Overview of presentation Update knowledge on cannabis, particularly within the Australian context Cannabis – facts or fiction? Introduce NCPIC

Overview of presentation

Update knowledge on cannabis, particularly within the Australian context

Cannabis – facts or fiction?

Introduce NCPIC

Show the DVD - Cannabis Facts: Clearing the Smoke

How much do you know about cannabis?

Complete the pre-test

If you don’t know the answer, please tick ‘don’t know’ rather than guess the answer

We’ll go through the correct answers at the end of the presentation

Patterns of cannabis use in Australia2007 National Drug Strategy Household Survey (AIHW, 2008)

Most commonly used illicit substance in Australia 1 in 3 have ever used it 1 in 10 have used it in the last year (‘recent use’) 1 in 15 in the last month and 1 in 22 in the last week

Much higher rates of use amongst Aboriginal and Torres Strait Islander peoples

Average age of initiation – 18.7 years in 1995, age of initiation was 19.1 years

Approximately 1 in 5 young Australians have ever used

Frequency order

1. Northern Territory

2. Tasmania

3. Western Australia

4. South Australia

5. Queensland

6. ACT

7. Victoria

8. New South Wales

Prevalence rates around the country

%

0

10

20

30

40

50

60

1996 13.3 21.7 34.3 44.7 49.6 55.4 36.4

1999 9.1 17 27.7 38.3 43.8 49.6 29.3

2002 6 10 23 32 37 42 25

2005 4.6 8.8 15.4 22.8 30 32.4 17.8

2008 3.2 5.5 11.3 17.7 22.9 26.2 13.6

12 years 13 years 14 years 15 years 16 years 17 years 12-17 years

Lifetime cannabis use, Australian secondary school students, 1996-20081996-2008 ASSAD Surveys

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

63,272 12,739 2,080 31,100 479 2,461 13,802

Alcohol AmphetaminesBenzodiazepine

sCannabis Cocaine Nicotine Heroin

Principal drug of concernAlcohol and other drug treatment services in Australia 2008-09: Report on the National Minimum Data Set

Num

ber o

f tre

atm

ent

epis

odes

So what are some of the major concerns about cannabis use

in Australia?

Major concerns

Heavy use of cannabis by young people (particularly those under age of 16)

Use of cannabis by Aboriginal and Torres Strait Islander peoples

Long-term respiratory harms associated with cannabis use

Confusion about cannabis potency

Cannabis dependence and withdrawal

Cannabis and mental health

Problems associated with adolescent cannabis useResearch shows using cannabis during adolescence increases the risk of:

experiencing mental health problems up to 6 x the risk of developing schizophrenia earlier on-set of psychosis by up to 2.7 years

dropping out of school becoming dependent on cannabis having deviant peer affiliations and displaying antisocial behaviour using other drugs attempting suicide participating in criminal behaviour reduced life opportunities

Aboriginal and Torres Strait Islander peoples’ cannabis useNational Aboriginal and Torres Strait Islander Health Survey (NATSIHS) 2004/5

19.1% lifetime use 9.1% previous year

2004 survey rural community (Arnhem Land, NT) 69% of the males, 26% of the females had ever used 67% of the males, 22% of the females had used it in the last

month (among 336 13-36-year-olds)

2007 National Drug Household Survey almost one in four Indigenous Australians had used cannabis in

last year

Aboriginal and Torres Strait Islander peoples’ cannabis useThe limited available data suggests:

higher rates of use and dependence especially among rural communities

Indigenous secondary school children significantly more likely to use, more susceptible to initiating use, used more frequently

more harmful ways of using cannabis (e.g., ‘bucket bongs’) Indigenous communities have expressed concerns about; high

proportion of income spent on cannabis, community violence related to supply, child neglect, sexual exploitation, declining participation in community life, reduced participation in education and training

Respiratory harms

Cannabis is primarily smoked – with cannabis smoke being similar to tobacco smoke with regard to respiratory harms

Almost two thirds of all Australian cannabis smokers mix tobacco with their cannabis (‘mull’)

Harms appear to be additive for those that use both tobacco and cannabis

Respiratory harms

Cannabis smoke contains 3 times more tar and 5 times more carbon monoxide than a standard cigarette (1 bong/joint equal to 3-5 cigarettes in lung damage)

Cannabis smokers tend to inhale deeper and hold the smoke up to four times longer in their lungs

Cannabis has a higher combustion temperature and burns hotter on the throat and mouth

‘Bongs’

Many people use bongs as they believe: it is a more economical way to use cannabis it provides a bigger ‘hit’ it provides a smoother inhalation

Research shows that bongs do not reduce exposure to tar, carbon monoxide or provide deeper inhalation

using a plastic bong results in exposure to the by-products and petro chemicals caused by heating the implement

Vapourisers also expose users to potentially neurotoxic amounts of ammonia

Cannabis potency

Many believe that cannabis has become much stronger – mainly due to hydroponically grown cannabis becoming increasingly available

It is now believed to be twice as strong as it once was, due to the following factors:

genetic (selected seed varieties and cultivation of female plants) variation in cannabinoids and concentration of THC, CBN, etc environmental (cultivation techniques, prevention of fertilisation and seed

production) freshness (the risk of storage degradation of THC is less likely today)

Most importantly, we need to remember that users are now smoking the stronger part of the plant (heads/buds), more often

Taxonomy of cannabis

Cannabis sativa

Cannabis indica

Cannabis ruderalis

THC and other cannabinoids

Cannabis sativa contains around 500 compounds approximately 80 are cannabinoids, some of which provide the

psychoactive effect

THC – delta-9 tetrahydrocannabinol has the strongest psychoactive effect THC content commonly used as measure of potency effect of cannabis may depend not only on THC content but on the

presence of other cannabinoids such as: cannabidinol (CBD) not psychoactive but has anti-anxiety

properties cannabinol (CBN) mildly psychoactive cannabinodial (CBDL) mildly psychoactive

Cannabis dependence

People can become both psychologically and physically dependent on cannabis

Prevalence rates amongst those who ever try cannabis are around 9-15% (about one in ten)

Risk increases the more often cannabis is smoked

Early initiation is linked with progression to heavy use and dependence

Withdrawal symptoms

Generally last 1-7 days anger, aggression, irritability anxiety/nervousness decreased appetite restlessness sleep difficulties including strange dreams

Less common symptoms chills depressed mood stomach pain/physical discomfort shakiness night sweats

Cannabis and mental health

There continues to be considerable debate in the literature about the links between cannabis and mental health

Some people experience very unpleasant psychological effects when they use cannabis such as:

severe anxiety or panic attacks or with higher doses – confusion, delusions and hallucinations

Symptoms more likely to be felt by people who aren’t used to the effects or have smoked more then they are used to

they usually do not last and many of these people try once or twice and never use again due to this effect

Cannabis-induced psychosis

A short-lived psychotic disorder that: can last up to a few days is often characterised by hallucinations, delusions, memory loss and

confusion usually results from prolonged or heavy cannabis use responds well to treatment

The association between cannabis use and psychosis is stronger for those who start using early and use heavily

peak age range during which males are more vulnerable to developing a psychosis is 18-30 years of age

Cannabis and schizophrenia

Schizophrenia is characterized by the person having difficulty distinguishing what is real from what is not real. They may also experience:

hallucinations or delusions muddled thinking and speech

Cannabis may trigger schizophrenia in those who have a family history

Early and heavy use of cannabis are factors associated with up to six times the risk of developing schizophrenia

Cannabis and depression

The link between cannabis and depression is not clear cut but people who use cannabis - particularly early, regular and heavy users – are more likely to develop depression

young women appear to be more likely affected

The relationship between cannabis use and suicide among adolescents is mixed

although an elevated risk factor appears to be heavy use under the age of 15

Cannabis and anxiety

Anxiety and panic attacks are among the most common negative reactions to cannabis reported by users

There is concern that cannabis may exacerbate longer lasting forms of anxiety disorders such as panic disorder

Many longer term users report that they continue to use cannabis because it relieves unpleasant feeling states such as anxiety and depression

Cannabis and mental health: summary

Cannabis use may not be directly associated with the more prevalent mental health problems – an indirect association is possible and there needs to be more research to be certain

A younger age of initiation to cannabis use is likely to increase the risks of mental-health problems substantially

Chronic heavy cannabis use can lead to psychotic symptoms in vulnerable individuals, symptoms usually recede after stopping

Cannabis may precipitate schizophrenia in vulnerable individuals and continued use worsens prognosis

NCPIC website

The NCPIC website contains up-to-date cannabis-related information in the form of fact sheets, as well as PDFs of all print resources

Future web-based interventions will also be delivered from the site: www.ncpic.org.au

NCPIC website: Young people

The NCPIC website has also developed a young people’s section – providing information from a prevention perspective. Some of the topics covered include psychosis, dependence, sniffer dogs, cannabis and driving, joints vs bongs, etc

9 young people and their experiences with cannabis – real-life stories and a series of questions that relate

Cannabis and drivingOne of NCPIC’s major education projects has been targeting cannabis and driving

young people are less likely to drink and drive than their parents

they know the risks involved and are aware of the legal consequences

the result is a change in behaviour research suggests that ‘smoking and

driving’ is becoming more prevalent poster and support materials launched in

August 2009

Cannabis and sportLinking in with the AGDHA’s ‘Drugs and Sport’ Campaign – a poster was designed highlighting the negative effect of cannabis on sporting performance – once again, a message widely supported

NCPIC partnered with five of the seven sports that signed up to the AGDHA’s Club Champions Program for their endorsement and assistance with rolling out the poster and supporting materials

AFL, FFA, RUPA, ACA and the NRL

Cannabis: it’s not our culture www.notourculture.org.auAboriginal and Torres Strait Islander peoples

Cannabis Facts: Clearing the Smoke

► Play DVD► Play DVD

Thanks for listening Any questions?

Remember: Cannabis Help Line

1800 30 40 50

Presentation prepared by Annie Bleeker, NCPIC