychology, sociology, criminology and epidemiology.
Recent, practical outputs of our investigations have included the development
and dissemination of low-risk drinking guidelines, best-advice papers
related to policy (e.g., on drinking and driving, harm reduction) and
the dissemination of research-based alcohol management policies for municipalities
(MAPs). Other areas of study include the impact of changes in hours of
sale and conditions of sale of alcohol on amount of alcohol use and harmful
consequences, and the impact of changes in the justice system on the incidences
of problems and recidivism.
In addition to ongoing research grants, members of the unit received
a number of multi-year grants during this fiscal year, totalling about
$4.2 million. The research will begin in the 2001/2002 fiscal year. The
largest of these grants was an Interdisciplinary Health Research Team
grant from the Canadian Institutes on Health Research to research opioid
use across Canada and, among other objectives, to assess the efficacy
of a variety of substitution techniques. A second grant, from the Networks
of Centres of Excellence Program, was awarded to research the issue of
alcohol road rage. The third, from the International Council of Canadian
Studies Program for International Research Linkages, will allow researchers
from CAMH and Australia to assess the feasibility of conducting a joint
study of alcohol policy options in indigenous populations.
Examples of research projects that were ongoing in 2000/2001 include
the following.
Comparative, Over-Time
Analysis of IDU-related Harms in Western Jurisdictions
Is there a correlation between the coverage and reach of prevention and
treatment efforts, and levels of harm (mortality, morbidity) related to
injection drug use (IDU) in different countries over time? Our investigators
are collecting and examining system data from eight Western countries.
Data include: number and prevalence of people who use injection drugs,
prevalence of infectious disease (HIV, HBV/HCV) among them, proportion
of them who are in treatment, and availability/accessibility of low threshold
prevention measures (e.g., needle exchange services), from 1988 to 2000.
Through univariate descriptive analysis and country-specific comparisons
in a first step, and cross-country comparisons in a second step (pooled
cross-sectional time-series analysis), we will test whether correlations
exist between levels and changes of prevention/treatment frameworks, and
harm indicator levels, for people who use injection drugs. This project
is unique in that it investigates IDU prevention, treatment and harms
on a comparative system level, and on this basis will offer policy implications.
This two-year research project is match-funded by the Connaught Fund,
University of Toronto and the Swiss Federal Office of Public Health.
Canadian-Nordic Alcohol
Policy Project
This three-year project is funded by the Swedish Ministry of Social Affairs,
as well as from contributions from Norwegian and Finnish Alcohol Retail
Monopolies, and includes in kind contributions from CAMH. The above-the-line
budget is $275,000. The project includes investigators from CAMH; Stockholm
University; Alcohol and Drug Research Group, Helsinki; and advisors from
the National Institute for Alcohol and Drug Research, Oslo; Pacific Institute
for Research & Evaluation, Berkeley; and University of California,
Riverside. A primary goal of the project is to explore the association
between trends in relative price of alcohol, density of alcohol outlets,
other changes in access to alcohol, specific policy interventions, per
capita consumption and a wide range of mortality, morbidity and safety
statistics. The project examines data from over at least 50 years for
all 10 Canadian provinces. Data collection and preliminary analysis are
now underway. Although no results have emerged at this early stage, we
expect to be able to determine whether a wide range of changes in distribution
and drinking arrangements in Canada are linked to aggregate rates of damage
and other negative consequences, and which interventions have the greatest
impact. These findings are expected to have implications for future policy
deliberations in Canada, for Nordic countries and for other jurisdictions.
Evaluation of the Toronto
Drug Treatment Court
The Drug Treatment Court in Toronto is the first of its kind in Canada.
Funded by the National Crime Prevention Centre, researchers are evaluating
the impact of the Drug Treatment Court on a number of dimensions. In its
second year of a four-and-one-half year investigation, the researchers
will document the process of setting up a drug treatment court, assess
the impact that the court has had on individuals, the community and the
judicial system and address the cost-effectiveness of such a program.
The results will inform other jurisdictions that are considering or are
in the process of establishing such a court.
Impact of Drugs and
Alcohol Use on Traffic Collisions and the Effects of Treatment
This study has been conducted with funds from the Medical Research Council.
Interviews, extraction of data from patient records and detailed driver
records from the Ontario Ministry of Transportation have been collected
from patients in treatment for problem use of alcohol, cannabis or cocaine.
Major findings show that the cocaine group had significantly worse driving
records (i.e., higher rates of collisions and traffic convictions) than
controls. Some beneficial effects of treatment have been noted.
Evaluation of the Administrative
Licence Suspension Law in Ontario
Investigators have been conducting a comprehensive evaluation of the
Administrative Drivers Licence Suspension law that came into effect in
Ontario on November 28, 1996. This law allowed the police to remove, for
90 days, the licence of a person charged with driving over the legal limit
of 80 mg% or failing to provide a breath sample. The results of this work
suggest that the number of drinking drivers declined significantly when
this law was introduced, and the proportion of fatally injured drivers
with a blood alcohol level over the legal limit declined significantly
by about 17 per cent over the first year after the law was introduced.
This research was funded by the Alcoholic Beverage Medical Research Foundation.
The Effects of Alcohol
Limits for Driving
With funding from Transport Canada, researchers have carried out an international
review of the effects of introducing or lowering legal alcohol limits
for driving. Most countries have now introduced laws making it an offence
to drive with a blood alcohol level over a certain level (in Canada, it
is 80 mg%). Many countries and jurisdictions have lowered these levels
in recent years. The international experience with legal limits is positive.
Most evaluations of introduced or lowered legal limits demonstrate some
form of reduction in alcohol-related collisions, injuries and fatalities,
although the effects of these measures also depend on such factors as
public awareness and law enforcement.
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