Rebecca is 24. She started drinking alcohol at 12 by sneaking drinks from her mum and dad’s drinks cabinet. She started smoking cigarettes at 14 and by 15 she was a regular cannabis user. By 17 she couldn’t live without it.
Rebecca went from smoking cannabis on the weekends to smoking it every day, until she couldn’t go to a party without being stoned. Things went from bad to worse: she started smoking by herself first thing in the morning, began ringing in sick for work every few days and stopped turning up for family get-togethers. She drifted away from her friends, and the more she smoked, the more fire was drained from her spirit.
Daniel smokes cannabis every few months, and only with friends. He plays cricket regularly in summer, holds down a good job as a junior accountant and has been in a happy stable relationship for the past two years. He drinks alcohol much more often than he smokes cannabis.
Recent data from the Victorian Youth Alcohol and Drugs Survey, showed that Daniel is one of every five young people who use cannabis irregularly. He is much less likely than Rebecca to have anxiety or depression, or to have any of the social problems associated with cannabis use.
On the other hand, Rebecca is one of 3 per cent of young people her age who are using cannabis daily. She is one of 7 per cent who use it more frequently than once a week. According to George Patton, VicHealth Professor of Adolescent Health at the University of Melbourne, her pattern of social disconnection is not unusual, and that it’s very likely that Rebecca will have depression and anxiety severe enough to really get in the way of her day-to-day activities.
According to the Australian Drug Foundation, there is mounting evidence that regular cannabis use increases the likelihood of psychotic symptoms occurring if users also have a personal or family history of mental illness. Susceptible individuals who avoid cannabis have a 25 per cent chance of developing psychosis, whereas susceptible individuals who smoke cannabis have a 50 per cent risk. It appears the more cannabis Rebecca smokes, and the earlier she started, the worse the outcome.
As we have seen from the recent debate about the AFL’s drug testing code of practice, there are polarised views about cannabis in our community. A former cannabis addict to whom I spoke, bluntly characterised this divide by saying, “some would argue that any level of use is harmful, usually teetotalling self-righteous types, others would say that there is no harm whatsoever associated with any level of use - usually burnt out hippie types. Both of these can be dismissed out of hand”.
The truth, and you have to remember that it is only now that we are gathering sufficient research to understand the effects of cannabis, appears to lie somewhere between the two. The Australian Drug Foundation recommends that there is no safe level of drug use. At the same time the evidence strongly suggests, not surprisingly, that the harms described above are directly associated with the amount, regularity and strength of cannabis consumed.
So what approach should we take to reduce harm? Last year, the (Victorian) Premier’s Drug Prevention Council undertook research among 13-29 year olds, both users and non-users, to find out what messages work to reduce uptake and harms. The response was clear. We should focus on the physical side effects of long-term and heavy marijuana use, such as depression and anxiety, as well as the social downsides, such as loss of friends and the effects on family, using graphic imagery and realistic situations.
The young people we interviewed advised against using blanket approaches such as “just say no to cannabis”, or campaigns which stereotyped users with moralistic overtones. They also advised against saying using cannabis can’t ever be fun or doesn’t have upsides (because for many, it can and does), and said it shouldn’t be delivered by medical professionals or government officials (so that counts me out).
This advice coincides with some good news. Dr Cameron Duff, director of the Centre for Youth Drug Studies at the Australian Drug Foundation, has been looking at trends in Australia over the past six years. Recent use of cannabis among 14-19 year old Australians has almost halved from 1998 to 2004, and has dropped from 44 per cent among 20-29 year olds in 1998 to 32 per cent in 2004.
Asked about the decline, Dr Duff replied saying that other research is showing some very interesting cultural shifts which include the growing perception that the cannabis “high” doesn’t look like as much fun as it has in the past. They also report knowing friends with physical and social problems related to cannabis.
There is no doubt we are doing better in Australia, but that we still don’t stack up well enough compared to other countries. Adult usage rates are higher in Australia (15 per cent) than in all other English-speaking countries such as New Zealand 13.4 per cent, the UK 10.6 per cent and the USA at 9.3 per cent. And we have higher levels than a country like the Netherlands which has much more liberal laws.
Our challenge is to ensure that the harm from drugs like cannabis, just as with tobacco and alcohol, is reduced to an absolute minimum. To do that we need to improve our collective knowledge about the potential harms of cannabis, our community awareness and provision of treatment and care.
Rebecca was lucky. She realised that she had a problem when it began costing her more than money. She has an exhausted but supportive family, she’s been through treatment, and, as they say in the trade, she’s been clean - for three years.