APPENDIX 1

LAWS

The Controlled Drugs and Substances Act includes eight schedules, the first three of which cover the majority of illegal drugs (see Table, page 161).

The Controlled Drugs and Substances Act (laws.justice.gc.ca/en/C-38.8/index.html) defines several offences and penalties in relation to controlled substances which include illicit drugs and psychotropic medications. Offences include illegal possession, trafficking, possession for the purpose of trafficking, production, importing, and exporting of these substances. The Canadian Criminal Code also includes drug-related provisions. Anyone who knowingly imports, exports, manufactures, promotes or sells instruments for illicit drug use (sec. 462.2) or launders the proceeds of a crime (sec. 462.31) is guilty of an offence and subject to a penalty.

There is no specific law in Canada regarding compulsory drug rehabilitation. But there are many legal mechanisms, (court orders, probation orders, and parole orders, etc.) for encouraging or forcing offenders to obtain treatment for their drug abuse.

Controlled substances in Canada are regulated through legislation. The main laws governing legal drugs are the Food and Drugs Act, and the Controlled Drugs and Substances Act.

Psychotropic medications including controlled substances are governed by the Food and Drugs Act and the Controlled Drugs and Substances Act. Before a medication can be sold, it must undergo clinical, pharmacological, and toxicological trials, the results of which must receive a favourable assessment. The rules for producing, importing, exporting, obtaining, and selling medications are very strict, and violators can be punished.

The prescribing and distributing of medications by health-care professionals are also strictly regulated. To write or renew prescriptions, doctors must follow very strict criteria (for example, regarding clinical assessment and ongoing diagnosis). Certain medications are included in schedules I to IV and VI of the Controlled Drugs and Substances Act because of their psychoactive properties.

APPENDIX 2

ESTIMATING YOUR BLOOD ALCOHOL CONCENTRATION

The effects of alcohol are long-lasting. Always take a cautious approach: if there is any possibility that alcohol has impaired your ability to drive, operate machinery, etc., do not engage in these activities, and never use a blood alcohol concentration lower than 0.08 as a justification for taking risks. The following tables are provided for information only. They must be interpreted with caution because an individual’s reaction to alcohol will differ depending on his/her build and health, and the specific drinking circumstances. Drinking alcohol without eating allows the alcohol to enter the bloodstream much faster and its effects are stronger. It is therefore better to eat when drinking alcohol.

Example

A woman who weighs 68 kg (150 pounds) spends the evening at the home of friends. At 7 p.m., she drinks one 341 mL glass of beer with a 5% alcohol content. Then she drinks three 5-ounce glasses of wine, each with a 12% alcohol content. At 10 p.m., she finishes her last drink of the evening, a 1.5-ounce glass of cognac with a 40% alcohol content. She doesn’t eat anything. The liver eliminates alcohol at a rate of about 15 mg of alcohol per 100 mL of blood per hour.

What is her blood alcohol concentration at 11 p.m.?

Answer: 109 mg %.

APPENDIX 3

ACUTE ALCOHOL INTOXICATION

How to recognize acute alcohol intoxication

Alcohol overdose is a relatively common phenomenon, especially when someone absorbs large amounts of alcohol in a short amount of time.

Acute alcohol intoxication can cause death in less than an hour. That is why, when someone seems to have drunk a large amount of alcohol in a fairly short time, it is important to watch for the signs of acute intoxication.

Though these signs are generally proportional to the person’s blood alcohol concentration, not all people react to a given level of alcohol in the same way. Reactions can be affected by many factors, including weight, gender, tolerance to alcohol, whether or not food has been eaten (food can slow the absorption of alcohol into the blood), and the context in which they are drinking.
It is therefore important to watch closely for the signs described in the following table and react quickly.

1. The number of drinks shown here is an approximate indication only. The influence of alcohol on any individual depends on many factors, (physical condition, personal sensitivity or tolerance, interaction with other substances, etc.)
2. To estimate a person’s blood alcohol concentration according to his or her gender and weight and how many drinks he or she has had, see the tables in Appendix 2.

APPENDIX 4

EFFECTS OF ALCOHOL AND DRUGS WHILE DRIVING A MOTOR VEHICLE

Driving a motor vehicle is a relatively complex task that demands the coordination of several different actions simultaneously. These include perception (good vision and hearing), attention (being able to react quickly and properly in a variety of unforeseeable situations), concentration (being able to concentrate on a particular task for a certain period of time), memory (remembering situations which occured in the past), anticipation (being able to foresee how situations will unfold as you are driving now), good judgment (absorbing and processing information from various sources promptly, and making the right decisions at the right time), and movement co-ordination (braking and steering so as to avoid collisions and properly manoeuvre the vehicle).

Effects of alcohol on the ability to drive

Alcohol’s effects on the brain are responsible for impairing a person’s driving ability. These effects depend primarily on the following factors:

• blood alcohol concentration: there is a direct relationship between the concentrations of alcohol in the blood and its effects (see appendices 2 and 3);
• individual genetic makeup: influences individuals’ sensitivities to alcohol and how quickly their bodies eliminate alcohol;
• drinking habits: people who drink alcohol repeatedly will eventually develop a tolerance to it;
• current physical condition: fasting, unhealthy eating, poor health or a state of intense fatigue will increase the risk of alcohol intoxication);
• the course of alcohol in the system: at the same blood alcohol concentration, the effects of alcohol on the brain are greater during the absorbtion phase compared to those during the elimination phase;
• pharmacological interactions: when people consume alcohol and medications or other drugs at the same time, these drugs can interact with alcohol in ways that produce synergistic or antagonistic effects;
• the psychological state and the social setting: expectations about the effects of alcohol, and the social setting in which alcohol is consumed, can have a decisive influence both on subjective perceptions and on behaviour.

Effects of drugs on the ability to drive

Since the 1970s, a number of studies have been done to determine how drugs other than alcohol affect people’s ability to drive and what risk of fatal accidents these drugs present. The main findings of these studies were as follows:

• In a Quebec survey²⁵ according to urine samples, the presence of drugs was detected in nearly 12% of the drivers who were stopped at random in a roadside survey.
• Different studies examined the presence of drugs in blood samples taken from drivers fatally injured in highway accidents. The following levels were reported: 26% in Ontario²⁶, 20% in British Columbia²⁷, and 32% in Quebec²⁸.
• The two main drugs found in the fatally injured drivers were cannabis (16% in Ontario26, 18% in British Columbia²⁷, 20% in Quebec²⁸) and benzodiazepines (6% in Ontario²⁶, 5% in British Columbia²⁷, 10% in Quebec²⁸).
• A study of seriously injured drivers admitted to a Toronto trauma unit²⁹ reported the presence of drugs in 41% of the cases, the most common drugs being cannabis (14%) and benzodiazepines (12%).
• The risk of being involved in a fatal road accident²⁵, after having used cannabis, cocaine or benzodiazepines is 2 to 5 times higher than among drivers who are not impaired.
• A combination of alcohol and drugs or of several different drugs substantially increases the risk of being involved in a fatal road accident²⁵.

APPENDIX 5

LIST OF PROHIBITED SUBSTANCES AND PROHIBITED METHODS IDENTIFIED IN THE WORLD ANTI-DOPING CODE

The Prohibited List in the World Anti-Doping Code is defined and regularly updated by the World Anti-Doping Agency.

Prohibited Substances

• Anabolic androgenic steroids
• Other anabolic agents, including but not limited to: clenbuterol, tibolone, zeranol, zilpaterol
• Stimulants
• Beta-2 agonists
• Hormones and related substances:
• Erythropoietin (EPO)
• Growth hormone (HGH), insulin-like growth factors (e.g., IGF-1), mechano growth factors (MGFs)
• Gonadotrophins (LH, hCG), prohibited in male athletes only
• Insulin;
• Corticotrophins
• Agents with antiestrogenic activity:
• Aromatase inhibitors including, but not limited to: aminoglutethimide, anastrozole, exemestane, formestane, letrozole, testolactone
• Selective Estrogen Receptor Modulators (SERMs) including, but not limited to: raloxifene, tamoxifen, toremifene
• Other anti-estrogenic substances including, but not limited to: clomiphene, cyclofenil, fulvestrant
• Glucocorticoids
• Cannabinoids
• Narcotics
• Diuretics and other masking agents

Prohibited Methods

• Enhancement of oxygen transfer (e.g., blood doping)
• Chemical and physical manipulation: tampering with blood or urine samples collected during doping controls (e.g., use of masking agents, substitution of samples, intravenous infusions)
• Gene doping: use of genetically modified cells, or of genes or of various genetic elements that have the capacity to enhance athletic performance

APPENDIX 6

EFFECTS SOUGHT BY ATHLETES WHO TAKE ANABOLIC SUBSTANCES

Athletes illegally abuse anabolic agents in the belief that taking these substances will enhance their athletic performance. Though some scientists question this belief, under certain conditions anabolic steroids can produce the following effects:

• increased weight and muscle mass;
• increased muscle strength;
• increased aggressiveness and motivation in training and competition;
• increased physical endurance due to enhanced resistance to fatigue;
• faster recovery after injuries, exercise, or intensive training periods.