what’s new in cannabis?
Thank you to all those subscribers who completed the pop-up survey about the E-Zine and website’s effectiveness and gave feedback about how we can improve our services. Overall, the respondents found the NCPIC website and E-Zine to be useful resources with up-to-date and relevant information. The feedback provided has given us a valuable insight into how workers in the field, cannabis users and others view and utilise the website.
Communications report
The Communications Team is extremely proud of the work that we have completed over the past few years. Consistent with NCPIC’s strategic focus on prevention, we have now grown into the largest team at NCPIC and we are excited about the projects we have planned for the coming year. It is vital, however, that we evaluate our Communications Strategy and collect information on the effectiveness of what we are doing, i.e., are the projects being conducted, and resulting products, reaching the target groups for which they are intended, and what, if any, are their impacts on the intended audiences?
With that in mind, in February of this year, Carroll Communications was commissioned by the Centre to assist in the evaluation of a number of the Centre’s Communication Strategy initiatives.
Carroll Communications is a specialist consultancy with a primary focus on public health social marketing, research and policy development. The consultancy’s principals, Dr Tom Carroll and Bev Carroll have each spent more than 25 years specialising in researching, developing, managing and evaluating public health programs and multi-faceted social marketing campaigns for a range of state and national government and non-government organisations.
The aim of the evaluation project was to gain an assessment of these communication initiatives against NCPIC’s Strategic Plan’s outcomes and goals with an emphasis on:
- reaching young people with complex needs – through the Clear Your Vision resource which was developed in collaboration with the Youth Off The Streets organisation;
- reaching Aboriginal and Torres Strait Islander communities – through a range of Cannabis: It’s not our culture resources and projects including the Indigenous communities project, the cannabis factsheet series and the Indigenous Music competition;
- and the Centre’s ability to ‘enhance capacity of health, human service and criminal justice systems to deliver evidence-based interventions’ – through the GP Education Package which comprises a set of resources designed to encourage GPs to screen for cannabis use with their high risk patients, and resources and information to treat and refer patients with problem cannabis use.
The focus of the evaluation project was on the level of target audience reach for these initiatives and their responses to the communication approaches and materials. The design of the evaluation framework was begun in February and the research was conducted from April to June 2011. A combination of qualitative and quantitative research methodologies was employed within the project. These methodologies included community visits, meetings with youth health services and Aboriginal health services, individual telephone and face-to-face interviews and group discussions, and online surveys. The approach was to apply this range of methodologies in order to address the evaluation project’s research questions as comprehensively as possible within the project’s limited time frame.
Carroll Communications has recently completed and delivered the report to the Centre. It outlines the research questions addressed for each of the NCPIC projects examined, methodologies employed as well as the findings from each of the three studies. A series of recommendations are also provided regarding these projects and future Communication Strategy projects for the Centre.
We look forward to using the findings of this report, as well as its recommendations, to improve the effectiveness of our work. We hope this will be the beginning of a strong relationship with Carroll Communications, and particularly Tom Carroll, well known for his work on the National Drug Campaigns over the years, to ensure that NCPIC continues to effectively disseminate quality, evidence-based cannabis-related information to the Australian public.
Research Publications
Relevant publications examining issues to do with cannabis that have been published in the last month include the following:
- Agrawal, A., Lynskey, M.T., Hinrichs, A., Grucza, R., Saccone, S.F., Krueger, R., Neuman, R., Howells, W., Fisher, S., Fox, L., Cloninger, R., Dick, D.M., Doheny, K.F., Edenberg, H.J., Goate, A.M., Hesselbrock, V., Johnson, E., Kramer, J., Kuperman, S., Nurnberger, Jr. J.I., Pugh, E., Schuckit, M., Tischfield, J., The GENEVA Consortium, Rice, J.P., Bucholz, K.K., & Bierut, L.J. (2011). A genome-wide association study of DSM-IV cannabis dependence. Addiction Biology 16, 514-518.
- Brière, F.N., Fallu, J.S., Descheneaux, A., & Janosz, M. (2011). Predictors and consequences of simultaneous alcohol and cannabis use in adolescents. Addictive Behaviors 36, 785-788.
- Cadenhead, K.S. (2011). Startle reactivity and prepulse inhibition in prodromal and early psychosis: Effects of age, antipsychotics, tobacco and cannabis in a vulnerable population. Psychiatry Research 188, 208-216.
- Griffith-Lendering, M.F., Huijbregts, S.C., Mooijaart, A., Vollebergh, W.A., & Swaab, H. (2011). Cannabis use and development of externalizing and internalizing behaviour problems in early adolescence: A TRAILS study. Drug and Alcohol Dependence 116, 11-17.
- Gronewold, A. & Skopp, G. (2011). A preliminary investigation on the distribution of cannabinoids in man. Forensic Science International 210, 7-11.
- Han, E., Choi, H., Lee, S., Chung, H., & Song, J.M. (2011). A study on the concentrations of 11-nor-Δ(9)-tetrahydrocannabinol-9-carboxylic acid (THCCOOH) in hair root and whole hair. Forensic Science International 210, 201-205.
- Han, E., Park, Y., Kim, E., In, S., Yang, W., Lee, S., Choi, H., Lee, S., Chung, H., & Song, J.M. (2011). Simultaneous analysis of Δ(9)-tetrahydrocannabinol and 11-nor-9-carboxy-tetrahydrocannabinol in hair without different sample preparation and derivatization by gas chromatography-tandem mass spectrometry. Journal of Pharmaceutical and Biomedical Analysis 55, 1096-1103.
- Justinová, Z., Ferré, S., Redhi, G.H., Mascia, P., Stroik, J., Quarta, D., Yasar, S., Müller, C.E., Franco, R., & Goldberg, S.R. (2011). Reinforcing and neurochemical effects of cannabinoid CB1 receptor agonists, but not cocaine, are altered by an adenosine A2A receptor antagonist. Addiction Biology 16, 405-415.
- Kleijn, J., Cremers, T.I., Hofland, C.M., & Westerink, B.H. (2011). CB-1 receptors modulate the effect of the selective serotonin reuptake inhibitor, citalopram on extracellular serotonin levels in the rat prefrontal cortex. Neuroscience Research 70, 334-337.
- Leung, L. (2011). Cannabis and its derivatives: Review of medical use. Journal of the American Board of Family Medicine 24, 452-462.
- Levin, F.R., Mariani, J.J., Brooks, D.J., Pavlicova, M., Cheng, W., & Nunes, E.V. (2011). Dronabinol for the treatment of cannabis dependence: A randomized, double-blind, placebo-controlled trial. Drug and Alcohol Dependence 116, 142-150.
- Lile, J.A., Kelly, T.H. & Hays, L.R. (2011). Separate and combined effects of the cannabinoid agonists nabilone and Δ(9)-THC in humans discriminating Δ(9)-THC. Drug and Alcohol Dependence 116, 86-92.
- Maisto, S.A., Krenek, M., Chung, T., Martin, C.S., Clark, D., & Cornelius, J. (2011). Comparison of the concurrent and predictive validity of three measures of readiness to change marijuana use in a clinical sample of adolescents. Journal of Studies on Alcohol and Drugs 72, 592-601.
- Marmorstein, N.R. & Iacono, W.G. (2011). Explaining associations between cannabis use disorders in adolescence and later major depression: A test of the psychosocial failure model. Addictive Behaviors 36, 773-776.
- McCambridge, J., Day, M., Thomas, B.A., & Strang, J. (2011). Fidelity to Motivational Interviewing and subsequent cannabis cessation among adolescents. Addictive Behaviors 36, 749-754.
- Prescot, A.P., Locatelli, A.E., Renshaw, P.F., & Yurgelun-Todd, D.A. (2011). Neurochemical alterations in adolescent chronic marijuana smokers: A proton MRS study. Neuroimage 57, 69-75.
- Pulido, J., Barrio, G., Lardelli, P., Bravo, M.J., Brugal, M.T., Espelt, A., de la Fuente, L., Pulido, J., Barrio, G., Lardelli, P., Bravo, M.J., Brugal, M.T., Espelt, A., de la Fuente, L., Ambrós, M., Belza, M.J., Castellano, Y., Domingo-Salvany, A., Fernández, F., Molist, G., Sánchez-Niubó, A., Santos, S., Sordo, L., Vallejo, F., & The Itínere Project Group. (2011). Cannabis use and traffic injuries. Epidemiology 22, 609-610.
- Safont, G., Corripio, I., Escartí, M.J., Portella, M.J., Pérez, V., Ferrer, M., Camacho, V., Sauras, R.B., Alonso, A., Grasa, E.M., Arranz, B., San, L., Dueñas, R., Carrió, I., & Alvarez, E. (2011). Cannabis use and striatal D2 receptor density in untreated first-episode psychosis: An in vivo SPECT study. Schizophrenia Research 129, 169-171.
- Shrivastava, A., Kuzontkoski, P.M., Groopman, J.E., & Prasad, A. (2011). Cannabidiol induces programmed cell death in breast cancer cells by coordinating the cross-talk between apoptosis and autophagy. Molecular Cancer Therapeutics 10, 1161-1172.
- Solowij, N., Jones, K.A., Rozman, M.E., Davis, S.M., Ciarrochi, J., Heaven, P.C., Lubman, D.I., & Yücel, M. (2011). Verbal learning and memory in adolescent cannabis users, alcohol users and non-users. Psychopharmacology 216, 131-144.
- Tarter, R.E., Fishbein, D., Kirisci, L., Mezzich, A., Ridenour, T., & Vanyukov, M. (2011). Deviant socialization mediates transmissible and contextual risk on cannabis use disorder development: A prospective study. Addiction 106, 1301-1308.
- Vara, D., Salazar, M., Olea-Herrero, N., Guzmán, M., Velasco, G., & Díaz-Laviada, I. (2011). Anti-tumoral action of cannabinoids on hepatocellular carcinoma: Role of AMPK-dependent activation of autophagy. Cell Death and Differentiation 18, 1099-1111.
Commentary on research
Fidelity to motivational interviewing and subsequent cannabis cessation among adolescents – a comment on McCambridge and colleagues
Addressing ambivalence and motivating change in a collaborative style between counsellor and client is core to the motivational interviewing (MI) counselling style. When applied to substance use treatment, MI typically involves one to four, 45-90 minute face-to-face counselling sessions. The client is motivated by the counsellor toward change through strategically expressed empathy and the use of client-centred techniques such as reflecting on key issues communicated by the client and exploring the pros and cons of change.
MI was first tailored to be utilised as a cannabis use intervention by Stephens and colleagues (2000) and evaluated by a randomised controlled trial. This initial trial, and a small body of research following it, has highlighted the effectiveness of MI in cannabis treatment. The literature illustrates the effectiveness of MI over delayed treatment control groups that is comparable to more intensive interventions based on cognitive behavioural therapy.
As McCambridge and colleagues (2011) detail in the present study, although MI shows promise as a cannabis use intervention, there is sparse evidence to indicate the specific mechanisms by which MI is capable of reducing cannabis use. Some early work reports that treatment outcomes vary between the practitioners charged with delivering them, and the extent to which the practitioners confront their clients. To enhance knowledge in this area a Motivational Interviewing Treatment Integrity Scale has been developed to assist process studies. The researchers conducted such a study drawing from information collected as part of a previously conducted randomized controlled trial of a single half-hour MI session targeting cannabis use.
In the original trial, McCambridge and colleagues (2008) recruited 326 adolescents (16-19 years) from eleven different colleges in London. Participants were randomized to receive the intervention (n=164) or be in the information and advice only control group (n=162). Of interest in the present study, was 75 intervention sessions (delivered by four different practitioners) where recorded information and three month followup data was available.
As in the previous study, results showed a significant difference between practitioners and treatment outcomes, with one practitioner notably more effective than three other practitioners at assisting participants to reach abstinence from cannabis at three month followup. In addition, the “motivational spirit” (referring to the extent to which the practitioner had a collaborative style, evoked the use of personal reasons for change and supported the participants’ autonomy) and “complex reflections” (referring to a reflection that adds substantial meaning to the participant’s communications) expressed by the counsellors were significantly associated with increased rates of abstinence.
The authors suggest some caution when interpreting results as certain biasing factors could not be ruled out. Namely, the participants that reported abstinence from cannabis may have been easier for counsellors to engage with and more receptive of treatment, or may have reported abstinence despite using cannabis. Despite these concerns and a small sample size, the evidence from MI process studies is mounting: it matters what is said and how it is said, and efforts to ensure the fidelity of MI training will not be wasted on treatment outcomes.
- McCambridge, J., Day, M., Thomas, B.A., & Strang, J. (2011). Fidelity to Motivational Interviewing and subsequent cannabis cessation among adolescents. Addictive Behaviors 36, 749-754.
- McCambridge, J., Slym, R.L. & Strang, J. (2008). Randomized controlled trial of motivational interviewing compared with drug information and advice for early intervention among young cannabis users. Addiction 103, 1809-1818.
- Stephens, R.S., Roffman, R.A. & Curtin, L. (2000). Comparison of extended versus brief treatments for marijuana use. Journal of Consulting and Clinical Psychology 68, 898-908.
Media stories this issue
Each issue we will examine some of the cannabis-related stories that have received media attention across the country. The headlines are listed below in bold, with a short summary and/or commentary regarding the content of the news story beneath. If you are interested in obtaining a copy of a particular story, please contact Clare Chenoweth at c.chenoweth@unsw.edu.au
Legal high crisis talks to be held
Reports that some synthetic cannabinoid products in New Zealand contained the “prescription sedative phenazepam” have prompted those involved in producing these products to meet and “rein in behavior that could lead to prohibition” [in New Zealand]. The meeting will also discuss “a code of practice for ingredient testing, limits on advertising, dairies near schools stocking synthetic cannabis, and Kronic’s pre-rolled joints – which health officials have said targets younger users.”
Germany launch for cannabis drug Sativex
GW Pharmaceuticals recently “launched its cannabis-derived multiple sclerosis drug in Germany.” Sativex contains cannabinoids that are “extracted” from cannabis plants.
Cape York on ‘high’ alert over cannabis use, says JCU study
Research done by Associate Professor Alan Clough of James Cook University (JCU) in three Indigenous communities in Cape York, has shown high levels of cannabis use and related issues. Dr India Bohanna, of JCU says “Through the surveys we found that one in two [of the 300 people surveyed in three Indigenous communities in Cape York] is currently using cannabis regularly... with most of them using it daily.” The mental health impacts and “psycho-social distress” caused by the high levels of cannabis use are of particular concern. In two of the surveyed communities, the majority of cannabis users expressed a desire to quit, which Dr Bohanna sees as a good “opportunity to tap into interventions to support people to quit.” Associate Professor Alan Clough says there is “a need for more and improved community based services including counselling, treatments for mental health and support to quit.”
Pot smokers more likely to use other drugs
A study conducted by NDARC’s Dr Wendy Swift has found that people in their twenties “who regularly smoke cannabis are up to three times more likely to use illicit drugs” than those who only use cannabis occasionally. The drug habits of almost 2000 Victorian high school students were studied, starting from their teenage years to their late twenties. Despite cannabis use tending to fall as participants grew closer to 30 years of age, “those who persisted [using cannabis] used the drug more frequently” as time went on. In addition, “those who smoked cannabis regularly were also found to be two to three times more likely to start using other illicit drugs, such as cocaine and amphetamines, than occasional users.” In addition, “the prevalence of cigarette smoking and high risk alcohol use was also greater among those reporting at least weekly cannabis use.”
Australians smoking less, doing more drugs
The recently released 2010 National Drug Strategy Household Survey results have shown a decrease in the number of Australians aged over 14 years smoking tobacco daily, but an increase in the use of some drugs, including “cannabis, pharmaceuticals for non-medical purposes, cocaine and hallucinogens.” The Australian Institute of Health and Welfare’s Brent Diverty said “For the first time since 1995, ecstasy use declined between 2007 and 2010, from 3.5 per cent to three per cent.”
One in seven high on cannabis
Results from the 2010 National Drug Strategy Household Survey show that Western Australia has the second highest level of recent cannabis use in the country, with the Northern Territory having higher rates of use. One in seven Western Australian teenagers and adults used cannabis in the 12 months prior to the survey. The National Drug Research Institute’s Professor Steve Allsop, emphasised the need for continued education to “highlight the risks associated with cannabis use”, particularly in schools.
Cannabis-like drugs to be outlawed
The Hon Catherine King MP, Parliamentary Secretary for Health and Ageing 7 July, 2011
Eight synthetic cannabis-like substances will be classified as prohibited substances throughout Australia from 8 July, Parliamentary Secretary for Health and Ageing, Catherine King, announced today.
“This will enable a uniform, nationwide prohibition on these drugs,” Ms King said.
“There is a lack of evidence of any therapeutic value for these substances and their use poses potential health risks.
“There have been widespread reports of abuse and symptoms, including severe hallucinations, psychosis and heart palpitations.
“Little is known about the long-term health effects from continued use.
“The drugs mimic the effects of existing illicit substances, but have not been uniformly illegal across Australia because they fall outside current controls.
“In response to calls for uniform restrictions on these types of substances, the Commonwealth has considered the matter and made a decision to prohibit eight of the most widely-used and abused synthetic cannabinoids,” Ms King said.
Australian Government restrictions on access to medicines and other chemical substances are determined through scheduling, a classification process. Scheduling decisions are made by select delegates in the federal Department of Health and Ageing. They are then given legal effect through state and territory legislation. Synthetic cannabis-like substances have been widely available on the Internet, these products have already been banned in Western Australia and South Australia with New South Wales to follow tomorrow. Commonwealth decisions on prohibiting a drug are made independently of the Australian Government, based on evidence and information available to the delegate.
“This matter has been considered by a delegate who decided that uniform prohibition of eight of these substances was required across the nation,” Ms King said.
“Therefore, from 8 July 2011, eight of the most widely-misused of these drugs will be listed as prohibited substances.
“These restrictions will still allow access to these substances for use in strictly-controlled medical and clinical studies to allow for appropriate investigation of any potential future therapeutic uses.”
Further details of this decision and supporting reasons are available in the July 2011 Public Notice of final decisions by delegates for amendments to the Poisons Standard—available, from today, at www.tga.gov.au/industry/scheduling-decisions-final.htm.
“The department’s delegate intends to also consider broader restrictions on synthetic cannabinoids and will seek advice on such restrictions from the October 2011 meeting of the Advisory Committee on Medicines Scheduling,” Ms King said.
“On 10 August the Therapeutic Goods Administration’s scheduling website will publish these proposed broader restrictions inviting public submissions on them.”
http://www.health.gov.au/internet/ ministers/publishing.nsf/Content/mr-yr11-ck-ck024.htm
Football Federation Australia: Supporting ‘Cannabis and Sport Don’t Mix’ through Indigenous engagement
Football Federation Australia (FFA) recently presented the ‘Indigenous Football Festival’, held in Alice Springs, Northern Territory, between July 6–8. The Festival catered for 165 Indigenous players from regions across Australia. In the boys division, teams were represented from Perth, Adelaide, Alice Springs, Darwin, Borroloola and Sydney. While in the girls category, players were selected from areas including Brisbane, Sydney, Moree, Melbourne, Adelaide and Borroloola.
Not only did the Festival provide players with the opportunity to participate in a non-competitive football ‘carnival’ style event, important educational messages were also delivered to all participants.
Current Hyundai A-League Melbourne Heart and capped Socceroo – David Williams, together with Westfield W-League Adelaide United player Ruth Wallace, presented to both male and female participants, sharing their life and playing experiences with the captive audience, emphasizing the importance that commitment and dedication, combined with a healthy lifestyle, have in contributing to a long and successful career. Both David and Ruth also highlighted the effects alcohol and other drugs could have on an individual’s life and the limits it may have on one’s career.
Using real life examples, David and Ruth were able to provide all players attending the Festival a greater understanding and appreciation of alcohol and other drugs, and re-enforced the message that there is no place in life for the abuse of these substances.
