Trends in reported illegal narcotic use in Canada: 1956-1973

Sections

Abstract
Introduction
Findings
Summary and discussion
Acknowledgements

Details

Author: Irving ROOTMAN, Alex RICHMAN
Pages: 27 to 40
Creation Date: 1975/01/01

Trends in reported illegal narcotic use in Canada: 1956-1973 *

Ph.D. Irving ROOTMAN Chief, Epidemiological and Social Research Division
M.D. Alex RICHMAN Consultant, Epidemiological and Social Research Division, Non-Medical Use of Drugs Directorate Health and Welfare Canada, Journal Building, Ottawa

Abstract

Information on reported narcotic users aids in the development of drug control policy as well as programmes of prevention, treatment, and rehabilitation. In Canada, such information may be obtained from a narcotic users index which classifies known narcotic drug users into three categories: "illicit", "licit", and "professional". This paper presents trend data on known narcotic users in Canada from 1956 to 1973 by category, location, initially reported drug, sex and age.

Between 1956 and 1973, the number of known "licit" and "professional" narcotic drug users steadily decreased, while the number of "illicit" narcotic drug users increased by 283 per cent, with the greatest increase taking place after 1969.

Heroin was the most frequent initially reported drug (representing between 80 per cent and 89 per cent of known "illicit" narcotic drug users). Cocaine, as an initially reported "narcotic", had the largest proportional increase from 1956 to 1973.

There were generally more reported male users than female in all age groups, a trend that increased over the time span considered.

There were recent dramatic increases in the numbers and rates of reported users in the 20-24 year-old group, which has become the dominant pattern among new cases in recent years.

Although the index on which this paper is based does not provide figures on total narcotic use in Canada, it is a valuable resource for epidemiologic research. This narcotic user index may be used to make minimum estimates of the extent and geographic and social distribution of narcotic-related problems in Canada.

Introduction

Continuos updating of our epidemiologic knowledge of drug-related problems is essential for the development of drug control policy as well as programmes of prevention, treatment, and rehabilitation. This paper contributes to this end by presenting information on reported narcotic users in Cannada obtained from a narcotic users index maintained by the Bureau of Dangerous Drugs (formerly the Narcotic Control Division) of Health and Welfare Canada.

* This paper is the first report of a series of collaborative studies between the epidemiological and Social Research Division, Non-Medical use of Drug Directorate and the Bureau of Dangerous Drugs, which are both part of Health Protection Branch, Health and Welfare Canada.

This index, which is a type of case register, 1 is a record of known users of the major natural and synthetic opiates governed by the Narcotic Control Act in Canada. 2 It has been systematically maintained and revised annually by the Bureau of Dangerous Drugs (B.D.D.) since 1955, and is based on information provided by law enforcement agencies, treatment centres, physicians, pharmacists and other sources (chiefly B.D.D. inspectors). Narcotic drug users in the index are classified into three categories: "illicit", "licit", and "professional". 3

Information on these three groups is recorded on McBee cards, and updated as new reports are received. Each year, the B.D.D. prepares basic statistical tabulations of some of the information in the narcotics users index (by manual sorting of the McBee cards). Tabulations describing the total group of cases in the index ("reported prevalence") have been prepared and published since 1955. Since 1965 (with the exception of 1971 and 1972) tabulations have also been describing the numbers and characteristics of cases first reported for illicit narcotic use during the previous year excluding those who had been previously reported to the B.D.D. for cannabis or non-narcotic drug offences.

The data presented in this paper are taken from the annual reports of the B.D.D. Relevant data were extracted from these reports and population-based rates calculated using the appropriate population figures (obtained from Statistics Canada). All rates are presented in terms of a base population of 100,000. Rates are calculated using Canadian population figures for individuals over the age of 14.

Findings

Most of the findings in this paper pertain to all narcotics cases reported to the B.D.D. during the previous ten years (tables I to III). In other words, this paper is mainly about "reported prevalence" rather than "reported incidence". This is due to this type of information being available over a longer time period. The paper does however, present information on cases first reported to the B.D.D. during 1967, 1970 and 1973 (table IV, and the figure). Because the latter excludes cases previously known to the B.D.D. for non-narcotic offences (Cannabis or drugs covered by the Food and Drug Act), the data presented here do not completely represent "reported incidence". On the other hand, as most of the cases did not have previous records the figures contained in this paper are estimates of "reported incidence" for the years covered. Another report will present a detailed analysis of all cases newly reported in 1973 and 1974.

1 Although the B.D.D. narcotic users index is a type of case register, Canada in contrast to Great Britain, does not have an addict registration system. The term case register is used here in a generic sense, referring systems where "official registration" is required and to those such as the B.D.D. index where it is not.

2 Cocaine is also included under the Narcotic Control Act although there is some dispute over whether or not it should be (LeDain, 1973).

3 Illicit users, according to the B.D.D., include all cases for whom the source of the narcotic was initially illicit. Not all persons classified as "illicit" users have been convicted under the Narcotic Control Act, although in the past, this has been true of the majority of cases.

Licit or therapeutic drug users are "persons who have some medical condition upon which dependence has become superimposed or . . . who become dependent through medical treatment. Few persons in this class have any criminal background". (Health and Welfare Canada, 1973.)

Professional users are "members of the medical or allied professions" (Health and Welfare Canada, 1973) on whom reports have been received involving use of narcotics.

REPORTED PREVALENCE

(1) Category

Table I shows the number and rates of reported narcotics users in Canada in selected years between 1956 and 1973 by category ("illicit", "licit" and "professional") and location. It is apparent from this table that there has been a substantial increase in the number of "illicit" narcotics users known to the B.D.D. between 1956 and 1973. 4 Specifically, the increase in numbers over the entire seventeen years was 7,572 or 283 per cent, with the largest increases taking place after 1969. In contrast to the increase in reported "illicit" users, there was a steady decrease in the number of "licit" and "professional" users reported. Between 1956 and 1973 the number of persons registered as "licit" users decreased 57 per cent (from 352 to 150) and the number of "professional" users decreased 46 per cent (from 211 to 114).

These trends in absolute number are reflected in the population-based rates. For instance the rate of "illicit" narcotic users known to the B.D.D. increased from 25 per 100,000 population (15 and over) in 1956, to 64 in 1973. The "licit" user rate decreased from 3 per 100,000 in 1956, to 1 in 1973 and the rate for "professional" users from 2 to 1 over the time span.

(2) Location

Historically, the concentration of "illicit" narcotics users has moved westward (Richman and Humphrey, 1969). Since the 1950s the greatest concentration has been in British Columbia. In 1973, 61 per cent were in British Columbia which has 10 per cent of Canada's population. For the purposes of this report therefore, British Columbia is reported separately from the other provinces.

Trends noted for Canada as a whole apply equally to British Columbia and other provinces, although the numbers and rates are higher in the former. As was the case for Canada as a whole, the rates in British Columbia for "illicit" users increased from 158 to 369 per 100,000 (age 15 and above). Again, the greatest increases occurred after 1969. The same trends for "licit" and "professional" users noted above for Canada hold for British Columbia and other provinces, with a slightly greater concentration of "licit" users in British Columbia in all years with the exception of 1966.

(3) Initially reported narcotic

Table II present the number and proportion of "illicit" narcotics users known to the B.D.D. by their initially reported 5narcotic and location. Heroin has been and continues to be the most frequently initially reported narcotic among known "illicit" narcotics users in Canada, particularly in British Columbia. In Canada for 1973, the proportion of "illicit" narcotic drug users initially reported as using heroin was 88 per cent of all cases, compared to 89 per cent in 1956. In British Columbia for 1973, the proportion was 92 per cent of all cases, compared to 93 per cent in 1956. Following heroin as the most frequently initially reported narcotic in 1973, was the category "synthetics" (almost exclusively methadone). "Synthetics", unlike heroin, were proportionately more frequent in provinces outside British Columbia(9 per cent compared to 5 per cent). Opiates declined steadily in relative proportion of initial reports since 1956, from 9 per cent to 2 per cent in Canada as a whole, 7 per cent to 1 per cent in British Columbia and 12 per cent to 4 per cent in the rest of Canada. Cocaine, as an initially reported "narcotic", had the largest increase in the proportion of cases over the time span from 1956 to 1973, especially outside of British Columbia. [ 2]

4 A person first identified in 1956 for whom there were no subsequent reports would not be removed from the tabulations for 10 years.

5 Although subsequent narcotic reports are recorded on the McBee cards, the initially reported narcotic is tabulated in the annual reports prepared by the B.D.D.

TABLE I

Narcotic drug users in Canada known to the Bureau of Dangerous Drugs in 1956, 1966, 1969, 1971 and 1973 by category and location (Number and rate per 100,000 population aged 15 and over)

 

1956

1966

1969

1971

1973

CANADA
         
Illicit a
         
Number
2 678 3 182 3 733 6 425 10 250
Rate
25 24 26 42 64
Licit a
         
Number
352 259 178 155 150
Rate
3 2 1 1 1
Professional a
         
Number
211 151 149 116 114
Rate
2 1 1 1 1
BRITISH COLUMBIA
         
Illicit
         
Number
1 570 2 023 2 449 4 112 6 271
Rate
158 156 167 261 369
Licit
         
Number
37 32 27 31 29
Rate
4 2 2 2 2
Professional
         
Number
16 13 14 15 14
Rate
2 1 1 1 1
OTHER PROVINCES
         
Illicit
         
Number
1 108 1 159 1 284 2 313 3 979
Rate
11 10 10 17 28
Licit
         
Number
315 227 151 124 121
Rate
3 2 1 1 1
Professional
         
Number
195 138 135 101 100
Rate
2 1 1 1 1

Source: Data from Bureau of Dangerous Drugs Annual Reports.

aSee text for definition of category.

TABLE II

Illicit narcotic drug users in Canada known to the Bureau of Dangerous Drugs 1956, 1966, 1969, 1971 and 1973 by choice of drugs and location

 

1956

1966

1969

1971

1973

CANADA
         
1. Cocaine a
         
Number
1 2 3 49 284
Percentage of known drugs
b
b
b
1 3
2. "Synthetics" c
         
Number
25 338 514 635 687
Percentage of known drugs
1 12 15 10 7
3. Opiates
         
Number
172 130 143 183 235
Percentage of known drugs
9 5 4 3 2
4. Heroin
         
Number
1 658 2 236 2 714 5 316 8 904
Percentage of known drugs
89 83 80 86 88
5. All Known Drugs
         
Number
1 856 2 706 3 374 6 183 10 110
Percentage of known drugs
100 100 100 100 100
6. Total drugs
         
Number
2 678 3 182 3 733 6 425 10 250
BRITISH COLUMBIA
         
1. Cocainea
         
Number
-
2 1 17 86
Percentage of known drugs
-
b
b
b
1
2. "Synthetics" c
         
Number
3 196 335 383 332
Percentage of known drugs
b
11 15 10 5
3. Opiates
         
Number
70 33 39 41 61
Percentage of known drugs
7 2 2 1 1
4. Heroin
         
Number
961 1 503 1 874 3 490 5 685
Percentage of known drugs
93 87 83 89 92
5. All Known Drugs
         
Number
1 034 1 734 2 249 3 931 6 164
Percentage of known drugs
100 100 100 100 100
6. Total drugs
         
Number
1 570 2 023 2 449 4 112 6 276
OTHER PROVINCES
         
1. Cocainea
         
Number
1
-
2 32 198
Percentage of known drugs
b
-
b
1 5
2. "Synthetics" c
         
Number
22 142 179 252 355
Percentage of known drugs
3 15 16 11 9

TABLE II (continued)

Illicit narcotic drug users in Canada known to the Bureau of Dangerous Drugs 1956, 1966, 1969, 1971 and 1973 by choice of drugs and allocations

 

1956

1966

1969

1971

1973

3.Opiates
         
Number
102 97 104 142 174
Percentage of known drugs
12 10 9 6 4
4.Heroin
         
Number
697 733 840 1 826 3 219
Percentage of known drugs
85 75 75 81 82
5.All Known Drugs
         
Number
822 972 1 125 2 252 3 946
Percentage of known drugs
100 100 100 100 100
6.Total drugs
         
Number
1 108 1 159 1 284 2 313 3 974

Source: Data from Bureau of Dangerous Drugs Annual Reports.

NOTE. Refers to all cases where the specific drug is known to the B.D.D.

Total Drugs includes unknown drugs.

aPercentages may not add up to 100 because of rounding these percentages are less than 0.5.

bAs noted in the paper, there has been some dispute regarding whether or not cocaine should be included under the Narcotic Control Act (4).

c Synthetics include methadone, piminodine (Alvodine), and pethidine or meperidine (Demerol).

(4) Sex and age

Table III A and B present numbers and rates of all known "illicit" narcotics user in Canada by sex, age and location from 1956 to 1973. A number of patterns emerge from examination of this table.

The rates generally show an over-all increase in reported "illicit" narcotic users from 1956 to 1973 in all age and sex categories in British Columbia and other provinces (two exceptions: males and females over 40 outside British Columbia). The increase in uniformly greater among males than among females. The major increases occurred after 1969, with the most dramatic increases in the 20-24 age group, especially between 1971 and 1973. The rates for males were generally greater than those for females in all age groups and locations during and after 1969 (exception: 25-29 age group in 1969 for provinces outside British Columbia). Prior to 1969, the rates for females were slightly higher than those for males in a few age groups, including the 15-19 age group in British Columbia and the 20-24 and 25-29 age groups in other provinces in 1966, and the 20-24 age group in other provinces in 1956. Since 1971 rates have been highest in the 20-24 age group for each sex in British Columbia and other provinces (exception: females in other provinces, 1971). Prior to 1971, the rates tended to be highest in the 25-29 age group or the 30-39 age group.

TABLE III A

Illicit narcotic drug users in Canada known to the Bureau of Dangerous Drugs in 1956, 1966, 1969, 1971 and 1973, by sex and age-group (Number)

 

Canada

British Columbia

Other Provinces

 

1956

1966

1969

1971

1973

1956

1966

1969

1971

1973

1956

1966

1969

1971

1973

Males
                             
15-19 years
22 6 33 254 438 17 3 18 121 241 5 3 15 133 197
20-24 years
139 141 207 1 039 2 517 126 112 153 598 1 366 13 29 54 441 1 151
25-29 years
275 342 371 671 1 474 207 255 285 477 915 68 87 86 194 559
30-39 years
523 693 794 1 009 1 265 359 455 545 695 863 164 238 249 314 302
40 plus 700 768 901 983 991 358 479 551 645 663 342 289 350 338 328
Age unknown
294 216 296 664 885 128 144 201 487 584 166 72 95 177 301
TOTAL
1 953 2 166 2 602 4 620 7 570 1 195 1 448 1 753 3 023 4 636 758 718 849 1 597 2 834
Females
                           
15-19 years
16 9 23 147 271 12 8 17 78 185 4 1 6 69 86
20-24 years
98 161 157 373 897 74 106 108 228 511 24 55 49 145 386
25-29 years
141 236 296 349 511 91 131 187 226 317 50 105 109 123 194
30-39 years
194 304 340 463 492 96 154 178 263 321 98 150 162 200 171
40 plus 164 195 212 237 194 65 108 123 145 117 99 87 89 92 77
Age unknown
112 111 133 236 315 37 68 83 149 188 75 43 50 87 127
TOTAL
725 1 016 1 161 1 805 2 680 375 575 696 1 089 1 640 350 441 465 716 1 040

Source:Data from Bureau of Dangerous Drugs Annual Reports.

TABLE III B

Illicit narcotic drug users in Canada known to the Bureau of Dangerous Drugs in 1956, 1966, 1969, 1971 and 1973, by sex and age-group (Rate per 100,000 populations)

 

Canada

British Columbia

Other Provinces

 

1956

1966

1969

1971

1973

1956

1966

1969

1971

1973

1956

1966

1969

1971

1973

Males
                             
15-19 years
4 1 3 24 38 39 4 19 118 216 1
a
2 14 19
20-24 years
25 19 23 110 258 276 170 182 642 1 365 2 4 7 52 131
25-29 years
45 55 52 84 166 394 441 398 583 959 12 12 13 27 71
30-39 years
45 54 61 77 93 349 371 406 514 578 16 21 22 27 25
40 plus 27 25 29 28 29 133 146 156 171 168 15 10 12 13 11
Females
                             
15-19 years
3 1 2 14 25 28 10 19 76 172 1
a
1 7 9
20-24 years
17 161 157 373 897 74 106 108 228 511 24 55 49 145 386
25-29 years
24 38 41 459 58 190 234 268 289 340 9 19 17 18 25
30-39 years
17 24 27 37 37 90 136 146 211 232 9 13 14 18 15
40 plus 7 6 6 7 5 27 32 34 37 28 6 3 3 3 2

Source:Data from Bureau of Dangerous Drugs Annual Reports.

NOTE. Rates are based on age-specific populations; age unknown has been excluded.

a The rate is less than 0.5.

REPORTED INCIDENCE

The findings presented to this point pertain to "reported prevalence" of illegal narcotics users over a ten year period and therefore do not reflect current illegal activity or needs for intervention. In this section, an attempt is made to deal with this limitation by presenting available historical data on new cases who were first reported as narcotic users during a particular year. All these cases can be considered as "active" during the reported years in question, although as noted, they do not include cases previously known to the B.D.D. for use of other substances.

TABLE IV

Illicit narcotic drug users in Canada first reported to the Bureau of Dangerous Drugs in 1967, 1970, and 1973 by sex and age-group (Number and rate per 100,000 population)

 

Number

Rate

 

1967

1970

1973

1967

1970

1973

Males
           
15-19 years
8 104 162 1 10 14
20-24 years
34 258 397 4 28 41
25-29 years
41 113 204 6 15 23
30-39 years
31 71 86 2 5 6
40 plus 15 26 37
a
1 1
Age unknown
46 163 192      
Females
           
15-19 years
9 57 106 1 6 10
20-24 years
32 80 192 4 9 20
25-29 years
20 49 46 3 6 5
30-39 years
10 14 21 1 1 2
40 plus 1 10 2
a
a
a
Age unknown
21 75 82      

Source: Data from Bureau of Dangerous Drugs Annual Reports.

NOTE. Rates are based on age-specific populations.

a The rate is less than 0.5

(1) Sex and age

Table IV presents data on the number and rate of "illicit" narcotics users first reported to the B.D.D. in 1967, 1970 and 1973 (years for which such data were available) by sex and age. The figures exclude those cases where earlier reports pertaining to other substances (e.g. marihuana) had been made to the B.D.D. Future reports will include these cases for 1973 and later years.

The table shows a marked continual rise in first reported cases between 1967 and 1973. The greatest increases in rates for both sexes were in the 20-24 year age group, with an increase of 37 per 100,000 among males and 16 per 100,000 among females. The national rates for males were higher than those for females in all time periods and age groups with the exception of 1967, in which male and female rates were equal among those under 25 years old. The greatest increases tended to be between 1967 and 1970 (exception: females 20-24 for whom greater increases took place between 1970 and 1973). It should be noted however, that the rates are uniformly higher in 1973 than in 1970 with the exception of females over the age of 25. In addition, the highest rates for both sexes in all time periods were in the 20-24 age group with the exception of males in 1967 for whom the highest rate was in the 25-29 year old group.

These findings are illustrated in the figure which presents the rates for males and females in the four age categories under 40 for the three years.

Summary and discussion

This paper has examined data on reported narcotic users in Canada from 1956 to 1973 based on the narcotic users index maintained by the Bureau of Dangerous Drugs and reported in their annual reports. The major findings were as follows:

  1. There was a substantial increase in the number and rate of reported "illicit" narcotic users (from 2,678 in 1956 to 10,250 in 1973, and a corresponding rate increase from 25 to 64 per 100,000 population);

  2. The greatest increases took place after 1969 (See table I);

  3. There were decreases in the number and rate of "licit" and "professional" users (licit: from 352 in 1956 to 150 in 1973, and a rate decrease from 3 to 1; professional: from 211 in 1956 to 114 in 1973 and rate decrease from 2 to 1);

  4. There was a concentration of known narcotics users in British Columbia representing over half of the total known users in Canada (ranging from 59 per cent in 1956 to 61 per cent in 1973 with a peak of 66 per cent in 1969);

  5. Heroin was most frequently initially reported as the narcotic of use (representing between 80 per cent to 89 per cent of known narcotic drug users from 1956 to 1973) especially in British Columbia;

  6. There was a decrease in the proportion initially reposed using "synthetics" and opiates, and a recent increase in proportion initially reported using cocaine, especially outside of British Columbia (see table II);

  7. There were generally more reported male users than female in all age groups, a trend that increased over the total time period (with 74 per cent of 1973 known users being male);

  8. There were recent dramatic increases in the numbers and rates of reported users within the 20-24 year old group, which has become the dominant pattern among new cases in recent years (see tables III and IV and the figure).

Illicit narcotic drug users in Canada first reported to the Bureau of Dangerous Drugs in 1967, 1970 and 1973 by sex and age group (Logarithmic Scale)

Full size image: 22 kB, Illicit narcotic drug users in Canada first reported to the Bureau of Dangerous Drugs in 1967, 1970 and 1973 by sex and age group (Logarithmic Scale)

As is true of any data source, B.D.D. index has a number of limitations, many of which apply to other case registers (Richman, 1970; Weddell, 1973). For one, the fact that the index is dependent upon reports from a number of sources means that the original data vary somewhat in content and completeness. For example, enforcement reports often contain some information not covered in reports from specialized treatment centres and vice versa. It is thus difficult to know the extent to which findings based on the cumulated information reflect differences in recording procedures of the various sources, although it is possible to differentiate source of ascertainment.

For another there have been changes in the level of narcotics law enforcement and reporting over time even within the same source. For example, recently, municipal and provincial police have been involved in the enforcement of the Narcotic Control Act in Canada whereas prior to 1972 most enforcement was by the Royal Canadian Mounted Police. Thus, changes over time may reflect changes in reporting or enforcement rather than in extent. It should be noted however, that such major differences in reporting are less likely over short time-spans of comparison than over longer.

A third limitation arises from the procedures used for removing cases from the file. Cases are removed if no adverse reports are received for ten years for "illicit", and five years for "licit" and "professional" users. During that time period, cases are removed only because of reports of death or deportation which are received on an ad hoc basis. There is no systematic wat for removing cases where narcotic use has terminated during that period. Thus, the total number of known users reported during a given year ("reported prevalence") is probably an overstatement. This source of error is reduced however, by focusing on newly reported cases ("reported incidence") which we intend to do in future reports.

Finally, the B.D.D. data do not include systematic and complete accounts of the pharmacological, psychological and socio-cultural factors which affect individual and social risks associated with the consumption of narcotic drugs. Apart from age, sex, and in some cases, occupation, the register generally includes little systematic information about the frequency or duration of drug use, mode of administration, dosage levels, motivations for use, social and legal conditions of use, or a wide range of other factors.

It is critical that we keep these limitations in perspective, however. It would be self-defeating to take the position that because of these, and other limitations inherent in case registers, the B.D.D. index is totally without value for epidemiologic purposes. Any source of data (including surveys, participant observation studies, etc.) has limitations. What is important, is to clearly recognize boththe limitations andstrengths of the data source. With regard to the latter, the B.D.D. narcotic drug users index is currently the most comprehensive national source of information on reported narcotics users in Canada. For instance, a recent study of Toronto heroin users known to the Addiction Research Foundation of Ontario, the Royal Canadian Mounted Police, or the B.D.D., found that 64 per cent of the combined total were known to the B.D.D. (Oki, 1972). A study of heroin and methadone-related deaths in Canada from 1970 to early 1972 conducted by the LeDain Commission found that slightly less than one-half of the cases were known to the B.D.D. as opiate narcotic users (LeDain, 1973), and a similar study of drug-related deaths in Vancouver in 1973 which we conducted found that 60 per cent were known. The results of these studies suggest the extent to which the B.D.D. index may represent the real user population, and give some basis for assessing the coverage of the B.D.D. index. The relationship between known users on the index and the actual population of users in Canada may not be constant over time. Therefore, studies on drug-related deaths and other phenomena relevant to the epedimiology of narcotic drug use are essential to supplement information provided by research based on the register alone. Such projects are underway.

As mentioned earlier, most of the data presented in this paper refer to cases for whom reports have been received over the past 10 years (i.e. "reported prevelence"). Some of these were first reported many years earlier, and an unknown number may no longer be using narcotics. In analysing trends it is preferable to focus on newly reported cases which reflect "incidence" and thus give a better picture of more recent onsets and of greater current need for intervention than is obtained by "prevalence" data. Such "incidence" data are not readily available for earlier years.

An attempt is being made to correct this situation through two approaches. First, detailed analyses (e.g. social characteristics, geographic distribution, method of ascertainment) have been carried out on illicit narcotics cases first reported to the B.D.D. 1973. These analysis will be reported elsewhere and will provide a baseline for the analyses of trends. Second, the possibility of developing a machine-readable file within the B.D.D. is under investigation. If this is done, it should be possible to review in greater detail the trends in the characteristics of new cases over the past 10 or more years.

The Epidemiological and Social Research Division of the Non-Medical Use of Drugs Directorate is currently collaborating with the B.D.D. in analysing the valuable data maintained by the B.D.D. in order to make this perspective on known narcotic users more widely available to researchers, treatment personnel and the general public. These studies include retention studies of persons in methadone treatment; the relation of drug index information to other sources of ascertainment of narcotic users: a follow-up of subsequent reports for cases newly reported; and a study of spread of narcotics use outside of metropolitan areas.

The extent to which the findings presented in this paper can be projected to provide accurate estimates of the incidence and prevalence of narcotic use in Canada is unknown and perhaps unknowable. On the other hand, as minimum estimates of the extent and geographic and social distribution of narcotic-related problems in Canada, these data and other based on the B.D.D. drug users index are currently without parallel, and the index is an unrivalled resource for epidemiologic research on narcotic-related problems in Canada.

Acknowledgements

The authors would like to express their gratitude to Reid McKim, Eugene Wilson and Jacques Lecavalier of the Bureau of Dangerous Drugs for their outstanding co-operation in this project. The assistance of Linda Campbell, Eleanor Thomas, Lise Desormeaux, Mireille Albert, Mike Bryan, and Bruce MacLean and staff of the Bureau of Dangerous Drugs is also gratefully acknowledged.

Bibliography

Canada. Annual Report, Bureau of Dangerous Drugs, Ottawa, 1973.

LeDain, G. Final Report of the Commission of Inquiry into the Non-Medical Use of Drugs, Information Canada, Ottawa, 1973.

Oki, G. "Heroin Abuse in the Greater Toronto Area", Addiction Research Foundation, Substudy 454, Toronto, 1972.

Richman, A. and B. Humphrey. Epidemiology of criminal Narcotic Addiction in Canada, Bulletin on Narcotics, XXI:l, p. 31-39, 1969.

Richman, A. Proceedings of the Aberdeen Symposium on Psychiatric Epidemiology, Oxford University Press, Chapter 7, Oxford, 1970.

Weddell, J. M. "Registers and Registries: A Review", International Journal of Epidemiology, 2, 221-228, 1973.