What's new in cannabis?
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Director's report
Jan Copeland (PhD)
(Professor/Director, NCPIC)
It’s always a big relief when you hold a party and people turn up - it’s even better when they report that they had a good time! Despite the severe financial constraints on many service provider organisations in the current economic climate we had around 200 registrants to our inaugural National Cannabis Conference. There were delegates and speakers from Europe, USA, and New Zealand joining a wide range of locals from a variety of sectors.
The conference was covered by broadcast, radio and print media including a feature on Triple J The Hack Program on web-based interventions for cannabis-related problems featuring Dr Lisa Marsch and our own Dr Sally Rooke. To watch the feature please go to the following URL: http://www.abc.net.au/triplej/media/s2698757.htm
Professor David Fergusson’s paper attracted a great deal of interest and set the theme that adolescent cannabis use is particularly high risk. He presented a new analysis of longitudinal birth cohort datasets to confirm that, even when controlling for all other known risk factors, cannabis use before the age of 16 years was associated with an almost three fold risk of not completing high school, accounting for 17% of the attributable risk of this outcome.
There were a number of great papers that informed this theme further. From the school-based prevention aspect, the MAKINGtheLINK project presented by Bonnie Berridge and Dr Kate Hall from ORYGEN was very well received. It is a new program for senior high school students promoting help seeking for cannabis and mental health problems that has been developed and evaluated as part of the NCPIC work program. The session on cannabinoids and the brain from the perspectives of pharmacology, cognitive science and adolescent mental health was a conference highlight. It shed light on why adolescence is such a critical period for cannabis-related harms, with enduring social and health consequences.
The conference presentations also highlighted the importance of focussing attention on community and individual approaches to address cannabis-related problems among indigenous communities from demand and supply reduction perspectives. Alan Clough’s paper was powerful, particularly the video of remote indigenous community members speaking of the impact cannabis has had on their communities. To complement that work, we were very pleased to be able to display some fantastic artwork spontaneously offered by indigenous women prisoners from New South Wales. This artwork and the stories that accompany them will be included in our web materials arising from the conference.
I realise while highlighting strong themes I am missing a number of excellent papers on a range of other important topics. This particularly includes cannabis and mental health with terrific papers by Prof Alan Green and Dr Peter McKenna. Prof David Kavanagh concluded the meeting with a paper on the impact of cannabis on mental health care service delivery, supported by Prof Ian Webster’s closing remarks. There have been valuable collaborations flowing on from the meeting and the presence of a group of Members of Parliament ensured an immediate impact on policy development.
I would like to especially thank all NCPIC staff for their personal contribution to the success of the meeting. A particular thank you to the NCPIC speakers, Melissa Norberg, John Howard, and Paul Dillon for their scholarship. The skills and enthusiasm of communications staff, Clare Chenoweth and Morag Millington, were vital in bringing it all together.
A number of the papers, a DVD including interviews with some key speakers, and the indigenous artwork will soon be posted on the website. The delegates evaluated the meeting very positively overall (with the clear exception of not having enough tables for meals) and with continuing support from the Commonwealth Department of Health & Ageing we hope to be able to hold a second meeting in the next 2-3 years.
Best wishes, Jan
Research publications
Relevant publications examining issues to do with cannabis that have been published in the last month include the following:
- Baeza, I., Graell, M., Moreno, D., Castro-Fornieles, J., Parellada, M., González-Pinto, A., Payá, B., Soutullo, C., de la Serna, E., & Arango, C. (2009). Cannabis use in children and adolescents with first episode psychosis: Influence on psychopathology and short-term outcome (CAFEPS study). Schizophrenia Research 113, 129-137.
- Beck, K.H., Caldeira, K.M., Vincent, K.B., O’Grady, K.E., Wish, E.D., & Arria, A.M. (2009). The social context of cannabis use: Relationship to cannabis use disorders and depressive symptoms among college students. Addictive Behaviors 34, 764-768.
- Bonn-Miller, M.O. & Moos, R.H. (2009). Marijuana discontinuation, anxiety symptoms, and relapse to marijuana. Addictive Behaviors 34, 782-785.
- Caris, L., Anthony, C.B., Ríos-Bedoya, C.F., & Anthony, J.C. (2009). Behavioral problems and the occurrence of tobacco, cannabis, and coca paste smoking in Chile: Evidence based on multivariate response models for school survey data. Drug and Alcohol Dependence 104, 50-55.
- Centers for Disease Control and Prevention (CDC). (2009). Inadvertent ingestion of marijuana - Los Angeles, California, 2009. Morbidity and Mortality Weekly Report 58, 947-950.
- Compton, M.T., Chien, V.H. & Bollini, A.M. (2009). Associations between past alcohol, cannabis, and cocaine use and current schizotypy among first-degree relatives of patients with schizophrenia and non-psychiatric controls. The Psychiatric Quarterly 80, 143-154.
- Creemers, H.E., Korhonen, T., Kaprio, J., Vollebergh, W.A., Ormel, J., Verhulst, F.C., & Huizink, A.C. (2009). The role of temperament in the relationship between early onset of tobacco and cannabis use: The TRAILS study. Drug and Alcohol Dependence 104, 113-118.
- Frisher, M., Crome, I., Martino, O., & Croft, P. (2009). Assessing the impact of cannabis use on trends in diagnosed schizophrenia in the United Kingdom from 1996 to 2005. Schizophrenia Research 113, 123-128.
- Hartman, C.A., Hopfer, C.J., Haberstick, B., Rhee, S.H., Crowley, T.J., Corley, R.P., Hewitt, J.K., & Ehringer, M.A. (2009). The association between cannabinoid receptor 1 gene (CNR1) and cannabis dependence symptoms in adolescents and young adults. Drug and Alcohol Dependence 104, 11-16.
- Kocabay, G., Yildiz, M., Duran, N.E., & Ozkan, M. (2009). Acute inferior myocardial infarction due to cannabis smoking in a young man. Journal of Cardiovascular Medicine 10, 669-670.
- Magen, I., Avraham, Y., Ackerman, Z., Vorobiev, L., Mechoulam, R., & Berry, E.M. (2009). Cannabidiol ameliorates cognitive and motor impairments in mice with bile duct ligation. Journal of Hepatology 51, 528-534.
- Maxwell, J.C., Freeman, J. & Davey, J. (2009). Too young to drink but old enough to drive under the influence: A study of underage offenders as seen in substance abuse treatment in Texas. Drug and Alcohol Dependence 104, 107-112.
- Miller, R., Ream, G., McCormack, J., Gunduz-Bruce, H., Sevy, S., & Robinson, D. (2009). A prospective study of cannabis use as a risk factor for non-adherence and treatment dropout in first-episode schizophrenia. Schizophrenia Research 113, 138-144.
- Puighermanal, E., Marsicano, G., Busquets-Garcia, A., Lutz, B., Maldonado, R., & Ozaita, A. (2009). Cannabinoid modulation of hippocampal long-term memory is mediated by mTOR signaling. Nature Neuroscience 12, 1152-1158.
- Pujazon-Zazik, M. & Park, M.J. (2009). Marijuana: Use among young males and health outcomes. American Journal of Men’s Health 3, 265-274.
- Vigna-Taglianti, F., Vadrucci, S., Faggiano, F., Burkhart, G., Siliquini, R., Galanti, M.R., & Eu-Dap Study Group. (2009). Is universal prevention against youths’ substance misuse really universal? Gender-specific effects in the EU-Dap school-based prevention trial. Journal of Epidemiology and Community Health 63, 722-728.
- Waldron, M., Heath, A.C., Lynskey, M.T., Nelson, E.C., Bucholz, K.K., Madden, P.A., & Martin, N.G. (2009). Smoking and illicit drug use associations with early versus delayed reproduction: Findings in a young adult cohort of Australian twins. Journal of Studies on Alcohol and Drugs 70, 786-796.
Commentary on research
Too young to drink but old enough to drive under the influence: a study of underage offenders as seen in substance abuse treatment in Texas – a comment on Maxwell, Freeman & Davey (2009)
While driving under the influence (DUI) of alcohol has long been acknowledged as a risk to the safety of drivers, passengers, and pedestrians, driving under the influence of cannabis has only recently gained the attention of researchers and policy makers. Based on a sample of young people (under the age of 21) in Texas, Maxwell and Colleagues (2009) compared the prevalence of DUI offenses involving alcohol and DUI offenses involving cannabis. The authors found that DUI occurred more frequently with alcohol in 1997, but a decade later, alcohol was replaced by cannabis as the primary substance involved in DUI offenses. The study also examined the factors that were associated with completion of treatment for DUI offenses and abstinence from substances. The major predictors of treatment completion were being abstinent in the month prior to treatment ending, having alcohol as the primary substance problem, and having more family involvement. On the other hand, the strongest predictors of using substances after treatment were being exposed to alcohol or drug use in the household, having received treatment in a residential setting, and having family members with more drug and alcohol problems. This study provides further evidence for the important role that family plays in substance-related problems among young people and highlights the need to target cannabis as a substance of issue in driving.
- Maxwell, J.C., Freeman, J. & Davey, J. (2009). Too young to drink but old enough to drive under the influence: A study of underage offenders as seen in substance abuse treatment in Texas. Drug and Alcohol Dependence 104, 107-112.
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
Don’t dope and drive
NCPIC’s cannabis and driving project is featured in this article, along with an image of the poster: Smoke and drive and you’re as good as drunk. The article includes comment on the project’s aims by Centre Director, Professor Jan Copeland, “We hope that the poster and the accompanying message will alert cannabis users to the potential dangers associated with getting behind the wheel of a car after using the drug.” The posters in both A2 and A4 sizes can be ordered here, and the additional promotional material including bumper stickers and mouse mats are available to order free, from our online order form.
Global tide turning against the war on drugs
The so called ‘war on drugs’ is heavily criticised in this article, with assertions that skunk is not stronger than the cannabis of the 60s and that it is fallacious to link it with schizophrenia. The article also claims that recent findings showing links between cannabis use and brain shrinkage, oral health issues and cancer are “myths.” It also claims that NCPIC’s recent cannabis and driving project and other reports are not accurate and that the Centre is over-funded.
“Mr Gormly is a well known critic of NCPIC and outspoken advocate for drug legalisation. The Centre is not a lobby group for any position, it is funded to provide evidence-based information on cannabis and to provide support to the workforce on appropriate responses. Dr Arcuri’s review of the evidence on cannabis and driving was a summary of the literature overall, including older and less rigorous research. The conclusion that cannabis increases the likelihood of being involved in a road traffic accident by 2-3 fold is well supported by recent reviews of the best quality evidence.” Jan Copeland.
Bongs as sedatives for children ‘endangering lives’: experts
An enormous amount of media coverage resulted from this AAP report about young children in Melbourne and Sydney being ‘sedated’ with cannabis by their parents. Les Twentyman, a Melbourne social worker, is said to believe this “practice continues to become more prevalent in ‘impoverished’ areas” in both cities. Children are being exposed to cannabis through both passive smoking and by their parents giving them bongs, sometimes in an attempt to curb problematic behaviour. These parents’ inability to afford medication for “behavioural problems,” along with a lack of understanding about the long-term effects of cannabis on young children are put forward as reasons for this disturbing practice.
“These are concerning anecdotes from very experienced workers in the field. There is almost no research on this question. Given what we are learning about the effects of cannabis on the developing brain, exposure to cannabis smoke in childhood is extremely concerning. Its use to “manage” behavioural problems suggests that these are families with multiple and complex problems that extend beyond cannabis use alone.”
Jan Copeland.
Cannabis linked to school dropout rate
NCPIC’s inaugural ‘1st National Cannabis Conference’ received widespread radio coverage around the country as well as a selection of print, online and television media. A popular theme in this coverage were findings discussed by conference presenter Professor David Fergusson, from New Zealand’s Otago University, that “The early use of cannabis may have a ... substantial impact on education.” Prof Fergusson told the conference delegates that “the earlier teenagers begin to use cannabis, the bigger the impact it has on whether they will complete year 12.”
School drug plea
Townsville MP, Lindy Nelson-Carr has “called for better awareness in schools of the dangers of cannabis use, following reports of children as young as eight regularly puffing away on joints in Australia’s indigenous communities.” She commented on information presented at the NCPIC conference that “there was a declining age of first-time use of cannabis in indigenous communities.” Ms Nelson-Carr also emphasised that “the younger the age of users, the greater the risk to their health” and noted that prevention is a “key in indigenous communities, as control was too difficult.” She believes that teachers play a vital role in prevention-based approaches and need to “be more skilled in educating students about the serious mental health issues, including addiction and dependency, depression and schizophrenia, associated with regular use of cannabis.”
Potted sex
The Journal of Sexual Medicine recently published a study which “found that cannabis users reported greater numbers of sexual partners for both women and men...[and] that men have difficulties with orgasm.”
Cannabis conference weeds out supporters
This article covered a protest staged by The Hemp Embassy outside the Powerhouse Museum, where NCPIC’s conference was being held. The protest criticised Australia’s cannabis laws, “which prohibit the medicinal use of marijuana” and NCPIC’s apparent ‘bias’. Professor Copeland provided comment for this article, emphasising that “The free national Cannabis Information and Helpline is not targeted at those who seek information on possible medicinal uses of cannabis and is not funded for this purpose.” The article described the conference, topics presented, delegates who attended and gave the Cannabis Information and Helpline at the end of the article. A retraction was sought by NCPIC for a statement in the article that members of The Hemp Embassy had not been invited to attend the conference. In fact, the conference was open to all members of the public to register. The retraction appeared soon after stating this along with an apology for the error.
Illicit drug use common among young with diabetes
St Vincent’s Hospital conducted a survey of “324 patients with type 1 diabetes to determine the prevalence and pattern of recreational drug use and its impact on glycaemia.” Dr Paul Lee from the hospital’s endocrinology department reported that “a significant proportion [close to 50%] reported drug use within the past 12 months and, even more scarily, close to a third of them reported daily drug use.” He went on to say “Recreational drug use is highly prevalent in young adults with type 1 diabetes, it’s under-reported, and may be a neglected contributor to poor glycaemic control.” Of respondents who “admitted to recreational drug use,” cannabis had been used by 84% of respondents, followed by ecstasy (72%).
Program of substance
Information from the Women’s and Children’s Institute at the Townsville Hospital, reveals that “the main substances abused by mothers-to-be in Townsville are nicotine, alcohol, amphetamines and cannabis.”
Some sad, some glad to see top cop go
Northern Territory police commissioner Paul White, is featured in this article as he leaves the police force after eight years as commissioner. He comments on his surprise at the high level of cannabis use in indigenous communities, along with alcohol use and crime. He stresses the links between cannabis use and “educational failure and psychosis”. He believes many people are changing their attitudes towards cannabis and no longer see it as a “harmless drug”.
Cannabis withdrawal study
The National Cannabis Prevention and Information Centre is currently recruiting participants for a study of cannabis withdrawal symptoms. We aim to develop a clinical tool for quantifying the severity and time course of cannabis withdrawal symptoms during a typical cannabis quit attempt. Such a tool will be useful to assist clinicians involved in supporting users who wish to reduce or quit their cannabis use. We decided to commission Avant Card to manage our recruitment campaign for this study, as they provide a contemporary spin on the advertising model. Avant Card provide a creative postcard design service, in conjunction with the logistics of printing and distribution to cafes, cinemas, record stores and other outlets that we felt would most effectively reach our target audience. We feel that Avant Card’s design strikes a balance between communicating a message of objective scientific research and being of aesthetic appeal to regular cannabis users. In addition, using a humorous image more effectively engages with cannabis users and avoids the risk of appearing patronising or judgmental.
We are currently seeking regular cannabis users for our withdrawal study, and will reimburse them for their time and transport costs. Participants must be over 18 years of age, live in the greater Sydney metropolitan area, and have daily access to the internet. Importantly, participants must also be prepared to quit smoking cannabis for a period of at least two weeks. Potential participants can get more information about the cannabis withdrawal study by emailing cannabiswithdrawal@unsw.edu.au, and leaving their name and contact phone number.
