Having Informed Conversations
Balanced and non-judgemental conversations about substances as well as other stigmatized behaviours, health conditions or identities can encourage informed, healthy or lower-risk behaviours among young people as they grow into adulthood. Substances include unregulated substances or regulated substances such as alcohol, cannabis, nicotine, prescription medications, etc.
The following resources offer key strategies for:
Create opportunities for yourself and the young people in your life to regularly exchange credible and practical information about substance use. The information below can help you get the conversations going.
When our brain is exposed to substances it will attempt to re-balance itself. This can make natural "feel good" sources like exercise and hobbies feel less pleasurable. Over time, it can take larger amounts of the substance used more often to get any effect or to make the symptoms of withdrawal go away.
A young person’s brain is in development until about age 25. This makes them more vulnerable to the long-term effects of substances. Substance use before and up to the early 20’s can cause long-term damage to the brain which is still in development. This can cause lasting problems with decision making, problem solving, dealing with emotions, and memory.
Alcohol is one of the most used substances among Ontario students (second only to high-caffeine energy drinks).1, 2
Many social gatherings feature alcoholic drinks. But alcohol use isn’t without risks. Consuming alcohol can slow the functioning of the brain and can affect judgement, attitudes and reflexes, which can lead to high-risk behaviours and injuries. Always plan a safe ride home if you or your driver consumes alcohol.
Over time, alcohol can also contribute to a range of chronic conditions, such as high blood pressure, stroke and certain types of cancer.
Anyone who consumes alcohol is encouraged to use Canada’s Guidance on Alcohol and Health as a tool to assess their drinking habits and see if any changes need to be made to maintain a healthy lifestyle and reduce the risk of health issues associated with drinking alcohol.
References
1 Boak, A., & Hamilton, H. A. (2024). “Drug use among Ontario students, 1977–2023: Findings from the Ontario Student Drug Use and Health Survey (OSDUHS),” Centre for Addiction and Mental Health, Toronto, ON, 2024. Available: https://www.camh.ca/-/media/research-files/osduhs-drug-use-report_2023.pdf
2 Boak, A., Elton-Marshall, T., & Hamilton, H. A., "The well-being of Ontario students: Findings from the 2021 Ontario Student Drug Use and Health Survey (OSDUHS)," Centre for Addiction and Mental Health, Toronto, ON, 2022. Available: https://www.camh.ca/-/media/files/pdf---osduhs/2021-osduhs-report-pdf.pdf
Energy drinks are heavily marketed toward young people and around extreme sports events or party scenes with promises of boosting energy levels. Many contain high amounts of caffeine (a stimulant) – more than the recommended maximum daily intake of caffeine for children and adolescents.
Energy drinks are one of the most used substances among Ontario students.1 Combining energy drinks with alcohol is a common trend among young people. The high caffeine content can mask the signs of alcohol intoxication, leading to greater levels of alcohol intake or binge drinking and an increased risk of health problems. There have been some cases of unexplained cardiac arrest in young people after combining energy drinks with alcohol.2 Health Canada requires a statement on energy drink labels advising consumers not to mix with alcohol. Individuals combining energy drinks with alcohol should avoid driving even if they don’t feel impaired.
Energy drinks are generally safe for adults to drink, but drinking more than the recommended daily maximum can cause negative effects.
Some of the side effects of consuming caffeine may include insomnia, irritability, headaches, nervousness and a rapid heart rate.
Public Health Ontario offers two evidence summaries with more information on the effects of energy drinks and mixing them with alcohol.
References
1 Boak, A., Elton-Marshall, T., & Hamilton, H. A., "The well-being of Ontario students: Findings from the 2021 Ontario Student Drug Use and Health Survey (OSDUHS)," Centre for Addiction and Mental Health, Toronto, ON, 2022. Available: https://www.camh.ca/-/media/files/pdf---osduhs/2021-osduhs-report-pdf.pdf
2 Kaşıkçıoğlu E., "Sports, energy drinks, and sudden cardiac death: stimulant cardiac syndrome," Anatol J Cardiol, vol. 17, no. 2, pp. 163-164, 2017.
Cannabis products are controlled by federal and provincial restrictions. Measures continue to be assessed as more is learned from Canada’s experience with the regulated cannabis market.
Keeping cannabis out of the hands of young people is important because using cannabis when you’re younger (below the age of 25, which is a critical time for brain development) can increase the risk of problems, including difficulties with memory, thinking, attention span, and mental health.
Like with alcohol and other substances, impairment can last, unknowingly, for a prolonged period of time. When cannabis is smoked or vaped, the effect can be felt almost immediately and may last about 6 hours. When cannabis is ingested (swallowed), the effect can be felt within about 30 minutes to 2 hours, peaks within 4 hours, and may last up to 12 hours, with some potential residual effects lasting up to 24 hours.
Always plan a safe ride home if you or your driver consumes cannabis.
Anyone who consumes cannabis is encouraged to follow Canada’s Lower-Risk Cannabis Use Guidelines (The Blunt Truth is a resource for young people) and consult their healthcare provider.
For more information on cannabis and how to reduce one’s harm, visit our Cannabis page.
Nicotine is addictive, whether it is synthetic (made in a lab) or tobacco derived (from the plant). Nicotine is in products like cigarettes, cigars, smokeless tobacco, hookah and most vaping liquids, many of which have levels of nicotine similar to or higher than cigarettes.
Children and youth are especially vulnerable to the effects of nicotine. They can become dependent on nicotine quicker than adults. Nicotine can change their brain development, affect memory and concentration, and may make them more vulnerable to other drug addictions.
Among youth, the top reasons for trying vaping are curiosity and to reduce stress. However, nicotine addiction causes stress. Cravings for nicotine feel stressful because your body begins to go through withdrawal.
Initially, vaping (or smoking) can feel good because nicotine increases the production of dopamine in the brain. For some youth, vaping (or smoking) can also feel like a way to bond socially with other people who vape and can be a distraction from stressful situations. These factors can motivate young people to continue vaping (or smoking).
The initial feel-good effect of nicotine wears off within a few hours and can lead to a desire to vape (or smoke) again. A person experiencing this nicotine withdrawal may have cravings or urges to vape (or smoke). They can feel irritated or upset, anxious or depressed, jumpy or restless and have difficulty concentrating, changes in sleep and eating habits.
Over time, it can take more nicotine, used more often, to get any feel-good effect or to make the symptoms of withdrawal go away. This is called nicotine dependence. Eventually, what started out as vaping (or smoking) to get a feel-good experience turns into vaping (or smoking) to get rid of withdrawal symptoms.
This cycle can make it feel like nicotine relieves stress. But the reality is that it only makes withdrawal symptoms go away temporarily and the cycle continues.
The best way to deal with stress is to identify what is causing anxious feelings. It’s how we react to situations, thoughts and feelings that can make a difference in our mental and emotional well-being.
More conversation starters are available to help you have ongoing meaningful discussions with young people about the effects of vaping:
• Conversation Starters About Vaping
• Let’s Talk About Vaping: A Quick Reference Guide
Support is available for people who want help to quit smoking or vaping. Along with talking with a healthcare provider for support and advice, youth can check out Quash.
Opioids are a broad group of narcotic medications that can be natural, semi-synthetic or synthetic. They can include Percocet, Percodan, Tylenol #3, Demerol, Dilaudid, OxyNEO, fentanyl, codeine, and more.
Opioids are consumed for medical and non-medical purposes. About 22% of Ontario students have used opioids (non-medically) in the past year.1 Safe storage and disposal help reduce the risk of medications or other substances being used by young people to get high.
When used medically as prescribed and under the guidance of a health care provider, they can help relieve pain. Opioids also have the potential for problematic use because they produce a feeling of well-being or a “high” which can lead to dependence. Opioids slow down the part of the brain that controls breathing. When too much of an opioid is taken, breathing can stop and result in death.
Anyone who uses opioids, whether obtained by prescription or not, is at risk. For more information on opioids and how to reduce one’s harm, visit our Opioids page.
Reference
1 Boak, A., & Hamilton, H. A. (2024). “Drug use among Ontario students, 1977–2023: Findings from the Ontario Student Drug Use and Health Survey (OSDUHS),” Centre for Addiction and Mental Health, Toronto, ON, 2024. Available: https://www.camh.ca/-/media/research-files/osduhs-drug-use-report_2023.pdf
Boak, A., & Hamilton, H. A. (2024). “Drug use among Ontario students, 1977–2023: Findings from the Ontario Student Drug Use and Health Survey (OSDUHS),” Centre for Addiction and Mental Health, Toronto, ON, 2024. Available: https://www.camh.ca/-/media/research-files/osduhs-drug-use-report_2023.pdf
Boak, A., Elton-Marshall, T., & Hamilton, H. A., "The well-being of Ontario students: Findings from the 2021 Ontario Student Drug Use and Health Survey (OSDUHS)," Centre for Addiction and Mental Health, Toronto, ON, 2022. Available: https://www.camh.ca/-/media/files/pdf---osduhs/2021-osduhs-report-pdf.pdf
Kaşıkçıoğlu E., "Sports, energy drinks, and sudden cardiac death: stimulant cardiac syndrome," Anatol J Cardiol, vol. 17, no. 2, pp. 163-164, 2017.
NIDA, "Drugs and the Brain," March 2022. [Online]. Available: https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain. [Accessed August 2023].
Arain M, Haque M, Johal L, Mathur P, Nel W, Rais A, Sandhu R, Sharma S., "Maturation of the adolescent brain," Neuropsychiatr Dis Treat, vol. 9, pp. 449-61, 2013.
Gould TJ, "Addiction and cognition," Addict Sci Clin Pract, vol. 5, no. 2, pp. 4-14.
National Institute on Alcohol Abuse and Alcoholism, "Alcohol and the Brain: An Overview," 2022. [Online]. Available: https://www.niaaa.nih.gov/publications/alcohol-and-brain-overview. [Accessed 9 August 2023].
Canadian Centre on Substance Use and Addiction, "Pharmacology and Substance Use," Canadian Centre on Substance Use and Addiction, 2017.
Paradis, C., Butt, P., Shield, K., Poole, N., Wells, S., Naimi, T., Sherk, A., &, "Canada’s Guidance on Alcohol and Health: Final Report," Canadian Centre on Substance Use and, Ottawa ON, 2023.
Centers for Disease Control and Prevention, "Alcohol and Caffeine," 7 December 2022. [Online]. Available: https://www.cdc.gov/alcohol/fact-sheets/caffeine-and-alcohol.htm. [Accessed 9 August 2023].
Health Canada, "Is cannabis safe to use? Facts for youth aged 13–17 years," 17 October 2018. [Online]. Available: https://www.canada.ca/en/health-canada/services/publications/drugs-health-products/is-cannabis-safe-use-facts-youth.html. [Accessed 22 August 2923].
Canadian Centre on Substance Use and Addiction, "Cannabis: Inhaling vs Ingesting," 2019. [Online]. Available: https://www.ccsa.ca/sites/default/files/2019-10/CCSA-Cannabis-Inhaling-Ingesting-Risks-Infographic-2019-en.pdf. [Accessed 22 August 2023].
Health Canada, "Risks of Vaping," [Online]. Available: https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/risks.html. [Accessed 22 August 2023].
US Department of Health and Human Services, "E-cigarette use among youth and young adults: A report of the Surgeon General," 2016.
England, L.J., Bunnell, R.E., Pechacek, T.F., Tong, V.T. and McAfee, T.A., "Nicotine and the developing human: A neglected element in the electronic cigarette debate," American Journal of Preventive Medicine, vol. 49, no. 2, pp. 286-293, 2015.
The National Academies of Science and Engineering, "Public health consequences of e-cigarettes," 2018. [Online]. Available: https://nap.nationalacademies.org/read/24952/chapter/1.
Health Canada, "Canadian Tobacco and Nicotine Survey (CTNS): summary of results for 2020," [Online]. Available: https://www.canada.ca/en/health-canada/services/canadian-tobacco-nicotine-survey/2020-summary.html. [Accessed 22 August 2023].
Smokefree.gov, "Reduce Your Stress," Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, [Online]. Available: https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/guide/stress-and-smoking.html.
Truth Initiative, "Nicotine use and stress," March 2022. [Online]. Available: https://truthinitiative.org/sites/default/files/media/files/2022/03/Nicotine%20Use%20and%20Stress_FINAL.pdf. [Accessed 22 August 2023].
