Cannabis use among remote Indigenous Australians: opportunities to support change identified in two waves of sampling

Graham, Veronica E., and Clough, Alan R. (2018) Cannabis use among remote Indigenous Australians: opportunities to support change identified in two waves of sampling. Frontiers in Public Health, 6. 310.

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Background: Cannabis harms among Indigenous populations in Australia, New Zealand, Canada and the United States may be magnified by poorer health and heavy use. However, little direct evidence is available to evaluate cannabis' impacts. In communities in remote northern Queensland (Australia) where cannabis has become endemic, opportunities to support change were investigated.

Methods: Opportunistically recruited participants (aged 15-49 years) discussed their cannabis use history in interviews in two waves of population sampling in Cape York (Queensland). Wave 1 included 429 people (235 males and 194 females); and wave 2 included 402 people (228 males and 174 females). Current users (used cannabis during the year before interview) described frequency of use, amount consumed, expenditure and dependence symptoms. Other substance use was recorded for 402 people at wave 2.

Results: Wave 1: 69% reported lifetime use and 44% current use. Males (55%) were more likely than females (30%) to be current users (P < 0.001). Most (96%) current users described at least weekly use; nearly half (48%) were "heavy" users (>= 6 cones/session at least once/week) and 77% met cannabis dependence criteria. Three communities spent up to $AUD14,200/week on cannabis, around $AUD2.0 million/year, or around 9% of community people's total income on cannabis. The majority (79%) of current users wanted to quit or reduce their cannabis use. Wave 2: no difference was observed in the proportion of lifetime (69%, vertical bar z vertical bar = 0.04, P = 0.968) or current cannabis users (39%, vertical bar z vertical bar = 1.39, P = 0.164); nor current use among males (71%, vertical bar z vertical bar = 0.91, P = 0.363) or females (62%, vertical bar z vertical bar = 0.36, P = 0.719). However, a significant reduction in current users by 15% (vertical bar z vertical bar = 2.36, P = 0.018) was observed in one community. Of 105 wave 1 current users re-assessed in 2, 29 (27%) had ceased use. These participants reported cost and family commitments as reasons to change and that social support and employment enabled abstinence. Current and lifetime cannabis use were closely associated with all other substance use, particularly tobacco and alcohol (both P > 0.001).

Conclusions: High rates of heavy cannabis use in remote Australian Indigenous communities warrant action. Successful cessation among some individuals suggests that significant opportunities are available to support change even where cannabis use may be endemic.

Item ID: 56167
Item Type: Article (Research - C1)
ISSN: 2296-2565
Keywords: cannabis (marijuana), indigenous, remote communities, substance use prevalence, cannabis abstinence, cannabis cessation
Copyright Information: Copyright © 2018 Graham and Clough. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Funders: National Health and Medical Research Council (NHMRC)
Projects and Grants: NHMRC project grant #601002
Date Deposited: 21 Nov 2018 08:08
FoR Codes: 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450417 Aboriginal and Torres Strait Islander public health and wellbeing @ 80%
42 HEALTH SCIENCES > 4203 Health services and systems > 420313 Mental health services @ 20%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920414 Substance Abuse @ 40%
92 HEALTH > 9203 Indigenous Health > 920301 Aboriginal and Torres Strait Islander Health - Determinants of Health @ 40%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920410 Mental Health @ 20%
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