To Whom it may concern

On behalf of Drug Free Australia and our coalition of drug prevention researchers, we wish to commend to you, research that could well be a game-changer in informing and preventing a large proportion of Australia’s substance use issues.

The research is in various stages of development and a synopsis of current and emerging research, being done by Dr Stuart Reece and Professor Gary Hulse should be of genuine interest for all Australian Health Professionals. However, it appears that, to date, too many of the world’s researchers have placed this important research in the ‘too hard’ basket, similar to the way the NHS in the United Kingdom did with research into Pandemics.

At present the COVID-19 pandemic and how it is being addressed, should be a ‘wakeup call’ to Australian health authorities that prevention is the single most important goal. A ‘Harm Minimisation’ only approach, fails to achieve best-practice primary prevention outcomes. The passive discounting of the primary pillar of the National Drug Strategy – Demand Reduction over the last 30 years (and particularly the last 10) has seen a very large increase in illegal drug use in this nation.

The only exception to this has been seen in the correct and full use of both demand and supply reduction on the drug Tobacco. There has been little or no use of harm reduction mechanisms and a relentless and unified approach to abstinent/cessation modelling and it has worked spectacularly well, seeing Australia with, arguably, the lowest daily tobacco use in the world.

The research, that we now summarise, should not be placed in Australia’s ‘too hard’ basket. Rather, it warrants recognition by all Australian Health authorities for the world break-through that it is. Such evidence-based data offers timely insights that should promote and resource primary prevention and demand reduction.

Synopsis of the research:
1. Canadian Cannabis Consumption and Patterns of Congenital Anomalies: An Ecological Geospatial Analysis Albert Stuart Reece, MBBS(Hons), FRCS(Ed), FRCS(Glas), FRACGP, MD(UNSW), and Gary Kenneth Hulse, BBSc(Hons), MBSc, PhD
https://journals.lww.com/journaladdictionmedicine/Abstract/publishahead/Canadian_Cannabis_Consumption_and_Patterns_of.99248.aspx

Status
Mapping showed cannabis use was more common in the northern Territories of Canada in the Second National Survey of Cannabis Use 2018. Total congenital anomalies, all cardiovascular defects, orofacial clefts, Downs syndrome and gastroschisis were all found to be more common in these same regions and rose as a function of cannabis exposure.

When Canada was dichotomized into high and low cannabis use zones by Provinces v Territories the Territories had a higher rate of total congenital anomalies 450.026 v 390.413 (O.R.=1.16 95%C.I. 1.08-1.25, P=0.000058; attributable fraction in exposed 13.25%, 95%C.I. 7.04–19.04%). In geospatial analysis in a spreml spatial error model cannabis was significant both alone as a main effect (P<2.0×10-16) and in all its first and second order interactions with both tobacco and opioids from P<2.0×10-16.

Conclusion:

These results show that the northern Territories of Canada share a higher rate of cannabis use together with elevated rates of total congenital anomalies, all cardiovascular defects, Down’s syndrome and gastroschisis. This is the second report of a significant association between cannabis use and both total defects and all cardiovascular anomalies and the fourth published report of a link with Downs syndrome and thereby direct major genotoxicity.

The correlative relationships described in this paper are confounded by many features of social disadvantage in Canada’s northern territories. However, in the context of a similar broad spectrum of defects described both in animals and in epidemiological reports from Hawaii, Colorado, USA and Australia they are cause for particular concern and indicate further research.

139 References – click on this link to access.
https://journals.lww.com/journaladdictionmedicine/Abstract/publishahead/Canadian_Cannabis_Consumption_and_Patterns_of.99248.aspx

2. Cannabis Consumption Patterns Parallel the East-West Gradient in Canadian Neural Tube Defect Incidence – An Ecological Study
https://www.researchgate.net/publication/337911618_Cannabis_Consumption_Patterns_Explain_the_East-West_Gradient_in_Canadian_Neural_Tube_Defect_Incidence_An_Ecological_Study

Status:
Whilst a known link between prenatal cannabis exposure (PCE) and anencephaly exists, the relationship of PCE with neural tube defects (NTD’s) generally has not been defined. Published data from Canada Health and Statistics Canada was used to assess this relationship. Both cannabis use and NTDs were shown to follow an east-west and north-south gradient. Last year cannabis consumption was significantly associated (P<0.0001; Cannabis use: time interaction P<0.0001). These results were confirmed when estimates of termination for anomaly were used. Canada Health population data allowed the calculation of an NTD O.R.=1.27 (95%C.I. 1.19-1.37; P<10-11) for high risk provinces v. the remainder with an attributable fraction in exposed populations of 16.52% (95%C.I. 12.22-20.62). Data show a robust positive statistical association between cannabis consumption as both a qualitative and quantitative variable and NTDs on a background of declining NTD incidence. In the context of multiple mechanistic pathways these strong statistical findings implicate causal mechanisms.

82 References – click on this link to access.
https://www.researchgate.net/publication/337911618_Cannabis_Consumption_Patterns_Explain_the_East-West_Gradient_in_Canadian_Neural_Tube_Defect_Incidence_An_Ecological_Study

3. Cannabis exposure as an interactive cardiovascular risk factor and accelerant of organismal ageing: a longitudinal study. Response to Lane
https://bmjopen.bmj.com/content/6/11/e011891.responses

Status:
We wish to thank Dr Lane for his interest in our study. We are pleased to see statistical input to the issues of cannabis medicine as we feel that sophisticated statistical methodologies have much to offer this field.

Most of the concerns raised are addressed in our very detailed report. As described our research question was whether, in our sizeable body of evidence (N=13,657 RAPWA studies), we could find evidence for the now well-described cannabis vasculopathy and what such implications might be. As this was the first study of its type to apply formal quantitative measures of vascular stiffness to these questions it was not clear at study outset if there would be any effect, much less an estimate of effect size. In the absence of this information power calculations would be mere guesswork. Nor indeed are they mandatory in an exploratory study of this type. Similarly the primary focus of our work was on whether cannabis exposure was an absolute cardiovascular risk factor in its own right, and how it compared to established risk factors. Hence Table 2 contains our main results. The role of Table 1 is to illustrate the bivariate (uncorrected) comparisons which can be made, show the various groups involved, and compare the matching of the groups. It is not intended to be a springboard for effect-size-power calculations which are of merely esoteric interest.
Calculations detailing the observed effect size are clearly described in our text being 11.84% and 8.35% age advance in males and females respectively.

Mixed-effects models are the canonical way to investigate longitudinal data given a usual random error structure 1. We agree with Lane that unusual error structures can affect significance conclusions. Diagnostic tests run on our models confirm that the residuals had the usual spheroidal error structure so that the application of mixed-effects models in the classical way is quite satisfactory. Another way to investigate this issue is that of incremental model building comparing models with and without cannabis exposure terms. If one considers regression equations from our data with cannabis use treated either as a categorical (RA/CA ~ Days_Post-Cannabis * BMI + * Cannabis_Category) or a continuous (RA/(CA*BMI) ~ Cigs*SP + * Cannabis_Use +Chol+DP+HDL+HR+CRH) variable one notes firstly that terms including cannabis use remain significant in final models (after model reduction) and secondly that models which include cannabis exposure are significantly better than ones without (Categorical: AIC = 1088.56 v. 1090.22, Log.Ratio = 19.62, P = 0.0204; Continuous: AIC = 412.33 v. 419.73, Log.Ratio = 9.37, P = 0.0022). Unfortunately formatting rules for BMJ Rapid Responses do not allow us to include a detailed table of regression results in each model in the present reply. We also note that AIC’s are little used in our report, and simply indicate the direction of the ANOVA results comparing models linear, quadratic and cubic in chronological age. They also appear routinely in the display of mixed-effects model results. Their use in such contexts is methodologically unremarkable. Control groups are also spelled out in fine detail in Table 1, in all our Figures and in the text.

We are aware that various algorithms for vascular age have been reported in the literature. The list proposed by Lane is correct but non-exhaustive. Such algorithms are generally derived from known cardiovascular risk factors. As clearly stated in our report the algorithm for vascular age we employed is derived from the proprietary software used. As such its details have not been publicized and indeed are commercially protected information.

We have however been assured by AtCor on many occasions that it includes measures of chronological age, sex, arterial stiffness and height (which is important as it dictates distance and thus speed parameters for the reflected and augmented central arterial pressure waves) and is very well validated and tested. AtCor recently advised that their algorithm is based on a very large series of studies done with arterial stiffness published in 2005 2. As such it has distinct advantages over algorithms which do not include indices of arterial stiffness. The AtCor website includes a very interesting, informative and educative animated loop which clearly illustrates the complex relationship between chronological and vascular age as a function of arterial stiffness and vascular tone 3

We are keen to see advanced statistical methods applied to such questions. We are becoming interested in geospatial and spacetime analyses and its application to the important questions of cannabis epidemiology 4. We find the very breadth of the organ systems impacted by cannabis to be quite remarkable with effects on the brain, cardiovasculature, liver, lungs, testes, ovaries, gastrointestinal, endocrine, reproductive and immune systems being well described and constituting most of the body’s major systems 5 6. Testicular and several pediatric cancers have also been described as being cannabis-associated 5. Such a multisystem generality of toxicity suggests to us that some basic cellular functions may be deleteriously affected – as implied by its well described mitochondriopathy 7, its heavy epigenetic footprint 8, accelerated aging as described in our present report 9 or some multi-way interaction between these and other processes. Given that the cannabis industry is presently entering a major commercialization growth phase, and given the multigenerational implications of mitochondriopathy-epigenotoxicity (by direct: substrate supply including ATP, NAD+ and acetate; and indirect: RNA transfer and malate-aspartate and glycerol-3-phosphate shuttle; pathways 10) further study and elucidation of these points is becoming an increasingly imperative international research priority.

Apropos of the recent Covid-19 pandemic emergency it is also worth noting that since cannabis is immunosuppressive, is known to be damaging to lungs and airways and often carries chemical, microbial and fungal contaminants cannabis use and cannabis vaping is also likely to have a deleterious effect on the coronavirus epidemic. Such data implies an untoward convergence of two public health epidemics. Appropriate controls on cannabis use imply improved public health management of SARS-CoV-2.

10 References – click on this link to access. https://bmjopen.bmj.com/content/6/11/e011891.responses

4. Cannabis Teratology Explains Current Patterns of Coloradan Congenital Defects: The Contribution of Increased Cannabinoid Exposure to Rising Teratological Trends.
https://www.researchgate.net/publication/334368364_Cannabis_Teratology_Explains_Current_Patterns_of_Coloradan_Congenital_Defects_The_Contribution_of_Increased_Cannabinoid_Exposure_to_Rising_Teratological_Trends/link/5d2d4d39a6fdcc2462e3097c/download

Status
Rising Δ9-tetrahydrocannabinol concentrations in modern cannabis invites investigation of the teratological implications of prenatal cannabis exposure.

Data from Colorado Responds to Children with Special Needs (CRCSN), National Survey of Drug Use and Health, and Drug Enforcement Agency was analyzed. Seven, 40, and 2 defects were rising, flat, and falling, respectively, and 10/12 summary indices rose. Atrial septal defect, spina bifida, microcephalus, Down’s syndrome, ventricular septal defect, and patent ductus arteriosus rose, and along with central nervous system, cardiovascular, genitourinary, respiratory, chromosomal, and musculoskeletal defects rose 5 to 37 times faster than the birth rate (3.3%) to generate an excess of 11 753 (22%) major anomalies. Cannabis was the only drug whose use grew from 2000 to 2014 while pain relievers, cocaine, alcohol, and tobacco did not. The correlation of cannabis use with major defects in 2014 (2019 dataset) was R = .77, P = .0011. Multiple cannabinoids were linked with summary measures of congenital anomalies and were robust to multivariate adjustment.

66 References – click on this link to access
https://www.researchgate.net/publication/334368364_Cannabis_Teratology_Explains_Current_Patterns_of_Coloradan_Congenital_Defects_The_Contribution_of_Increased_Cannabinoid_Exposure_to_Rising_Teratological_Trends/link/5d2d4d39a6fdcc2462e3097c/download

5. Impacts of cannabinoid epigenetics on human development: reflections on Murphy et. al. ‘cannabinoid exposure and altered DNA methylation in rat and human sperm’ epigenetics 2018; 13: 1208-1221.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773386/pdf/kepi-14-11-1633868.pdf
Status

ABSTRACT Recent data from the Kollins lab (‘Cannabinoid exposure and altered DNA methylation in rat and human sperm’ Epigenetics 2018; 13: 1208–1221) indicated epigenetic effects of cannabis use on sperm in man parallel those in rats and showed substantial shifts in both hypo- and hyper-DNA methylation with the latter predominating. This provides one likely mechanism for the transgenerational transmission of epigenomic instability with sperm as the vector. It therefore contributes important pathophysiological insights into the probable mechanisms underlying the epidemiology of prenatal cannabis exposure potentially explaining diverse features of cannabis-related teratology including effects on the neuraxis, cardiovasculature, immune stimulation, secondary genomic instability and carcinogenesis related to both adult and pediatric cancers. The potentially inheritable and therefore multigenerational nature of these defects needs to be carefully considered in the light of recent teratological and neurobehavioural trends in diverse jurisdictions such as the USA nationally, Hawaii, Colorado, Canada, France and Australia, particularly relating to mental retardation, age-related morbidity and oncogenesis including inheritable cancerogenesis.

Increasing demonstrations that the epigenome can respond directly and in real time and retain memories of environmental exposures of many kinds implies that the genome-epigenome is much more sensitive to environmental toxicants than has been generally realized. Issues of long-term multigenerational inheritance amplify these concerns. Further research particularly on the epigenomic toxicology of many cannabinoids is also required. 

206 References – click on this link to access

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773386/pdf/kepi-14-11-1633868.pdf

6. Canadian Cannabis Consumption and Patterns of Congenital Anomalies: An Ecological Geospatial Analysis.
https://www.ncbi.nlm.nih.gov/pubmed/32187114

Status:
These results show that the northern Territories of Canada share a higher rate of cannabis use together with elevated rates of total congenital anomalies, all cardiovascular defects, Down’s syndrome and gastroschisis. This is the second report of a significant association between cannabis use and both total defects and all cardiovascular anomalies and the fourth published report of a link with Downs syndrome and thereby direct major genotoxicity. The correlative relationships described in this paper are confounded by many features of social disadvantage in Canada’s northern territories. However, in the context of a similar broad spectrum of defects described both in animals and in epidemiological reports from Hawaii, Colorado, USA and Australia they are cause for particular concern and indicate
further.

139 references – click on this link to access https://www.ncbi.nlm.nih.gov/pubmed/32187114

7. The Potential Association Between Prenatal Cannabis use and Congenital Anomalies
https://journals.lww.com/journaladdictionmedicine/Citation/9000/The_Potential_Association_Between_Prenatal.99243.aspx

Status:
Rates of prenatal cannabis use are likely to rise with legalization, increasing social tolerability, and promotion in social media. Cannabis consumption does not appear to be a benign activity, and there may be significant risk factors to the developing fetus when used in pregnancy. Even as epidemiological data continue to emerge, The American College of Obstetricians and Gynecologists and The Society of Obstetricians and Gynecologists of Canada recommend that women avoid the use of cannabis during pregnancy.14 Whether we will definitively establish the risk of prenatal cannabis use on congenital anomalies using epidemiological approaches remains unclear; however, combing data from ecological and patient-level approaches will be crucial. Patient engagement and increasing awareness of the health implications of cannabis are critical first steps to highlight the potential risks of cannabis use in pregnancy.

14. References – click on this link to access
https://journals.lww.com/journaladdictionmedicine/Citation/9000/The_Potential_Association_Between_Prenatal.99243.aspx

8. America Addresses Two Epidemics – Cannabis and Coronavirus and their Interactions: An Ecological Geospatial Study
Status: Embargoed until publication.

Question: Since cannabis is immunosuppressive and is frequently variously contaminated, is its use associated epidemiologically with coronavirus infection rates?

Findings: Geospatial analytical techniques were used to combine coronavirus incidence, drug and cannabinoid use, population, ethnicity, international flight and income data. Cannabis use and daily cannabis use were associated with coronavirus incidence on both bivariate regression and after multivariable spatial regression with high levels of statistical significance. Cannabis use quintiles and cannabis legal status were also highly significant.

Meaning: Significant geospatial statistical associations were shown between cannabis use and coronavirus infection rates consistent with mechanistic reports and environmental exposure concerns.

Extracts from Abstract:

Results. Significant associations of daily cannabis use quintile with CVIR were identified with the highest quintile having a prevalence ratio 5.11 (95%C.I. 4.90-5.33), an attributable fraction in the exposed (AFE) 80.45% (79.61-81.25%) and an attributable fraction in the population of 77.80% (76.88-78.68%) with Chi-squared-for-trend (14,782, df=4) significant at P<10-500. Similarly when cannabis legalization was considered decriminalization was associated with an elevated CVIR prevalence ratio 4.51 (95%C.I. 4.45-4.58), AFE 77.84% (77.50-78.17%) and Chi-squared-for-trend (56,679, df=2) significant at P<10-500. Monthly and daily use were linked with CVIR in bivariate geospatial regression models (P=0.0027, P=0.0059). In multivariable additive models number of flight origins and population density were significant. In interactive geospatial models adjusted for international travel, ethnicity, income, population, population density and drug use, terms including last month cannabis were significant from P=7.3×10-15, daily cannabis use from P=7.3×10-11 and last month cannabis was independently associated (P=0.0365).

Conclusions and Relevance. Data indicate CVIR demonstrates significant trends across cannabis use intensity quintiles and with relaxed cannabis legislation. Recent cannabis use is independently predictive of CVIR in both bivariate and multivariable adjusted models and intensity of use is significant in several interactions. Cannabis thus joins tobacco as a SARS2-CoV-2 risk factor.

Summary and Conclusions

The above research clearly shows the links with substance use and Mental illness, Autism, Congenital anomalies and Paediatric cancer including testicular cancer with marijuana use and abuse. Drug Free Australia respectfully and urgently requests a Position Statement and proposed actions from your Department regarding this research and how it can be further promoted and supported within Australia. We look forward to your timely response.

You can find a list of list of Ngo’s and Medical Professional who written support for Drug Free Australia’s Response to the commercialization of Cannabis/Marijuana/CBD in Australia

https://drugfree.org.au/images/pdf-files/homepagepdf/DRReeceSupport2020_updated6May2020.pdf.

Yours sincerely
Major Brian Watters AO B.A.
President
Drug Free Australia
PO Box 379
Seaford, SA 516

 

Tragically, the last few months of music festivals repeatedly resembled scenes from a hospital emergency ward, witnessing this season’s highest number of drug related hospitalisations and the deaths of predominately young adults ranging from 19 to 25 years-old.
In the aftermath of these heart wrenching events, harm reduction advocates have taken to media on mass advocating for pill testing as the next risk minimisation strategy that could potentially save lives.
Often, supporters are quick to highlight that pill testing is “not a silver bullet”, just one measure among a plethora of strategies. But the metaphor is a false equivocation. Rather, pill testing is more like Russian Roulette.
Similar to Russian Roulette, taking psychotropic illicit drugs is a deadly, unpredictable high stakes ‘game’. It’s the reason they’re illegal. There is no ‘safe’ way to play.
But arguments and groups supporting pill testing construct this false perception, regardless of how strenuously advocates claim otherwise. Organisations such as STA-SAFE, Unharm, Harm Reduction Australia, the ‘Safer Summer’ campaign all exploit the context of harm and safety within an illicit drug taking culture.
To continue the metaphor of Russian Roulette, it’s rather like insisting on testing a ‘bullet’ for velocity or the gun for cleanliness and handing both back. It’s pointless. The bullet might not kill at first, but the odds increase exponentially after each attempt.

No Standard Dose Available and the Limitations of Pill Testing
In reality, no testing of the hundreds of new psychoactive substances flooding nations every year can make a dose safe.

As Drug Watch International succinctly puts it, “Most people have been conned into using the word ‘overdose’ regarding illicit drugs. No such thing. Why? Because it clearly implies there is a ‘safe’ dose which can be taken – and everyone knows that’s a lie. The same goes for the words, ‘use’ and ‘abuse’. Those terms can only be applied to prescribed pharmaceuticals because they have a prescribed safe dose. I have asked each jurisdiction in Australia if the legal amount of alcohol when driving, up to 0.49, is considered safe for driving. All said no – they would not state that.”
These substances remain prohibited because they are not manufactured to a pharmaceutical standard and are poisonous, unpredictable toxins that make it impossible to test which dose either in isolation or in a myriad of combinations proves fatal.
The limitations of pill testing4 have been discussed by Dr John Lewis (University of Technology Sydney) and prominent toxicologist Dr John Ramsey, emphasising that it is:
• Complex process
• Costly and time consuming
• Detects mainly major components of a sample that may not be the active substance
For example, even a relatively small amount of ingredients such as Carfentanil are lethal.
Speaking after Canberra’s pill trial in 2017, forensic toxicologist, Andrew Leibie, warned that pill testing trial is no “magic bullet” for preventing drug deaths but also expressed deep concern surrounding the freedom for scientific debate because public sector employees feared repercussions.

Leading harm reduction activist, Dr David Caldicott, in a 2015 interview admitted that the quality and type of pill testing would affect pill taking behaviour at festivals. When told that users potentially wouldn’t get their drugs back and the lengthy 45-minute process involved, “‘I think there’ll be a lot of people who will say forget it completely.’ His reasoning being that a lot of young people don’t have the money to spare a pill and it would slow down the momentum of the party.”

Could this be the motivation behind current trial of pill testing at Goovin’ the Moo where volunteering attendees where given the choice between testing the entire pill – effectively destroying it – or scraping the contents and handing back the remainder, despite the fact that the latter approach brings even less accuracy. This is another example of drug users, not evidence informing policy procedure.
The irony of course is that many of the advocates for pill testing would object to sugary drinks, foods and caffeinated energy drinks in school cafeterias on the basis these hinder the normal development of healthy children but do not object to the infinitely direr situation facing kids at music festivals.

Purity vs Contaminated – Another Misleading Contrast
The fallacious arguments surrounding safe dosage remain the same irrespective of whether the substance is tested as seemingly pure. Take MDMA that goes by various street names Molly and Ecstasy. It is the most popular recreational drug in Australia and was responsible for many of the deaths at music festivals.
In 1995, 15-year old, Anna Woods, died after several hours from consuming a single pill of pure MDMA at a Rave Party. Pill testing would not have changed this outcome. Anna’s case also highlights the idiosyncratic nature of drug taking in that while her three friends ingested the same tablets, Anna was the only one to have a reaction. Russian Roulette is again the most appropriate metaphor.
The Coroner’s report on Anna Wood’s death stated, “It is not unlikely that a tragedy such as this will occur again in N.S.W. In an effort to reduce the chance of that happening, I propose to recommend that the N.S.W. Health Department publishes a pamphlet, which will have the twofold effect of educating those who use the drug as to its dangers, and also educating the community as to the appropriate care of the individual who becomes ill following ingestion of the drug.”
Nearly twenty-five years later the fatalities involving MDMA keep mounting. In the only Australian study of 82 drug related deaths between 2001 to 2005, MDMA featured predominately. The fluctuating potency of this drug is further established as it is not only fifteen-year-old girls but grown men dying.

“The majority of decedents were male (83%), with a median age of 26 years. Deaths were predominantly due to drug toxicity (82%), with MDMA the sole drug causing death in 23% of cases, and combined drug toxicity in 59% of cases. The remaining deaths (18%) were primarily due to pathological events/disease or injury, with MDMA a significant contributing condition.”
The indiscriminate nature of MDMA was also witnessed with the latest fatalities at music festivals. For example, very different amounts of MDMA accounted for the five young people that died across New South Wales.
“In one case, a single MDMA pill had proved lethal while another young man who ingested six to nine pills over the course of the day had an MDMA purity of 77 per cent… (That is) a very high rate of purity,” Dr Dwyer said.”
Comparable stories are found all over the world including the UK case of Stephanie Jade Shevlin that is eerily similar to Anna Woods.
Drug dealers aware of the naïvely misleading narrative of pure and impure illicit drugs have been caught bringing pill testing kits to concerts in a bid to convince potential buyers of quality and hike up prices.

High Risk-Taking Culture

The prevailing culture at music festivals is one of blissful abandon and haste. It is a no longer fringe groups at the edges of society but the mainstream choice for generations of children and young adults fully embracing the legacy of, “tune in, turn on and drop out”.
Yet despite the prevailing culture, harm reductionists insist that pill testing will better inform partygoers of drug contents and provide the necessary platform for ‘further conversations about the drug dangers.’ (All of which of course can be achieved outside a venue.)
But this is conjecture and another attempt at experimental based policy.
As cited earlier, Dr Caldicott admitted, anything that stops the party momentum experience is likely rejected. This is because when dealing with high-risk behaviour removing too many risks takes away the thrill of reward.

In an age that has more educated men and women than ever before, it’s not the lack of information that is driving this level of experimentation but the growing indifference to it.
In the aftermath of the death of 25-year-old pharmacist, Sylvia Choi (2015), it was discovered that security staff at the Stereosonic festival were consuming and dealing drugs.
Further, the report often cited purporting to show a growing body of research for drug users wanting pill testing actually confirms that those with college degrees were less likely than those with high school qualifications to test their pills.
This seems to be a trend in Australia also with one judge fed up with groups of “well-off pill poppers” and “privileged” young professionals, including nurses and bankers – filling the court.
Another article describes the attitude of drug taking among festival goers (including University students) as not so much concerned about what is on offer but demand for cheap designer drugs.
The author notes, “A few deaths don’t deter experimentation, and if you’re going to experiment, you need to be sure you don’t die.”
But the determination for experimentation with different forms of self-destructive drugs is making staying alive increasingly less likely, as the levels of polydrug use is also on the rise.
According to Global Drug Survey, “Over 90% of people seeking Emergency Medical Treatment each year after MDMA have used other drugs (often cocaine or ketamine) and/or alcohol and more frequent use of MDMA is associated with the higher rates of combined MDMA use with other stimulant drugs and ketamine.”

Australia’s enquiry into MDMA supports this finding, “Nevertheless, the fact that half of the toxicology reports noted the detection of methamphetamine in the blood is consistent with the polydrug use patterns of living MDMA users.”

Pill Testing Overseas Failing to Stop Drug Demand and Supply

The push continues for Australia to adopt front of house or front-line pill testing at music festivals as in Europe and the UK. But not everyone is convinced of its resounding success.
Last year, UK’s largest festival organiser reversed its previous support for drug testing facilities. Managing director, Melvyn Benn, stating, “Front of house testing sounds perfect but has the ability to mislead I fear.”
Mr Benn details those fears, “Determining to a punter that a drug is in the ‘normal boundaries of what a drug should be’ takes no account of how many he or she will take, whether the person will mix it with other drugs or alcohol and nor does it give you any indicator of the receptiveness of a person’s body to that drug.”
In 2001, The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) produced its scientific report, On-Site Pill-Testing Interventions In The European Union.
Incomplete evaluation procedures have hindered the availability for empirical evidence on the effectiveness of pill testing. “The conclusions one can draw from that fact remain ambiguous.”
Perhaps the most disturbing feature of the report is the admission that decreasing black market activity isn’t within the scope of pill testing goals. “Overall, to alter black markets is ‘not a primary goal’ or ‘no goal at all’ for most pill-testing projects.” Within that same report drug users are classed as ‘consumers’ with an entitlement to know what their pills contain.
The report goes on to list the range of services offered alongside pill testing at venues. These include everything from: brain machines, internet consultations, needle exchange, presenting on-site results of pill-testings, chill-out zones, offering massage, giving out fruits, giving out free drinking water and giving out condoms.
And in another twist of just how far the common sense boundaries are stretched, for number of participating nations, tax payer funded pill testing is also offered at illegal rave venues.

Given the overwhelming lack of evidence that pill testing indeed saves lives, Australian toxicologist, Andrew Liebie’s claim is not easily dismissed, “the per capita death rate from new designer drugs was higher in Europe – where pill testing was available in some countries – than in Australia.”
The antipathy to drug taking was also witnessed by the Ambulance Commander at the latest pill testing trial, again in Canberra, Groovin’ the Moo.

No War on Drugs Just a Submission to Harm Reduction Promotion
The narrative for pill testing will at some stage mention the failed “war on drugs” and by association hard line but failing law enforcement measures either explicitly or implicitly such as in the statement below.
“Regardless of the desirability of treating it as a criminal issue rather than a health one, policing at festivals has limited impact on drug consumption, as research presented at the Global Cities After Dark conference last year suggests: 69.6 per cent of survey respondents said they would use drugs if police were present.”
But what this article completely fails to grasp is that police presence makes little impact because the law is rarely or, at best, laxly enforced and a climate of de facto decriminalisation has been the norm for decades. This was the situation with Portugal before finally decriminalising drugs for personal use in 2001.
Journalists for The Weekend Australian attempting to report events at a recent dance party stated sniffer dogs did nothing to stop the “rampart” stream of drugs. They described a scene of disarray; discarded condoms with traces of coffee grounds within toilets (believed to mask the smell of drugs), bodies strewn on the ground littered with drug paraphernalia, others were rushed to waiting ambulances, while one attendant told them “I got away with it” and another admitting popping two pills a night was “average”. Had they been allowed to stay longer maybe more party goers would be openly stating what many know, drugs supply and demand are at all-time highs irrespective of police presence.

Journalists instead were treated as criminal trespassers, threatened by security and ordered to leave under police escort.
The basis of Australia’s National Drug Strategy includes harm minimisation efforts as part of an overall strategy that also supports reductions in drug supply and demand.
The inadvertent admission that pill testing is not about curbing drug demand comes from another harm reduction stalwart, Alex Wodak, “It’s a supposition that this (pill testing) might increase drug use, but if it does increase drug use but decrease the number of deaths, surely that’s what we should be focusing on.”
In fact, Dr Wodak confirms that pill testing would incentivise drug dealers to provide a better product. “There was no commercial pressure on drug dealers to ensure their products were safe. But if we had testing and 10% of drug dealer A’s supply was getting rejected at the drug testing counter, then word would get around.”
A similar focus on consequences rather than causes is expressed by Dr David Caldicott, “I don’t give a s**t about the morality or philosophy of drug use. All I care about is people staying alive.”
In other words, take the pill, just don’t die…this time. What the long-term affects are to those drug users that survive hospitalisation, the impact on development, mental health, employment loss, families, the growing cost to taxpayers and the crushing weight on emergency services, hospitals and physicians let alone the constant appetite and entrenchment for more drugs will have to wait. Just don’t die.
The ongoing dilution of law enforcement is also seen by various experts all but demanding that police and sniffer dogs be removed entirely from music festivals. No doubt to be replaced with on-site massages, electrolyte drinks, brain machinery, chill out zones, fruit and more free condoms.
Prof Alison Ritter from the University of NSW and Fiona Measham from the University of Durham both agree that intensive policing combined with on-site dealing “could significantly increase drug related harm.” How intensive could police efforts be with such blatant on-site dealing was not explained.

The Unrelenting Push for Drug Legalisation
The real end game behind the dubious safety and harm messaging is drug legalisation. Pill testing, minus the caveat of being called a ‘trial’, would unlikely find full approval without a corresponding change in the law.
The limitations of pill testing and the legal ramifications in giving back a tested pill that proved lethal would become a public liability minefield.
This is clearly seen from the article in the Daily Telegraph, Pill Test Death Waiver Revealed, Jan 5, “The testing capabilities are so limited that revellers would be required to sign a death waiver, which includes a warning that tests cannot accurately determine drug purity levels or give any indication of safety.”
Later the article reports, “Mr Vumbaca said he had been given extensive legal advice to include the warnings on the waiver because of the limitations of testing information … we are not a laboratory and we have one piece of equipment … the test gives you an indication of purity, but you can’t tell the exact amount.”
The waiver would release everyone in testing from, “any liability for personal injury or death suffered … in any way from the services.”
Scattered within the pages of countless articles on pill testing released over the last few months, this admission of pill testing tied in within a broader agenda of drug legalisation is repeatedly made but easily missed among the hype.
Gary Barns from the Australian Lawyers Alliance said the latest deaths could be avoided or risk of death could be minimised with a “law change”.
Sydney Criminal Lawyers are more explicit, “And it seems clear that if adults were able to purchase quality controlled MDMA over the counter in plain packaging with the contents marked on the side, it would be far safer than buying from some backyard manufacturer with no oversight or guarantees.”
And disappointingly, even former AFP and DPP speaking on Four Corners state drug legalisation as a necessary public conversation.
It seems that these same advocates for policy and law change are willing to give a platform for the rights of those determined to self-destruct but not the rest of the law abiding community and their common good.

Pill testing – The Climate Change of Drugs
If comparing pill testing as a ‘silver bullet’ was an inaccurate metaphor, then the comparison to climate change shows the extent of not only erroneous but deliberate obfuscation. “This issue of pill-testing is climate change for drugs,” says Dr David Caldicott.
And yet the dark environment which produces the pills and wreaks so much unnecessary destruction to countless thousands of people all over the world is never fully understood or exposed to those that would blissfully take one small pill for a few hours of entertainment.
But talk of boycotting products that pollute the atmosphere, meat that is packaged from abused animals, clothing produced from exploited workers, or products genetically modified, most likely those same illicit pill takers would passionately relinquish and possibly even risk their personal safety to protest these injustices.
Yet, these are dwarfed by illicit drugs. The most barbaric network of human, economic and environmental exploitation.
Some of the social miseries are well known, including international crime syndicates and narco-terrorism. While others such as environmental damage due to deforestation, chemical waste and the recent drug toxicity detected in Adelaide waterways are often overlooked in an age of socially conscientious consumerism.
But the list of downward consequences is always local and personal, with illicit drugs linked to preventable death, disease and poverty. In cases of domestic violence, alcohol and drugs contributed to 49 per cent of women assaulted in the preceding 12 months.

Those who suffer the most are those who can least afford the consequences; the poor, young, vulnerable, indigenous and rural communities as revealed in the Australian Criminal Intelligence Commission report.
Faced with such overwhelming statistics pro-drug lobbyists use inevitability mantras such as, “they’re doing it anyway” to sway public opinion toward legalisation; but fail to apply the same arguments to other societal abuses such as paedophilia, obesity, gambling, domestic violence, alcohol or tobacco.
It is time to stop the dishonest rhetoric of harm reductionist activists and the deliberate intellectual disconnect that has greatly influenced the Australian government drug strategy and peak medical bodies toward policies emphasising reducing drug harms (injecting rooms, needle distribution, methadone and now pill testing) while minimising the need to reduce demand and supply.
Eleni Arapoglou
– Writer and Researcher, Drug Advisory Council of Australia (DACA)

Source: PillTestingDACA_PoliticianBrief05-02-19.pdf (drugfree.org.au) February 2019

Abstract

Researchers in Australia released the results of a new study examining the consequences of long-term marijuana use that began in adolescence or young adulthood. A total of 1,792 participants were included in the longitudinal study spanning 20 years (from ages 15-35). Investigators found that compared to non-users, both young‐adult and adolescent‐onset regular users were 20 times more likely to have used other illicit drugs, 4 times more likely be heavy drinkers, and 7 times more likely to be daily tobacco smokers. There were also less than half as likely as non-users to be in romantic relationships.

Dr. Sharif Mohr, epidemiologist at Drug Free America Foundation commented, “The results of this study clearly show the negative effects of marijuana use that can follow youth far into adulthood. It also confirms marijuana’s role as a gateway drug. We’ve already learned from Colorado and other states that no matter what safeguards are in place, legal weed will always manage to find its way into the hands of young people, much to their detriment. It’s time for lawmakers to do the right thing and put an end to this disastrous large-scale experiment which only serves to enrich Big Marijuana and other players at the expense of our young people.”

Source:  https://www.dfaf.org/australian-study-demonstrates-consequences-of-youth-marijuana-use/     29^th Jan. 2021

Cannabis Use and Health 2014
Introduction

Cannabis is a group of substances from the plant cannabis sativa. Cannabis is used in three main forms: flowering heads, cannabis resin (hashish) and cannabis oil. There are more than 60 psycho-active chemicals in cannabis, including the cannabinoids:
 delta-9 tetrahydrocannabinol (THC), which is found in the resin covering the flowering tops and upper leaves of the female plant and which alters mood and produces the feeling of a ‘high’;
and
 cannabidiol, which can offset the effects of THC.

Cannabis is usually smoked, either in a hand-rolled cigarette (a ‘joint’) containing the leaf, heads or resin of the plant, or through a water-pipe (a ‘bong’) where water is used to cool the smoke before it is inhaled. In Australia, cannabis is also commonly known as gunja, yarndi, weed and dope.

Patterns of Cannabis Use in Australia and its Public Health Impacts

In 2010, cannabis was the most commonly used illicit drug in Australia. Over one third of Australians (35.4%, approximately 6.5 million) aged 14 years and over had used cannabis at least once in their lifetime, and 1.9 million of these had used cannabis recently (i.e., in the last 12
months). Recent cannabis use among those 14 years and older has increased from 9.1% in 2007 to 10.3% in 2010, though daily users decreased from 14.9% in 2007 to 13% in 2010. In 2010, approximately 247,000 Australians 14 years and over used cannabis daily. For most cannabis users, use is relatively light. Most young people have used it once or twice. However, the younger people start using cannabis, and the greater the frequency with which they use it, the greater the risk of harm.
Based on current use patterns, alcohol abuse and tobacco pose much greater harms to individual and public health in Australia than cannabis. Cannabis-related psychosis, suicide, road-traffic crashes and dependence were estimated to account for 0.2% of the total disease burden in Australia in 2003. This compares to 7.8% of the total burden attributable to tobacco use and 2.3% attributable to alcohol use. In 2004-05, the estimated social costs of cannabis use (including health, crime, road crash and labour costs) was $3.1 billion. Ninety percent of this cost was due to dependent cannabis use. In comparison, the health, crime, road-crash and labour costs of alcohol use in 2004-05 are estimated to be more than three times as much ($9.4 billion).

The Health Effects of Cannabis Use

There is a dose-response relationship between cannabis use and its effects, with stronger effects
expected from larger doses.
 Intoxicating effects occur within seconds to minutes and can last for three hours;
 Effects last longer with larger doses;
 Effects on cognitive function and coordination can last up to 24 hours;
 Short-term memory impairment may last for several weeks; and
 A single dose in a chronic user can take up to 30 days for the metabolites to be excreted.

Short-term effects of small doses
The most common short-term effects of using cannabis are:
 a feeling of euphoria or ‘high’ – with a tendency to talk and laugh more than usual;
 impaired balance, reaction time, information processing, memory retention and retrieval, and perceptual-motor coordination;
 increased heart rate;
 decreased inhibitions such as being more likely to engage in risky behaviour, e.g. unsafe
sexual practice; and
 if smoked, increased respiratory problems including asthma.

Short-term effects of large doses
The most common short-term effects of a large dose can include:
 hallucinations and changed perceptions of time, sound, colour, distance, touch and other sensations;
 panic reactions;
 vomiting;
 loss of consciousness; and
 restlessness and confusion.

The severity of these short-term effects depend on a person’s weight, tolerance to the drug, amount taken, interactions with other drugs, circumstances in which the drug is taken, and the mode of administration.

Long-term effects
The evidence associating regular cannabis use with specific long-term health conditions and adverse effects is of variable quality. Cannabis use is highly correlated with use of alcohol, tobacco and other illicit drugs, all of which have potential adverse health effects. There is sufficient evidence, however, to indicate that cannabis is a risk factor for some chronic health effects and conditions.

Regular and prolonged cannabis use may cause:
 cannabis dependence, characterised by impaired control over its use and difficulties in ceasing use; increased tolerance (meaning more of the drug is needed to produce the same effect) and possible withdrawal symptoms, including anxiety, insomnia, appetite disturbance, and
depression;
 increased risk of myocardial infarction in those who have already had a myocardial infarction;
and
 deficits in verbal learning, memory and attention (in heavy users).

While not conclusive, there is evidence that regular cannabis use can cause chronic bronchitis and impaired immunological competence of the respiratory system. Occasional cannabis use however, is not associated with adverse effects on pulmonary function. Cannabis smoke contains many carcinogens, but there is variable evidence concerning the relationship between cannabis smoking and lung cancer.

Evidence supporting an association between cannabis use and sexual and reproductive effects is weak. However, some studies show an association between cannabis use and increased risk of testicular cancer.
Daily consumption of large quantities of cannabis may lead to the neglect of other important personal and social priorities such as relationships, parenting, careers and community responsibilities.

Pregnant women
Cannabis is the most commonly used illicit drug in women of child-bearing age. Cannabis use during pregnancy has been consistently associated with lower birth-weight babies and pre-term birth, but does not appear to increase the risk of miscarriage or birth abnormalities. Some studies suggest that children exposed to cannabis in utero may have slight impairment in higher cognitive processes such as perceptual organisation and planning. There is insufficient evidence of an association between prenatal cannabis use and postnatal behaviour.

Accidental ingestion by young children
Accidental ingestion of cannabis can cause coma in young children. Cannabis ingestion can be confirmed by positive urine screening for cannabinoids. Cannabis ingestion needs to be considered in toddlers and children with impaired consciousness.

Driving under the influence of cannabis
Cannabis slows reaction time and increases the risk of having a car crash. Other risk factors are blurred vision, poor judgement and drowsiness which can persist for several hours. The effects are increased by alcohol.

Dependence and tolerance
Cannabis dependence is usually defined as impaired control over continued use and difficulty ceasing despite the harms of continued use.19 Dependence can negatively affect personal relationships, education, employment and many other aspects of a person’s life. Data from Australia and other countries indicates that demand for professional help related to cannabis is increasing. Cannabis dependence is the most frequent type of substance-dependence in Australia after alcohol and tobacco. It has been estimated that cannabis dependence will affect around one in ten cannabis users, and around half of those who use it daily. Animal and human studies demonstrate that tolerance to many of the psychological and behavioural responses to cannabis occurs with repeated exposure to the drug. The symptoms of withdrawal from cannabis appear similar to those associated with tobacco, but less severe than withdrawal from alcohol or opiates.

There is a view that the cannabis being used today has a higher THC content and potency than in the past. This may be a perception caused by changes in the mode of use (i.e. through ‘bongs’ rather than ‘joints’, and with more consumption of the heads of the cannabis plant). However, there is some independent evidence that cannabis used today can be of a higher potency. The cannabis in recent street-level seizures in Sydney and the North Coast of NSW has been shown to have a high potency, with around 15% THC, with little or no cannabidiol.

Cannabis as a Gateway Drug
The gateway hypothesis is that cannabis use may act as a causal ‘gateway’ to the use of other illicit drugs such as cocaine and heroin. It is a controversial hypothesis with proponents arguing that because the use of so-called harder drugs is almost always preceded by cannabis use, this means that cannabis use physiologically and/or psychologically causes people to progress to harder drugs. The alternative theory is known as the ‘common cause’ theory whereby a person’s use of cannabis and their later use of other illicit drugs are both seen as effects of common causes such as personal or socio-economic factors, or exposure to illicit drug distribution networks. Evidence for the gateway hypothesis is inconclusive given the difficulties in disentangling the effect of other potential influences in drug use progression. Meta-analyses suggest that the progression in use that has been observed is likely to be due partially to the influence of independent common
causes.

Cannabis and Mental Health

Cannabis and psychosis
Cannabis use is associated with poor outcomes in existing psychosis and is a risk factor for developing psychosis. For those with existing psychosis, using cannabis can trigger further episodes of psychosis, worsen delusions, mood swings, hallucinations and feelings of paranoia, as well as contributing to poor compliance with medication regimes. The research base on cannabis and psychosis has expanded in recent years with studies showing a consistent association between early-aged onset of cannabis use, regular use and a later diagnosis of schizophrenia. Meta-analyses have noted a doubling of the risk of psychotic outcomes in regular cannabis users, and earlier onset (by 2.7 years) among cannabis users who develop psychosis.
There is increasing evidence that the association between cannabis and onset of psychosis is not due to other co-occurring factors. The most plausible view is that cannabis use is a ‘contributory cause’ of psychosis in vulnerable individuals, and that it is one of a number of potential factors that can bring on psychosis (including genetic predisposition)’

Cannabis and depression
The association between cannabis use and depression is weak and insufficient to establish a causal connection. Studies that have found an association are likely to have been affected by confounding variables such as family and personality factors, other drug use and marital status.
There is currently insufficient evidence available to conclude whether cannabis use is associated with suicide. Research is made difficult by confounding factors such as the stresses of an illicit drug-dependent life and pre-existing poor mental health.

Cannabis and anxiety
There is emerging evidence associating cannabis use with anxiety disorders. However, the current level of evidence is not yet sufficient to establish a causal relationship.

Medical Uses Of Cannabis
In addition to psychoactive compounds, cannabis has constituents with other pharmacological effects, including antispastic, analgesic, anti-emetic, and anti-inflammatory actions. These constituents may have therapeutic potential.

Cannabis extracts and synthetic formulations have been licensed for medicinal use in some countries, including Canada, the USA, Great Britain and Germany, for the treatment of severe spasticity in multiple sclerosis, nausea and vomiting due to cytotoxics, and loss of appetite and cachexia associated with AIDS. The synthetic cannabis product Nabiximols (Sativex), which is delivered as a buccal spray and so avoids the harms of cannabis smoke inhalation, is effective in the management of spasticity and pain associated with multiple sclerosis. The psycho-active effects of Nabiximols can also be managed through controlling dosage.

In Australia, the synthetic cannabinoids nabilone and dronabinol are scheduled by authorities for medicinal use. Sativex is also being trialed in Australia for cancer and cannabis withdrawal. Canada has allowed the medical use of smoked cannabis if this is authorised and monitored by a doctor.
There is a growing body of evidence that certain cannabinoids are effective in the treatment of chronic pain, particularly as an alternative or adjunct to the use of opiates, when the development of opiate tolerance and withdrawal can be avoided. Controlled trials have also shown positive effects of cannabis preparations on bladder dysfunction in multiple sclerosis, tics in Tourette syndrome, and involuntary movements associated with Parkinson’s disease. Based on existing data, the adverse events associated with the short-term medicinal use of cannabis are minor.
However, the risks associated with long-term medicinal use are less well understood, particularly the risk of dependence, and any heightened risk of cardiovascular disease. Though there is a growing body of evidence regarding the therapeutic use of cannabinoids, it is still experimental.

Synthetic Cannabis
Synthetic cannabis products have been developed, usually in herbal form for smoking. These products have been marketed in Australia as ‘legal highs’ with product names such as ‘Spice’, ‘K2’, and ‘Kronic’. The psychoactive components are usually THC analogues that bind to cannabinoid receptors in the brain. These analogues are not easily detectable by routine testing, and until recently have not been captured by legislation. These synthetic cannabis products are attractive to their users because they are perceived as safe, are not easily detectable in drug tests, and until recently have not been illegal.
The synthetic cannabis products can not be considered safe given that the synthesized psychoactive substances in them have not been rigorously tested, and little is known about their long or short-term health effects, dependence potential or adverse reactions. Psychotic
symptoms have been associated with use of some synthetic cannabinoids, as well as signs of addiction and withdrawal symptoms similar to those of cannabis. Adverse outcomes have been reported from the use of Kronic in Australia.

The Control of Cannabis Use and Supply

Australian legislation
The possession, cultivation, use, and supply of cannabis is prohibited in all Australian States and Territories. In some Australian jurisdictions there are criminal penalties for the possession, cultivation and use of cannabis, and in others there are less severe civil penalties. Legislation in Australia often distinguishes between possession of small amounts of cannabis (for personal use) possession of larger amounts (trafficable quantities), and possession of even larger “commercially trafficable” quantities. The supplying of cannabis and the possession of large quantities attract criminal penalties in all Australian jurisdictions. All Australian States and Territories have diversionary schemes for minor and early cannabis offenders which require them to undertake educative and treatment programs as an alternative to receiving a criminal penalty.

Criminalisation and health
It is often thought that criminal penalties are a deterrent to cannabis use and, therefore, an effective way to prevent the health impacts and other harms associated with cannabis use. These beliefs have little foundation. A system of criminal prohibition for cannabis use applied in Australia for many years, but the incidence of cannabis use was still significant. The introduction of less serious civil penalties and diversionary alternatives to criminal sanctions did not significantly increase the rates of uptake and use among Australians.

For those who are not deterred from use by criminal penalties, criminalisation can add to the potential health and other risks to which cannabis users are exposed. These include:

 exposure of cannabis users, including teenage and occasional users, to ‘harder drugs’. Those who acquire cannabis from large scale illicit drug distribution networks will also become exposed to more harmful drugs, including the direct marketing of those drugs to them;
 exposure of cannabis users to criminal networks and activity, including exposure to the threat of violence and the risk of taking part in criminal distribution;
 the personal and health-related costs of a criminal conviction. A criminal conviction can negatively impact on a person’s employment prospects and their accommodation and travel opportunities. Limited employment and accommodation prospects can lead to poor health,
including mental health. Individuals with a criminal record are also at a disadvantage in any subsequent criminal proceedings;
 a deterrent to individuals seeking health advice, treatment and support regarding their cannabis use;
 the inability to collect high quality, reliable data regarding patterns of use and harms.

Harm reduction
A harm-reduction approach is defined as policies and initiatives that aim to reduce the adverse health, social and economic consequences of substance use to individual drug users, their families and the community. Harm reduction considers both the potential harms to individuals using substances like cannabis and the potential harms and negative impacts of the different approaches for controlling the use and supply of these substances. When harm reduction is the primary goal, the key policy focus will be on measures to reduce individuals’ harmful levels of cannabis use, or cannabis use among individuals who are most vulnerable to adverse health impacts, or cannabis use in contexts which involve serious risks to users.

Harm-reduction measures include targeted efforts to reduce the supply of cannabis and to reduce demand for it among vulnerable groups. In certain contexts, and with certain groups, measures emphasizing abstinence may also contribute, in a preventive way, to reducing harms. Policy and legislative approaches that do not effectively address cannabis-related harms or create
significant risks and adverse impacts are not consistent with harm-reduction. Prohibition of cannabis use with criminal penalties has the potential to produce harms and risks. The effectiveness of criminal prohibition of cannabis use in reducing the health-related harms
associated with cannabis use is questionable.

Treatment Options
The number of people seeking treatment for cannabis use is increasing, but most of those who experience cannabis dependence do not seek help. Many regular cannabis users do not believe they need treatment, and there is also a low awareness of the treatment options available and how to access them.
There are fewer treatment options for cannabis dependence than for alcohol or opiate dependence, and limited research on the effectiveness of different cannabis treatment options. Treatments for problematic cannabis use include psychological interventions such as cognitive
behavioural therapy and motivational enhancement, and pharmacological interventions with medications to ease the symptoms of withdrawal or block the effects of cannabis. The research on pharmacological interventions for cannabis is in its infancy, with medications still in the experimental stages of development.

Cognitive behavioural therapy helps the cannabis user develop knowledge and skills to identify risk situations when using cannabis and to modify behaviour accordingly. Motivational enhancement techniques build the cannabis user’s desire to address their problematic use. These counseling interventions are increasingly available online as web-based programs, as well as face-to-face with a counselor. Online programs have the advantage of convenience and anonymity, for those who are concerned about possible stigma. Difficulties in maintaining motivation, and limitations in personalising the programs to individual needs, are drawbacks. According to current research, web-based treatment programs may not be as effective as in-person treatment. Some problematic cannabis users have particular treatment needs, including those with cannabis dependence and mental health issues. These individuals require integrated treatment and coordinated care. General practitioners can play an important role in developing a coordinated care plan to suit the needs of these patients.

The Australian Medical Association Position
The AMA acknowledges that cannabis use is harmful and can lead to adverse chronic health outcomes, including dependence, withdrawal symptoms, early onset psychosis and the exacerbation of pre-existing psychotic symptoms. While the absolute risk of these outcomes is low and those who use cannabis occasionally are unlikely to be affected, those who use cannabis frequently and for sustained periods, or who initiate cannabis use at an early age, or who are susceptible to psychosis, are most at risk.
The AMA also recognises that cannabis use has short-term effects on cognitive and perceptual functioning which can present risks to the safety of users and others. The AMA believes that cannabis use should be seen primarily as a health issue and not primarily as a matter for law enforcement. The most appropriate response to cannabis use should give priority to policies, programs and regulatory approaches that reduce the harms potentially associated with cannabis use, and particularly the health-related harms. The positions outlined below should be read in the light of this harm-reduction principle. The AMA believes the following are the important considerations and central elements in an appropriate harm-reduction response to cannabis use.

Prevention and Early Intervention
 As younger people and those who use cannabis frequently are most at risk of harm, prevention and early intervention initiatives to avoid, delay and reduce the frequency of cannabis use in these populations are essential.
 All children should have access to developmentally appropriate school-based life-skills programs to assist in preventing or reducing potential substance use problems.
 Evidence-based information on the potential risks of cannabis use and where to seek further assistance should be widely available, particularly to young people.
 Medical professionals can play an important role in the early identification of patients they believe to be at risk of adverse health outcomes from cannabis use.
 When a cannabis user comes into contact with law enforcement or justice administration agencies this should be used as an opportunity to direct them to education, counseling or treatment. This is particularly important with young and first time or early offenders.

Diagnosis and Treatment
 Medical professionals have the knowledge and opportunity to screen for and diagnose cannabis-related disorders, including dependence, withdrawal symptoms, and cannabis induced psychosis. Referral networks and linkages should be established within regions between primary care and specialist mental health and drug and alcohol services, to ensure integrated and coordinated treatment support for cannabis use problems.
 Medical professionals, particularly general practitioners, have the opportunity to counsel patients who are at risk of cannabis-related harms, and they should be supported to provide education and advice about those potential harms.
 Targeted treatment regimens should be developed and resourced for groups with particular needs, including those with dual diagnoses, multiple drug use, young teenage users and culturally appropriate services for Aboriginal peoples and Torres Strait Islanders. Of particular importance are suitable treatment services for cannabis users with mental health needs.
 Every effort should be made to address the personal and systemic barriers that cannabis users face in seeking treatment and support when they need it. These include barriers associated with perceptions of stigmatisation, users’ and professionals’ awareness of treatment options, and users’ beliefs that they do not have a health problem.
 Doctors should consider accidental cannabis ingestion in the differential diagnosis of children with impaired consciousness.
 Cannabis users should have access to the rehabilitative services and support they require to manage associated disorders and particularly the risk of relapse.

Medical Uses of Cannabis
The Australian Medical Association acknowledges that cannabis has constituents that have potential therapeutic uses.
 Appropriate clinical trials of potentially therapeutic cannabinoid formulations should be conducted to determine their safety and efficacy compared to existing medicines, and whether their long-term use for medical purposes has adverse effects.
 Therapeutic cannabinoids that are deemed safe and effective should be made available to patients for whom existing medications are not as effective.
 Smoking or ingesting a crude plant product is a risky way to deliver cannabinoids for medical purposes. Other appropriate ways of delivering cannabinoids for medical purposes should be developed.
 Any promotion of the medical use of cannabinoids will require extensive education of the public and the profession on the risks of the non-medical use of cannabis.

Law Enforcement, Cannabis Regulation and Health
 In assessing different legislative and policy approaches to the regulation of cannabis use and supply, primary consideration should be given to the impact of such approaches on the health and well-being of cannabis users.
 The AMA does not condone the trafficking or recreational use of cannabis. The AMA believes that there should be vigorous law enforcement and strong criminal penalties for the trafficking of cannabis. The personal recreational use of cannabis should also be
prohibited. However, criminal penalties for personal cannabis use can add to the potential health and other risks to which cannabis users are exposed. The AMA believes that it is consistent with a principle of harm reduction for the possession of cannabis for personal
use to attract civil penalties such as court orders requiring counselling and education (particularly for young and first time offenders), or attendance at ‘drug courts’ which divert users from the criminal justice system into treatment.
 When cannabis users come into contact with the police or courts, the opportunity should be taken to divert those users to preventive, educational and therapeutic options that they would not otherwise access.
 In allocating resources, priority should be given to policies, programs and initiatives that reduce the health-related risks of cannabis use. Law enforcement should be directed primarily at cannabis supply networks.
 The AMA believes that the availability and use of synthetic cannabis products (including herbal forms) poses significant health risks, given that the psychoactive chemical constituents of these products are unknown and unpredictable in their effect. There are
particular challenges in regulating these products, and Australian governments must make a concerted effort to develop consistent and effective legislation which captures current and emerging forms of synthetic cannabis.

Research
 Further research is needed into the relationship between cannabis use and psychosis and other mental health problems, including the identification of those at greatest risk of cannabis-induced psychosis.
 There should be continuing research to identify the risk factors that contribute to individuals developing problematic or early onset cannabis use, and the factors and interventions that can protect against these.
 Australian governments should fund research into best practice treatment methods, including suitable pharmacotherapies, for those who are cannabis-dependent or who wish to reduce or cease their use.
 There should be systematic ongoing monitoring of the different legislative and policy approaches on cannabis operating in overseas jurisdictions to assess their health and harm-related impacts. The evidence obtained should inform critical reviews of the
approaches that operate in Australia.

Source: 1 (ama.com.au) 2014

What is synthetic cannabis?

Synthetic cannabis is a new psychoactive substance that was originally designed to mimic or produce similar effects to cannabis and has been sold online since 2004. However, some of the newer substances claiming to be synthetic cannabis do not actually mimic the effects of THC (delta-9 tetrahydrocannabinol, the active ingredient in cannabis).

Reports suggest it also produces additional negative effects. These powdered chemicals are mixed with solvents and added to herbs and sold in colourful, branded packets. The chemicals usually vary from batch to batch as manufacturers try to stay ahead of the law, so different packets can produce different effects even if the name and branding on the package looks the same.

Other names

Synthetic cannabis is marketed under different brand names.

Spice was the earliest in a series of synthetic cannabis products sold in many European countries. Since then a number of similar products have been developed, such as Kronic, Northern Lights, Mojo, Lightning Gold, Blue Lotus and Godfather.

Synthetic cannabis is also marketed as aphrodisiac tea, herbal incense and potpourri.

How is it used?

It’s most commonly smoked and is sometimes drunk as a tea.

Effects of synthetic cannabis

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

Synthetic cannabis affects everyone differently, based on:

• Size, weight and health
• Whether the person is used to taking it
• Whether other drugs are taken around the same time
• The amount taken
• The chemical that is used and its strength (varies from batch to batch)

Synthetic cannabis is relatively new, so there is limited information available about its short- and long-term effects, including how safe or unsafe it is to use. However, it has been reported to have similar effects to cannabis along with some additional negative and potentially more harmful ones including:

• Fast and irregular heartbeat
• Racing thoughts
• Agitation, anxiety and paranoia
• Psychosis
• Aggressive and violent behaviour
• Chest pain
• Vomiting
• Acute kidney injury
• Seizures
• Stroke
• Death

Long-term effects

There has been limited research into synthetic cannabis dependence. However, anecdotal evidence suggests that long term, regular use can cause tolerance and dependence.

Withdrawal

Giving up synthetic cannabis after using it for a long time is challenging because the body has to get used to functioning without it.

It has been reported that some people who use synthetic cannabis heavily on a regular basis may experience withdrawal symptoms when they try to stop, including:

• Insomnia
• Paranoia
• Panic attacks
• Agitation and irritability
• Anxiety
• Mood swings
• Rapid heartbeat

The risk of tolerance and dependence on synthetic cannabis and their associated effects may be reduced by taking regular breaks from smoking the drug and avoiding using a lot of it at once.

Health and safety

There is no safe way to use synthetic cannabis. If you do decide to use the drug, it’s important to consider the following

Regulating intake

• It is difficult to predict the strength and effects of synthetic cannabis (even if it has been taken before) as its strength varies from batch to batch.
• Trying a very small dose first (less than the size of a match head) could help gauge the strength and possible effects. Dose size should only be increased slowly – time should be given for the previous dose to wear off.
• Taking synthetic cannabis on its own without a ‘mixer’ such as tobacco or dried parsley should always be avoided. Similarly, inhaling the drug via bongs or pipes can increase the risk of an overdose or bad reaction.

Misleading packaging

• The packaging of synthetic cannabis can be misleading. Although contents may be described as ‘herbal’, the actual psychoactive material is synthetic.
• Not all ingredients or their correct amounts might be listed, which can increase the risk of overdose.
• Chemicals usually vary from batch to batch, so different packets can produce different effects, even if the packaging looks the same.

Mental health risks

• People with mental health conditions or a family history of these conditions should avoid using synthetic cannabis. The drug can intensify the symptoms of anxiety and paranoia.
• Taking synthetic cannabis in a familiar environment in the company of people who are known and trusted may alleviate any unpleasant emotional effects. Anxiety can be counteracted by taking deep, regular breaths while sitting down.

When it absolutely shouldn’t be used

Use of synthetic cannabis is likely to be more dangerous when:

• Taken in combination with alcohol or other drugs, particularly stimulants such as crystal methamphetamine (‘ice’) or ecstasy
• Driving or operating heavy machinery
• Judgment or motor coordination is required
• Alone (in case medical assistance is required)
• The person has a mental health problem
• The person has an existing heart problem

In an emergency

There have been a number of deaths caused by synthetic cannabis. Call triple zero (000) immediately if someone is experiencing negative effects such as:

• Fast/irregular heart rate
• Chest pain
• Breathing difficulties
• Delusional behaviour

Ambulance officers don’t have to involve the police.

Synthetic cannabis statistics

National

• 2.8% of Australians aged 14 years and over have used synthetic cannabis at some stage in their lives.
• 0.3% of Australians aged 14 years and over have used synthetic cannabis in the previous 12 months.

According to Australian data from the Global Drug Survey, synthetic cannabis was the 33rd most commonly used drug – 1.1% of respondents had used this type of drug in the last 12 months

Synthetic cannabis and the law

The laws surrounding NPS are complex, constantly changing and differ between states/territories, but in general they are increasingly becoming stronger.

In Queensland, New South Wales, South Australia and Victoria there is now a ‘blanket ban’ on possessing or selling any substance that has a psychoactive effect other than alcohol, tobacco and food.
In other states and territories in Australia specific NPS substances are banned and new ones are regularly added to the list. This means that a drug that was legal to sell or possess today, may be illegal tomorrow. The substances banned differ between these states/territories.

Source: https://adf.org.au/drug-facts/synthetic-cannabis/ May 2019

For those who are still concerned about ‘evidence based science’ and ‘best medical and pharmaceutical practice’…the following ‘open letter’ with attachments was sent to all Federal Senators, NSW and Victorian Premiers last week. 

Dear Senator,
 
In the coming weeks/months, you will no doubt be presented with a Bill to consider changing both law and process to permit a new version of ‘medical marijuana’. On behalf of our Institute and a concerned public I would like you to carefully consider the following.

Firstly I write with some concerns about the consultation conducted on behalf of Victorian State government by the VLRC in Melbourne on May 6th this year and the now subsequent recommendations that have emerged from this very small Melbourne meeting (Less than 60 people in attendance! – This issue was directly raised with Victorian Health Minister earlier this year).

Whilst we gleaned from radio interviews with VLRC representatives prior to the consultation that the public discussions on the potential introduction of a new form ‘medical marijuana’ (different to existing medicinal forms of cannabis derived pharmaceuticals already in the Australian market) were not for changing laws to suit a particular agenda. It was instead implied that the purpose was to look at potential redundancies that might hinder best practice.  It was to be, for all intents and purposes an unbiased mechanism to: glean evidence, perspectives, opinions and ideas from the general public for consideration in the higher and more important discussion of wise, evidence based, best healthcare practice before making any move on the release of another version of therapeutic cannabis.

Conversely, our affiliate/colleagues experience of the very small Melbourne consultation did not reflect any of the above expectation. Rather those of our affiliates who attended observed the following:

1. A seemingly deliberately emotively charged atmosphere, in favour of getting cannabis legalised for medical purposes. The tone seemed to be set to that end from the outset.
2. The meeting was facilitated by representatives of the VLRC who appeared to have a bias toward the legalisation of ‘medical marijuana’ in manner that suited the self-medicating option, regardless of evidence based science.
3. When attempts were made to present evidence contrary to the seemingly predetermined agenda of these facilitators, they were either quickly shut down (if they dared to speak in the first place) or continually ignored; apparently, dissenting opinions were not welcome. Whilst at the same time, proponents for ‘self-medication’ use of cannabis were given complete and unfettered access to the floor, producing statements such as:“Many, many people have been cured – from just about anything and everything.”
   “What would you rather have – infertility or 35 seizures a day?”
   “Random workplace drug testing is wrong.”Not only are these statements (now on record) outrageous, they are also utterly unsubstantiated by any legitimate clinical trial. This very small contingent of pro-cannabis lobbyists were permitted to simply spruik anecdotes with no evidence based presentation yet also had their evidenced-deprived opinions affirmed and validated by the facilitators.
4. The facilitators appeared to infer that the Government (of Victoria, at least) already has legislation in place with this current ‘consultation’ process simply in play to validate those changes and therefore it is in essence a forgone conclusion. There was also a strong indication that either the A.M.A. or T.G.A. recommendations or processes would be ignored and negated wherever possible by simple legal changes.

Senator, it is a concern that if this particular experience of ours was repeated in other consultations with the same consensus manufacturing agenda, then this consultative process is a travesty.

If a government negates not only good evidence based science, but also established protective, best practice medical processes to enable a legal rite of passage for self-medication, it is placing itself at an extremely high risk of litigation. Future law-suits are likely, from the ‘victims’ of self-medicating regimes who will cite the changes in law that were NOT based on proper clinical trial or TGA and AMA recommendations and protocols.  When emotionally charged vitriol combines with vote chasing and misguided sympathies, it is the recipients of these untested substances that will be the final casualties – especially children! Compassion and wisdom dictate that all fair and democratic processes be engaged to maximise help and minimise harm, especially to children who will be the ones at greatest risk of an ill-advised self-medicating regime.

Senator, for purposes of clarification about the possible national legalisation of ‘another’ route/process/protocol for medicines are you able to confirm or deny that:

1. The representations by the facilitators at the Melbourne consultation are in fact reflective of the pre-ordained intent of the public consultation documented above in not only Victoria, but other States and Territories?
2. If not, will a review of the practice/method/behaviours be made into this particular process and subsequently the clearly questionable recommendations that have emerged from such narrow, non-evidence based and seemingly biased processes?
3. A fair and proper representation of all views on this matter be gleaned from these meetings/consultations and interpreted and represented fairly without prejudice?
4. A.M.A. and T.G.A. processes and protocols for best practice on medicines will be upheld and engaged, or simply ignored and by-passed?

Finally Senator, it is of grave concern that a pattern seems to be emerging from this ‘populist’ process, that best practice, evidence based protocols may simply be ignored and by passed.  If this is indeed the plan and the use of VLRC type agencies is the vehicle to do so, then the following must be raised.

The Dalgarno Institute ask:

• Do you want your government and your ministerial role to be linked with a poorly considered and non-evidenced based process that enables a self-medicating policy – particularly for the ones the State has greatest responsibility to protect – the children?
• Will your government and ministerial role be the ones who in so ignoring proper clinical processes facilitate a quasi-health regime that will precipitate immediate and long term unwanted side effects that can then be later subject to litigation and class-actions?
• If an unqualified and unproven self-medicating mechanism is sanctioned and approved by government, and the inevitable damage (particularly to children) emerges, will the taxpayers of Australia have to fund the damages of an ill-conceived and non-TGA/AMA approved medical practice? Or will there be iron-clad caveats in place that ensure those who chose to use their own version of ‘medicine’ be the only ones liable for the outcomes of it, and not place further healthcare and monetary burden on the vast majority of tax-payers who have sought to follow best evidence-based and prescriptive practices?
• If proper clinical trials and T.G.A and A.M.A. processes and protocols are negated or circumvented and a ‘new’ or ‘alternative’ process for registering, manufacturing, prescribing and dispensing marijuana as medicine be put in place, then how will you/your government  address the following important questions.

• • Who will be ‘growing’ and preparing this ‘medicine’?
  • Who will monitor content and quality of ‘medicine’?
  • Who will determine dosage rates and quantities?
  • What mechanisms will be in place to ensure quality control is followed?
  • What mechanisms will be in place to ensure, movement, dispensing and use of this ‘medicine’ is done without risk to non-patients?
  • Who will be able to prescribe this ‘medicine’ – Doctors, pharmacists, naturopaths, nurses, and counsellors? Who will monitor this process and ensure total safety?
  • What community safe-guards will be in place to ensure this new ‘medicine’ will not be misused?
  • Will the ‘medicine’ come in edible or smoked form and what safeguards will be in play around such a ‘medicine delivery’ system?
  • Will there be advertising and public promotion of this new form of ‘medicine’? Will that be strictly monitored to ensure no misinformation will mislead the public?
  • Which government department will oversee this process and how many more new protocols, processes, staff and finance will be required to set up this new vehicle for ‘medicine’ identification and management?
  • Who will be paying for this new and added cost?

We at Dalgarno Institute and its growing coalition remain very concerned for the overwhelming majority of Australians who are being kept in the dark about this new and illegitimate push to change evidence based processes and the laws that ensure those processes are protected. We are looking to you, in your role, to ensure that there is a genuine and robust pursuit of best medical and health practice outcomes for all Australians, particularly the most vulnerable – the young, very sick and disadvantaged – and that any mechanism that seeks to undermine that platform not be permitted to emerge under any circumstance.  Science and best health practice, NOT lawyers should determine pharmaceutical best practice.

I have also attached just a very small sample of the volumes of evidence-based data currently in the scientific space that raise clear warnings about a ‘new’ and untested version of cannabis as medicine. Please avail yourself of them and consult the people who do know better, compassion and good government demands it.
We look forward to receiving your response.

Sincerely Yours, 

Shane Varcoe
Executive Director
Dalgarno Institute

You can read our compassionate policy stance on M.M titled ‘CANNABIS AS MEDICINE? CAUTION NEEDED’!

https://dalgarnoinstitute.org.au/index.php/advocacy/dalgarno-aod-policy/86-open-letter-to-all-australian-politicians-regarding-new-version-of-medicinal-cannabis

Source: Email from Dalgarno Institute

September 2017

Sydney Parliament House, 09.07.2018

Cannabis has been greatly oversold by a left leaning press controlled by globalist and centralist forces while its real and known dangers have not been given appropriate weight in the popular press. In particular its genotoxic and teratogenic potential on an unborn generation for the next hundred years has not been aired or properly weighed in popular forums.

These weighty considerations clearly take cannabis out of the realm of personal choice or individual freedoms and place it squarely in the realm of the public good and a matter with which the whole community is rightly concerned and properly involved.

Cannabinoids are a group of 400 substances which occur only in the leaves of the Cannabis sativa plant where they are used by the plants as toxins and poisons in natural defence against other plants and against herbivores.

Major leading world experts such as Dr Nora Volkow, Director of the National Institute of Drug Abuse at NIH 1, Professor Wayne Hall, Previous Director of the Sydney Based National Drug and Alcohol Research Centre at UNSW 2, and Health Canada 3 – amongst many others – are agreed that cannabis is linked with the following impressive lists of toxicities:

1) Cannabis is addictive, particularly when used by teenagers

2) Cannabis affects brain development

3) Cannabis is a gateway to other harder drug use

4) Cannabis is linked with many mental health disorders including anxiety, depression,

psychosis, schizophrenia and bipolar disorder

5) Cannabis alters and greatly impairs the normal developmental trajectory – getting a

job, finishing a course and forming a long term stable relationship 4-11

6) Cannabis impairs driving ability 12

7) Cannabis damages the lungs

8) Cannabis is immunosuppressive

9) Cannabis is linked with heart attack, stroke and cardiovascular disease

10) Cannabis is commonly more potent in recent years, with forms up to 30% being widely available in many parts of USA, and oils up to 100% THC also widely available.

Serious questions have also been raised about its involvement in 12 different cancers, increased Emergency Room presentations and exposures of developing babies during pregnancy. It is with this latter group that the present address is mainly concerned.

Basic Physiology and Embryology Cells make energy in dedicated organelles called mitochondria. Mitochondrial energy, in the form of ATP, is known to be involved in both DNA protection and control of the immune system. This means that when the cell’s ATP is high DNA maintenance is good and the genome is intact. When cellular ATP drops DNA maintenance is impaired, DNA breaks remain unsealed, and cancers can form. Also immunity is triggered by low ATP.

As organisms age ATP falls by half each 20 years after the age of 20. Mitochondria signal and shuttle to the cell nucleus via several pathways. Not only do cells carry cannabinoid receptors on their surface, but they also exist, along with their signalling machinery, at high density on mitochondria themselves 13-19. Cannabis, and indeed all addictive drugs, are known to impair this cellular energy generation and thus promote the biochemical aging process 14-16,19,20. Most addictions are associated with increased cancers, increased infections and increased clinical signs of ageing 21-34.

The foetal heart forms very early inside the mother with a heartbeat present from day 21 of human gestation. The heart forms by complicated pathways, and arises from more than six groups of cells inside the embryo 35,36. First two arteries come together, they fold, then flex and twist to give the final shape of the adult heart. Structures in the centre of the heart mass called endocardial cushions grow out to form the heart valves between the atria and ventricles and parts of the septum which grows between the two atria and ventricles. These cardiac cushions, and their associated conoventricular ridges which grow into and divide the cardiac outflow tract into left and right halves, all carry high density cannabinoid type 1 receptors (CB1R’s) and cannabis is known to be able to interfere with their growth and development.CB1R’s appear on foetal arteries from week nine of human gestation 37.

The developing brain grows out in a complex way in the head section 35,36. Newborn brain cells are born centrally in the area adjacent to the central ventricles of the brain and then migrate along pathways into the remainder of the brain, and grow to populate the cortex, parietal lobes, olfactory lobes, limbic system, hypothalamus and hippocampus which is an important area deep in the centre of the temporal lobes where memories first form.

Developing bipolar neuroblasts migrate along pathways and then climb out along 200 million guide cells, called radial glia cells, to the cortex of the brain where they sprout dendrites and a major central axon which are then wired in to the electrical network in a “use it or lose it”, “cells that fire together wire together” manner.

The brain continues to grow and mature into the 20’s as new neurons are born and surplus dendrites are pruned by the immune system. Cannabinoids interfere with cellular migration, cellular division, the generation of newborn neurons and all the classes of glia, axonal pathfinding, dendrite sprouting, myelin formation around axons and axon tracts and the firing of both inhibitory and stimulatory synapses 14-16,19,20,38-40. Cannabinoids interfere with gene expression directly, via numerous epigenetic means, and via immune perturbation.

Cannabinoids also disrupt the mechanics of cell division by disrupting the mitotic spindle on which chromosomal separation occurs, causing severe genetic damage and frank chromosomal mis-segregation, disruption, rupture and pulverization 41-43.

Cannabis was found to be a human carcinogen by the California Environmental Protection agency in 2009 44. This makes it a likely human teratogen (deforms babies). Importantly, while discussion continues over some cancers, it bears repeating that a positive association between cannabis and testicular cancer was found in all four studies which investigated this question 45-49.

Cannabis Teratogenesis

The best animal models for human malformations are hamsters and rabbits. In rabbits cannabis exhibits a severe spectrum of foetal abnormalities when applied at high dose including shortened limbs, bowels hanging out, spina bifida and exencephaly (brain hanging out). There is also impaired foetal growth and increased foetal loss and resorption 50,51.

Many of these features have been noted in human studies 52. In 2014 Centres for Disease Control Atlanta Georgia reported increased rates of anencephaly (no brain, usually rapid death) gastroschisis (bowels hanging out), diaphragmatic hernia, and oesophageal narrowing 53,54. The American Heart Association and the American Academy of Pediatrics reported in 2007 an increased rate of ventricular septal defect and an abnormality of the tricuspid valve (Ebstein’s anomaly) 55. Strikingly, a number of studies have shown that cannabis exposure of the father is worse than that of the mother 56. In Colorado atrial septal defect is noted to have risen by over 260% from 2000-2013 (see Figure 1; note close correlation (correlation coefficient R = 0.95, P value = 0.000066) between teenage cannabis use and rising rate of major congenital anomalies in Colorado to 12.7%, or 1 in 8 live births, a rate four times higher than the USA national average !) 57.

And three longitudinal studies following children exposed to cannabis in utero have consistently noted abnormalities of brain growth with smaller brains and heads – persisting into adult life – and deficits of cortical and executive functioning persistent throughout primary, middle and high schools and into young adult life in the early 20’s 58-63. An Australian MRI neuroimaging study noted 88% disconnection of cortical wiring from the splenium to precuneus which are key integrating and computing centres in the cerebral cortex 38,39,64. Chromosomal defects were also found to be elevated in Colorado (rose 30%) 57, in Hawaii 52 in our recent analysis of cannabis use and congenital anomalies across USA, and in infants presenting from Northern New South Wales to Queensland hospitals 65. And gastroschisis shows a uniform pattern of elevation in all recent studies which have examined it (our univariate meta-analysis) 52,54,66-71.

Interestingly the gastroschisis rate doubled in North Carolina in just three years 1997-2001 72, but rose 24 times in Mexico 73 which for a long time formed a principal supply source for Southern USA 74. Within North Carolina gastroschisis and congenital heart defects closely followed cannabis distribution routes 74-76. In Canada a remarkable geographical analysis by the Canadian Government has shown repeatedly that the highest incidence of all anomalies – including chromosomal anomalies – occurs in those northern parts where most cannabis is smoked 77,78.

Congenital anomalies forms the largest cause of death of babies in the first year of life. The biggest group of them is cardiovascular defects. Since cannabis affects several major classes
of congenital defects it is obviously a major human teratogen. Its heavy epigenetic footprint,
by which it controls gene expression by controlling DNA methylation and histone modifications 79-81, imply that its effects will be felt for the next three to four generations – that is the next 100 years 82,83. Equally obviously it is presently being marketed globally as a major commodity apparently for commercial – or ideological – reasons. Since cannabis is clearly contraindicated in several groups of people including:

1) Babies

2) Children

3) Adolescents

4) Car drivers

5) Commercial Drivers – Taxis, Buses, Trains,

6) Pilots of Aeroplanes

7) Workers – Manual Tools, Construction, Concentration Jobs

8) Children

9) Adolescents

10) Males of Reproductive age

11) Females of Reproductive age

12) Pregnancy

13) Lactation

14) Workers

15) Older People – Mental Illness

16) Immunosuppressed

17) Asthmatics – 80% Population after severe chest infection

18) People with Personal History of Cancer

19) People with Family History of Cancer

20) People with Personal History of Mental Illness

21) People with Family History of Mental Illness

22) Anyone or any population concerned about ageing effects 34

… cannabis legalization is not likely to be in the best interests of public health.

Concluding Remarks

In 1854 Dr John Snow achieved lasting public health fame by taking the handle off the Broad Street pump and saving east London from its cholera epidemic, based upon the maps he drew of where the cholera cases were occurring – in the local vicinity of the Broad Street pump.

Looking across the broad spectrum of the above evidence one notices a trulyremarkable concordance of the evidence between:

1) Preclinical studies in

i) Rabbits and

ii) Hamsters

2) Cellular and biological mechanisms, particularly relating to:

i) Brain development

ii) Heart development

iii) Blood vessel development

iv) Genetic development

v) Abnormalities of chromosomal segregation

i. Downs syndrome

ii. Turners syndrome

iii. Trisomy 18

iv. Trisomy 13

vi) Cell division / mitotic poison / micronucleus formation

vii) Epigenetic change

viii) Growth inhibition

3) 84Cross-sectional Epidemiological studies, especially from:

i) Canada 77,85

ii) USA 86,87

iii) Northern New South Wales 65,88 4) Longitudinal studies from 58:

i) Ottawa 59-63

ii) Pittsburgh

iii) Netherlands

Our studies of congenital defects in USA have also shown a close concordance of congenital anomaly rates for 23 defects with the cannabis use rate indexed for the rising cannabis concentration in USA, and mostly in the three major classes of brain defects, cardiovascular defects and chromosomal defects, just as found by previous investigators in Hawaii 52.

Of no other toxin to our knowledge can it be said that it interferes with brain growth and development to the point where the brain is permanently shrunken in size or does not form at all. The demonstration by CDC twice that the incidence of anencephaly (no brain) is doubled by cannabis 53,54 implies that anencephaly is the most severe end of the neurobehavioural teratogenicity of cannabis and forms one end of a continuum with all the other impairments which are implied by the above commentary.

(Actually when blighted ova, foetal resorptions and spontaneous abortion are included in the teratological profile anencephaly is not the most severe end of the teratological spectrum – that is foetal death). It is our view that with the recent advent of high dose potent forms of cannabis reaching the foetus through both maternal and paternal lines major and clinically significant neurobehavioural teratological presentations will become commonplace, and might well become all but universal in infants experiencing significant gestational exposure.

One can only wonder if the community has been prepared for such a holocaust and tsunami amongst its children?

It is the view of myself and my collaborators that these matters are significant and salient and should be achieving greater airplay in the public discussion proceeding around the world at this time on this subject.

Whilst cannabis legalization may line the pockets of the few it will clearly not be in the public interest in any sense; and indeed the public will be picking up the bill for this unpremeditated move for generations to come. Oddly – financial gain seems to be one of the primary drivers of the present transnational push. When the above described public health message gets out amongst ambitious legal fraternities, financial gain and the threat of major medico-legal settlements for congenital defects – will quickly become be the worst reason for cannabis legalization.

Indeed it can be argued that the legalization lobby is well aware of all of the above concerns – and their controlled media pretend debate does not allow such issues to air in the public forum. The awareness of these concerns is then the likely direct reason that cannabis requires its own legislation. As noted in the patient information leaflet for the recently approved Epidiolex (cannabidiol oil for paediatric fits) the US Food and Drug Administration (FDA) is well aware of the genotoxicity of cannabinoids.

The only possible conclusion therefore is that the public is deliberately being duped. To which our only defence will be to publicize the truth.

Source: Summary of Address to Sydney Parliament House, 09.07.2018 by Professor Dr. Stuart Reece, Clinical Associate Professor, UWA Medical School. University of Western Australia

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SUMMARY

Background

Interest in the use of cannabis and cannabinoids to treat chronic non-cancer pain is increasing, because of their potential to reduce opioid dose requirements. We aimed to investigate cannabis use in people living with chronic non-cancer pain who had been prescribed opioids, including their reasons for use and perceived effectiveness of cannabis; associations between amount of cannabis use and pain, mental health, and opioid use; the effect of cannabis use on pain severity and interference over time; and potential opioid-sparing effects of cannabis.

Methods

The Pain and Opioids IN Treatment study is a prospective, national, observational cohort of people with chronic non-cancer pain prescribed opioids. Participants were recruited through community pharmacies across Australia, completed baseline interviews, and were followed up with phone interviews or self-complete questionnaires yearly for 4 years.

Recruitment took place from August 13, 2012, to April 8, 2014. Participants were asked about lifetime and past year chronic pain conditions, duration of chronic non-cancer pain, pain self-efficacy, whether pain was neuropathic, lifetime and past 12-month cannabis use, number of days cannabis was used in the past month, and current depression and generalised anxiety disorder. We also estimated daily oral morphine equivalent doses of opioids.

We used logistic regression to investigate cross-sectional associations with frequency of cannabis use, and lagged mixed-effects models to examine temporal associations between cannabis use and outcomes.

Findings

1514 participants completed the baseline interview and were included in the study from Aug 20, 2012, to April 14, 2014. Cannabis use was common, and by 4-year follow-up, 295 (24%) participants had used cannabis for pain. Interest in using cannabis for pain increased from 364 (33%) participants (at baseline) to 723 (60%) participants (at 4 years). At 4-year follow-up, compared with people with no cannabis use, we found that participants who used cannabis had a greater pain severity score (risk ratio 1·14, 95% CI 1·01–1·29, for less frequent cannabis use; and 1·17, 1·03–1·32, for daily or near-daily cannabis use), greater pain interference score (1·21, 1·09–1·35; and 1·14, 1·03–1·26), lower pain self-efficacy scores (0·97, 0·96–1·00; and 0·98, 0·96–1·00), and greater generalised anxiety disorder severity scores (1·07, 1·03–1·12; and 1·10, 1·06–1·15).

We found no evidence of a temporal relationship between cannabis use and pain severity or pain interference, and no evidence that cannabis use reduced prescribed opioid use or increased rates of opioid discontinuation.

Interpretation

Cannabis use was common in people with chronic non-cancer pain who had been prescribed opioids, but we found no evidence that cannabis use improved patient outcomes. People who used cannabis had greater pain and lower self-efficacy in managing pain, and there was no evidence that cannabis use reduced pain severity or interference or exerted an opioid-sparing effect. As cannabis use for medicinal purposes increases globally, it is important that large well designed clinical trials, which include people with complex comorbidities, are conducted to determine the efficacy of cannabis for chronic non-cancer pain. Funding National Health and Medical Research Council and the Australian Government.

Source:https://www.thelancet.com/pdfs/journals/lanpub/PIIS2468-2667(18)30110-5.pdf July 2018

The following letter was submitted to the US government Food and Drug Adminstration by Australian Professor Dr. Stuart Reece as evidence against the suggested re-scheduling of cannabinoids in the USA. This item can be found online where a full list of carefully researched references is included. Professor Reece has produced an extraordinary article which should be widely read.

We cannot recommend this article highly enough.

NDPA April 2018

http://GordonDrugAbusePrevention.com

This website has been created as a public service to help address the problem of the use of marijuana and other mood- and mind-altering substances in the United States and around the world. A purpose is help inform the public, the media, and those in positions of public responsibility of the challenges facing the nation as a result of the widespread use of psychoactive and mood-altering substances, particularly marijuana and designer drugs. The harmful effects of these substances have not been well understood. In fact, there is great ignorance of the harmful effects of marijuana and other drugs that are being used for experimental or recreational purposes. The implications that the harmful effects that these drugs have for the health and wellbeing of individuals, families, and society are legion. * * * * * * *

Federal Register Submission
Food and Drug Administration,
10903 New Hampshire Ave.,
Silver Spring,
MD, 20993-0002, USA.

Re: Re-Scheduling of Cannabinoids in USA – Tetrahydrocannabinol and Cannabidiol Related Arteriopathy, Genotoxicity and Teratogenesis

I am very concerned about the potential for increased cannabis availability in USA implied by full drug legalization; however, a comprehensive and authoritative submission of the evidence would take weeks and months to prepare. Knowing what we know now and indeed, what has been available in the scientific literature for a growing number of years concerning a myriad of harmful effects of marijuana, marijuana containing THC should not be reclassified.

These effects that are now well documented in the scientific literature include, alarmingly, harm involving reproductive function and birth anomalies as a result of exposure to or use of marijuana with THC. In addition to all of the usual concerns which you will have heard from many sources including the following I have further particular concerns:

1) Effect on developing brains

2) Effect on driving

3) Effect as a Gateway drug to other drug use including the opioid epidemic

4) Effect on developmental trajectory and failure to attain normal adult goals(stable relationship, work, education)

5) Effect on IQ and IQ regression

6) Effect to increase numerous psychiatric and psychological disorders

7) Effect on respiratory system

8) Effect on reproductive system

9) Effect in relation to immunity and immunosuppression

10) Effect of now very concentrated forms of cannabis, THC and CBD which are widely available

11) Outdated epidemiological studies which apply only to the era before cannabis became so potent and so concentrated

12) Cannabis is now known to have an important arteriopathic effect and cardiovascular toxic effect .

These issues are all well covered by a rich recent literature including reviews from such major international authorities as Dr Nora Volkow Director of NIDA, Professor Wayne Hall and others .

Cannabinoid Therapeutics

In my view the therapeutic effects of cannabinoids have been wildly inflated by the press. Moreover, with over 1,000 studies listed for cannabinoids on clinicaltrials.gov, the chance of a type I experimental error, or studies being falsely reported to be positive when in fact they are not, is at last 25/1,000 at the 0.05 level.

THC as dronabinol is actually a failed drug from USA which has such a high incidence of side effects that it was rarely used as superior agents are readily available for virtually all of its touted and alleged therapeutic applications. My American liaisons advise that dronabinol sales have climbed in recent times as patients use it as a ruse to avoid detection of cannabinoid use at work in states where it is not yet legal. So when I call it a failed therapeutic I mean in a traditional sense, not in the novel way it is now applied for flagrantly flouting the law.

In considering the alleged benefits of cannabis one has to be particularly mindful of cannabis addiction in which cannabinoids will alleviate the effect of drug withdrawal as they do in any other addiction. Moreover, the fact that cannabis itself is known to cause both pain and nausea, greatly complicates the interpretation of many studies.

I also have the following concerns which relate in sum to the arteriopathy and vasculopathy and the genotoxicity of cannabis, tetrahydrocannabinol and likely including cannabidiol and various other cannabinoids:

Cannabinoid Arteriopathy

Particularly noteworthy amongst these various reports are two reports by Dr Nora Volkow in 2014, the Director of the National Institute of Drug Abuse at NIH to the New England Journal of Medicine which together document the adverse cardiovascular and cerebrovascular effects of cannabis at the epidemiological level ; a report from our own increase cardiovascular aging to BMJ Open ; a series of reports showing a fivefold

increase in the rate of heart attack within one hour after cannabis smoking ; several reports of cannabis related arteritis ; other reports of the cerebrovascular actions of cannabis ; documentation that cannabis exposure increases arterial stiffness and cardiovascular and organismal aging ; and a recent report showing that human endothelial vascular function – vasodilation – is substantially inhibited within just one minute of cannabis exposure .

It is also relevant that a synthetic cannabinoid was recently shown to directly induce both thromboxane synthase and lipoxygenase, and so be directly vasoconstrictive, prothrombotic and proinflammatory .

Vascular aging, including both macrovascular and microvascular aging is a major pathological feature not only because most adults in western nations die from myocardial infarction or cerebrovascular accidents, but also because local blood flow and microvascular function is a key determinant of stem cell niche activity in many stem cell beds. This has given rise to the vascular theory of aging which has been produced by some of the leading researchers at the National Health Lung and Blood Institute at NIH, amongst many others .

It can thus be said not only that “You are as old as your (macrovascular) arteries”, but also that “you are as old as your (microvascular) stem cells.” Hence the now compelling evidence for the little known arteriopathic complications of cannabis and cannabinoids, carry very far reaching implications indeed. This was confirmed directly in the clinical study of arterial stiffness from my clinic mentioned above .

Whilst aging, myocardial infarction and cerebrovascular accidents are all highly significant outcomes and major public health endpoints, these effects assume added significance in the context of congenital anomalies. Some congenital defects, such as gastroschisis, are thought to be due to a failure of vascular supply of part of the anterior abdominal wall . Hence in one recent study the unadjusted odds ratio of having a gastroschisis pregnancy amongst cannabis users (O.R.=8.03, 95%C.I. 5.63-11.46) was almost as high as that for heroin, cocaine and amphetamine users (O.R.= 9.35, 95%C.I.
6.64-13.15), and the adjusted odds ratio for any illicit drug use (of which was 84% cannabis) was O.R.=3.54 (95%C.I. 2.22-5.63) and for cannabis alone was said by these Canadian authors to be O.R.=3.0. Hence cannabis related vasculopathy – arteriopathy beyond its very serious implications in adults also carries implications for paediatric and congenital disorders and may also constitute a major teratogenic mechanism.

Cannabinoid Genotoxicity and Teratogenesis

Cannabis is associated with 11 cancers (lung, throat, bladder, airways, testes, prostate,

cervix, larynx) including;

Four congenital and thus inherited cancers (rhabdomyosarcoma, neuroblastoma,ALL,

AML and AMML);

Sativex product insert in many nations carries standard warning against its use by

males or females who might be having a baby.

Cannabis – and likely also CBD – is known to be associated with epigenetic changes

some of which are believed to be inheritable for at least four generations.

Cannabis is known to interfere with tubulin synthesis and binding and it also

acts via Stathmin so that microtubule function is impeded . This leads directly to

micronucleus formation. Cannabis has been known to test positive in the

micronucleus assay for over fifty years. This is a major and standard test for

genotoxicity. Micronucleus formation is known to lead directly to major chromosomal toxicity including chromosomal shattering – so-called chromothripsis –and is known to be associated with cell death, cancerogenesis and major foetal abnormalities.

Cannabis has also been linked definitively with congenital heart disease is a statement

by the American Heart Association and the American Academy of Pediatrics in 2007, on the basis of just three epidemiological studies, all done in the days before cannabis became so concentrated. Congenital heart defects have also been linked with

the father’s cannabis use . Indeed, one study showed that paternal cannabis use was

the strongest risk factor of all for preventable congenital cardiac defects.

Cannabis has also been linked with gastroschisis in at least seven cohort and case

control studies some of which are summarized in a Canadian Government

Report 200. In that report the geographic incidence of most major congenital anomalies

closely paralleled the use of cannabis as described in other major Canadian reports.

The overall adjusted odds ratio for cannabis induction of gastroschisis was

quoted by these authors as 3.0. Moreover, outbreaks of both congenital heart disease and gastroschisis in North Carolina also paralleled the local use of cannabis in that state as described by Department of Justice Reports . The incidence of gastroschisis was noted to double in North Carolina 1999-2001 in the same period the cannabis trade there was rising.

Figures of cannabis use in pregnant women in California by age were also

recently reported to JAMA 229, age group trend lines by age group which closely

approximate those reported by CDC for the age incidence of gastroschisis in the USA

Importantly much of the cannabis coming into both North Carolina and Florida is said to originate in Mexico. An eight-fold rise in the rate of gastroschisis has been reported from Mexico . Gastroschisis has also risen in Washington state. Cannabis has also been associated with 17 other major congenital defects by major Hawaiian epidemiological study reported by Forrester in 2007 when it was used alone

When considered in association with other drug use – which in many cases cannabis leads to – cannabis use was associated with a further 19 major congenital defects. In addition to the effect of cannabinoids on the epigenome and microtubules, cannabinoids have been firmly linked to a reduction of the ability of the cell to produce energy from their mitochondria. An extensive and robust evidence base now links cellular energy generation to the maintenance and care of cellular DNA .

Moreover, as the cellular energy charge falls so too DNA maintenance collapses, and indeed, the cell can spiral where its remaining energy resources, particularly as NAD+, are routed into failing and futile DNA repair, the cell slips into pseudohypoxic metabolism like the Warburg effect well known in cancerogenesis , NAD+ falls below the level required for further energy generation and cellular metabolism collapses. Hence this well-established collapse of the mitochondrial energy charge and transmembrane potential forms a potent engine of continuing and accelerating genotoxicity .

Moreover, the well documented decline in mitochondrial respiration induced by cannabinoids, including tetrahydrocannabinol, cannabidiol and anandamide achieves particular significance in the light of the robustly documented decline in cellular energetics including NAD+ which not only occurs with age but indeed, has now been shown to be one of the primary drivers of cellular and whole organismal aging. It follows therefore that cannabinoid administration (including THC andCBD) necessarily phenocopies cellular aging. This implies of course that cannabinoid dependent patients are old at the cellular level. Indeed, normal human aging is phenocopied in the clinical syndrome of cannabinoid dependence which includes:

1) Neurological deficits in:

i) attention,

ii) learning and

iii) memory;

iv) social withdrawal and disengagement and

v) academic and

vi) occupational underachievement

2) Psychiatric disorders including

i) Anxiety,

ii) Depression,

iii) Mixed Psychosis

iv) Bipolar Affective disorder and

v) Schizophrenia,

3) Respiratory disorders including:

i) Asthma

ii) Chronic Bronchitis (increased sputum production)

iii) Emphysema (Increased residual volume)

iv) Probably increased carcinomas of the aerodigestive tract

4) Immune suppression which generally implies

i) segmental immunostimulation in some parts of the immune system since the innate and adaptive immune systems exert profound homeostatic mechanisms in response to suppression of one of its parts. A Substantial literature on immunostimulation

5) Reproductive effects generally characterized by reduced

i) Male and

ii) Female fertility

6) Cardiovascular toxicity with elevated rates of

i) Myocardial infarction

ii) Cerebrovascular accident

iii) Arteritis

iv) Vascular age – vascular stiffness

7) Genotoxicity in

i) Respiratory epithelium and

ii) Gonadal tissues.

8) Osteoporosis

9) Cancers of the

i) Head and neck

ii) Larynx

iii) Lung

iv) Leukaemia

v) Prostate

vi) Cervix

vii) Testes

viii) Bladder

ix) Childhood neuroblastoma

x) Childhood acute lymphoblastic leukaemia

xi) Childhood Acuter Myeloid and myelomonocytic leukaemia

xii) Childhood rhabdomyosarcoma 201,202.

The issue here of course is that cannabinoid dependence therefore copies without exception all of the major disorders of old age, each of which is also faithfully phenocopied by cannabis dependence.

The most prominent disorders of older age include:

1) Alzheimer’s disease

2) Cardiovascular and cerebrovascular disease

3) Osteoporosis

4) Systemic inflammatory syndrome

5) Changes in lung volume and the mechanics of breathing

6) Cancers

Hence this provides one powerful pathway by which cannabinoid exposure can replicate and phenocopy the disorders of old age. This is not of course to suggest that this is the only such pathway. Obviously changes of the general level of immune activity, or alterations of the level of DNA repair occurring directly or indirectly associated with cannabis use can form similar such pathways: both are well documented in cannabis use and also in the aging literature as major pathways implicated in systemic aging.

Nevertheless, the decline in mitochondrial energetics together with its inherent genotoxic implications does seem to be a particularly well substantiated and robustly demonstrated pathway which must give serious pause to cannabinoid advocates if the sustainability of the health and welfare systems is to be factored in together with any consideration of individual patient, advocate and industrial-complex rights.

The genotoxicity of THC, CBD and CBN has been noted against sperm since at least 1999 (Zimmerman and Zimmerman in Nahas “Marijuana and Medicine” 1999, Springer). This is clearly highly significant as sperm go directly into the formation of the zygote and the new human individual. CB1R receptors are known to exist intracellularly on both the membranes of endoplasmic reticulum and mitochondria. In both locations they can induce organellar stress and major cell toxicity including disruption of DNA maintenance. Interestingly mitochondrial outer membrane CB1R’s signal via a complex signalling chain involving the G-protein transduction machinery, protein kinase A and cyclic-AMP across the intermembrane space to the inner membrane and cristae, in a fashion replicating much of the G-protein signalling occurring at the cell membrane. This machinery is also implicated in mitonuclear signalling, and the mitonuclear DNA balance between mitochondrial DNA and nuclear DNA transcriptional control, which has long been implicated in inducing the mitochondrial unfolded protein cellular stress response cell aging, stem cell behaviour and DNA genotoxic mechanisms.

You are no doubt aware that human sperm are structured like express outboard motors behind DNA packets with layers of mitochondria densely coiled around the rotating flagellum which powers their progress in the female reproductive tract. These mitochondria also carry CB1R’s and are significantly inhibited even at 100 nanomolar THC. The acrosome reaction is also inhibited .

Cannabidiol is known to act via the PPARγ system 101,302-308. PPARγ is known to have a major effect on gene expression, reproductive and embryonic and zygote function during development 309-332 so that significant genotoxic and / or teratogenic effects seem inevitable via this route. Drugs which act in this class, known as the thiazolidinediones, are classed as category B3 in pregnancy and caution is indicated in their use in pregnancy and lactation.

The Report of the Reproductive and Cancer Hazard Assessment Branch of the Office of Environmental Health Hazard Assessment of the Health Department of California was mentioned above in connection with the carcinogenicity of marijuana smoke . Since virtually all mutagens are also teratogens it follows therefore from the basic tenets of mutagenesis that if cannabis is unsafe as a known carcinogen it must also be at the very least a putative teratogen.

CBD has also been noted to be a genotoxic in other studies . All of which points to major teratogenic activity for both THC and CBD. Some of the quotations from Professor James Graham’s classical book on the effects of THC in hamsters and white rabbits, the best animal models for human genotoxicity, bear repeating:

a) “The concentration of THC was relatively low and the malignancy severe.”

b) “40-100μg resin/ml there occurred marked inhibition of cell division.

c) “large total dose, Hamsters, 25-300mg/kg …“oedema,phocomelia,omphalocoele, spina bifida, exencephaly, multiple malformations and myelocoele. This is a formidable list.”

d) “It is to this anti-mitotic action that the authors attribute the embryotoxic action of cannabis.”

e) “By such criteria resin or extract of cannabis would be forbidden to women

during the first three months of pregnancy.”

Indeed, even from the other side of the world I have heard many exceedingly adverse reports from US states in which cannabis has been legalized including Colorado, Washington, Oregon, Florida and California. Taken together the above evidence suggests that these negative reports stem directly from the now known actions of cannabis and cannabinoids, and are by no means incidental epiphenomena somehow related to social constructs surrounding cannabis use or the product forms, dosages, or routes of administration involved.

Cannabis that contains increasingly high levels of THC is now widely available, particularly in the jurisdictions where the use of cannabis has been legalized. This means that another major genotoxin, akin to Thalidomide, is being unleashed on the USA and the world. This is clearly a very grave, and. indeed, an entirely preventable occurrence.

Dr Frances Kelsey of FDA is said to have the public servant based at FDA who saved American from the thalidomide scandal which devastated so many other English-speaking nations including my own . This occurred because the genotoxicity section of the file application with FDA was blank. It was blank because thalidomide tested positive in various white rabbit and guinea pig assays. It is these same tests which cannabis is known to have failed. Dr Kelsey’s photograph has been published in the medical press with President Kennedy for her service to the nation. The challenge to FDA at this time seems whether Science can triumph over agenda driven populism, its primary vehicle, the mass media, and its primary proximate driver the burgeoning cannabis industry. Since FDA is the Federal agency par excellence where Health Science is weighed, commissioned and thoughtfully considered the challenge in our time would appear to be no less.

Evidence to date does not suggest that major congenital malformations are as common after prenatal cannabis exposure as they are after prenatal thalidomide exposure. Nevertheless the qualitative similarities remain and indeed are prominent. It is yet to be seen whether the rate of congenital anomalies after cannabis are quantitatively as common: epidemiological studies in a high potency era have not been undertaken; and even the birth defects rates from most birth defects registers in western nations including that held by CDC, Atlanta appear to be seriously out of date at the time of writing. Moreover the non-linear dose response curve in many cannabis genotoxicity studies which includes a sharp knee bend upwards beyond a certain threshold level which suggests that we could well be in for a very unpleasant quantitative surprise. At the time of writing this remains to be formally determined.

Dr Bertha Madras, Professor of Addiction Psychiatry at Harvard Medical School has recently argued against re-scheduling of cannabis. Her comments include the following:

“Why do nations schedule drugs? …… Nations schedule psychoactive drugs because we revere this three-pound organ (of our brain) differently than any other part of our body. It is the repository of our humanity. It is the place that enables us to write poetry and to do theater, to conjure up calculus and send rockets to Pluto three billion miles away, and to create I Phones and 3 D computer printing. And that is the magnificence of the human brain. Drugs can influence (the brain) adversely. So, this is not a war on drugs. This is a defense of our brains, the ultimate source of our humanity” .

I look forward to seeing the comments that you post concerning the reasons why the classification for marijuana should not be changed and that, indeed, the public should be alerted to the very harmful effects of marijuana with THC, especially in light of the wide range of marijuana’s harmful effects and the high potency of THC in today’s marijuana and in light of the idiosyncratic effects of marijuana of even low doses of THC and owing to the certain risk of harm to progeny and babies born to users of marijuana.

Please feel free to call on me if you would like further information concerning the research to which I have referred herein.

Yours sincerely,

Professor Dr. Stuart Reece, MBBS (Hons.), FRCS(Ed.), FRCS(Glas.), FRACGP, MD(UNSW). School of Psychiatry and Clinical Neurosciences Edith Cowan University and University of Western Australia, Perth, WA stuart.reece@uwa.edu.au

Source: http://GordonDrugAbusePrevention.com.

A pair of new studies has revealed that marijuana use could lead to abuse of other drugs and alcohol. Experts said that these risks need to be considered not only by doctors and patients but by policy makers as well particularly in states where marijuana is legalized for recreational or medical use.

For the first study, which was published in the journal Drug and Alcohol Dependence, the results showed that adults who smoke marijuana have five times increased odds of developing alcohol use disorder (AUD) compared with their counterparts who do not smoke.

By looking at the data of more than 27,000 adults, researchers found that the participants who did not have AUD but reported using cannabis during the first survey were 5.4 times more likely to have an AUD three years later.  The participants who already battle with an alcohol use disorder and were using marijuana were also found to aggravate their dependence on alcohol.

“Among adults with no history of AUD, cannabis use at Wave 1 was associated with increased incidence of an AUD three years later relative to no cannabis use,” study researcher Renee Goodwin, from Columbia University, and colleagues wrote. “Among adults with a history of AUD, cannabis use at Wave 1 was associated with increased likelihood of AUD persistence three years later relative to no cannabis use.”

The second study, which was published in JAMA Psychiatry and involved more than 34,000 subjects, revealed that participants who used cannabis during the first survey were about six times as likely to suffer from substance use disorder after three years.

Researchers also found an increased risk for drug use disorders and nicotine dependence among pot smokers.   Although the study authors said that their findings do not establish a cause and effect relationship between pot use and substance abuse, they noted that there may be an overlap in brain circuitry that influence drug use and dependence.

“Our study indicates that cannabis use is associated with increased prevalence and incidence of substance use disorders,” Carlos Blanco, from the National Institute on Drug Abuse, and colleagues wrote. “These adverse psychiatric outcomes should be taken under careful consideration in clinical care and policy planning.”

 Source:  http://www.techtimes.com/articles/135554/20160222   22^nd Feb 2016

A study by researchers from the Murdoch Children’s Research Institute (MCRI) that followed a sample of almost 2000 Victorian school children from the age of 14 until the age of 35 found that social disadvantage, anxiety, and licit and illicit substance use (in particular cannabis), were all more common in participants who had reported self-harm during adolescence.

The longitudinal study, the Victorian Adolescent Health Cohort Study, was the first in the world to document health-related outcomes in people in their 30s who had self-harmed during their adolescence. Until now, very little has been known about the longer-term health and social outcomes of adolescents who self-harm.

Published in the new Lancet Child and Adolescent Health journal, the study found the following common elements:

· People who self-harmed as teenagers were more than twice as likely to be weekly cannabis users at age 35

· Anxiety, drug use, and social disadvantage were more common at age 35 among participants who had self-harmed during their teenage years. While most of these associations can be explained by things like mental health problems during adolescence and substance use during adolescence, adolescent self-harm was strongly and independently associated with using cannabis on a weekly basis at age 35 years

· Self-harm during the adolescent years is a marker for distress and not just a ‘passing phase’

The findings suggest that adolescents who self-harm are more likely to experience a wide range of psychosocial problems later in life, said the study’s lead author, Dr Rohan Borschmann from MCRI. “Adolescent self-harm should be viewed as a conspicuous marker of emotional and behavioural problems that are associated with poor life outcomes,” Dr Borschmann said.

The study found that anxiety, drug use, and social disadvantage were more common at age 35 among participants who had self-harmed during their teenage years. “While most of this can be explained partly by things like mental healthduring adolescence and substance use during adolescence, adolescent self-harm was strongly and independently associated with using cannabis on a weekly basis at age 35 years,” Dr Borschmann said.

Interventions during adolescence which address multiple risk-taking behaviours are likely to be more successful in helping this vulnerable group adjust to adult life.

More information: Rohan Borschmann et al. 20-year outcomes in adolescents who self-harm: a population-based cohort study, The Lancet Child & Adolescent Health (2017). DOI: 10.1016/S2352-4642(17)30007-X

Source:  https://medicalxpress.com/news/2017-07-twenty-year-outcomes-adolescents-self-harm-substance.htm

The first to die was the family’s pet duck, killed in an attempt to rid the house of evil.

By then, Raina Thaiday had already been on a cleaning frenzy for a week, scrubbing the ceilings of her Cairns home and tossing possessions out into the yard in a bid to “cleanse” the house.  But it was when she heard a dove’s call, which she interpreted as a sign from God, that she decided she must “kill her children in order to save them”.

The Mental Health Court of Queensland last month ruled, in a decision not made public until Thursday, that Raina Mersane Ina Thaiday was of unsound mind when she stabbed to death seven of her children and a niece in her home on December 19, 2014.

In 2009, Raina Thaiday was interviewed thanking paramedics for safely delivering her child in the back of an ambulance. Photo: Nine News

“To her way of thinking at the time, what she was doing was the best thing she could do for her children. She was trying to save them,” Justice Jean Dalton said, exempting the mother from trial and confining her to mental health treatment.

Along the way the court heard details of the 40-year-old’s descent into “schizophrenia at its very depths”, likely exacerbated by years of heavy cannabis use, and culminating in her being in a psychotic state when she killed eight children under the age of 15.

A week before the killing, her then-20-year-old son, Lewis Warria found Mrs Thaiday stressed and serious, spending large amounts of time lecturing him about God, the court heard.  She went on a mission to “cleanse” her house, which Justice Dalton noted went far beyond a “normal spring clean”.

“All the furniture from the house was taken outside and put in the yard,” she said.”Inside the house was cleaned, in a most unusual way, including scrubbing the ceilings and the walls and a lot of Mrs Thaiday’s possessions were thrown away.  “And a lot of them were quite valuable.”

Things deteriorated still further the night of December 18. Her eldest daughter, niece and godchild had gone out shopping and did not return at 10pm as she had requested. Mrs Thaiday walked up and down the street, “preaching” to neighbours about their use of drugs and alcohol.  Agitated, she slept outside on a mattress dragged out in the cleaning.

Justice Dalton said with the benefit of hindsight, the things neighbours heard as Mrs Thaiday walked up and down the street, talking to herself or on the phone, were “clearly psychotic”.  “She was saying things like ‘I am the chosen one’,” the judge said.

“‘I have the power to kill people and to curse people. You hurt my kids, I hurt them first. You stab my kids, I stab them first. If you kill them, I’ll kill them’.”

At 11.40am on December 19, Mr Warria arrived home to find his mother slumped on the front verandah, covered in approximately 35 self-inflicted stab wounds that included a punctured lung. His siblings and cousin were dead inside.

Nearly two-and-a-half years later Mr Warria was in the courtroom inside Brisbane’s Queen Elizabeth II Courts of Law as a judge heard the opinions of six psychiatrists who had painstakingly analysed his mother’s mental state.

The court heard when police and paramedics arrived Mrs Thaiday immediately admitted she had killed the children inside. “Papa God” had been speaking to her, she told

psychiatrists, describing herself as the “anointed one” at risk from demons, who had to rid her Cairns home of an evil presence.

Psychiatrist Dr Angela Voita treated Mrs Thaiday from the day she came into The Park, one of Australia’s largest mental health facilities, on Christmas Eve 2014, five days after the mass killing.  She assessed her more than 50 times and, along with three other psychiatrists who gave evidence to the hearing, unanimously agreed she was mentally ill at the time of the offences.

After examining reams of evidence and interviews, Dr Voita said her patient was not capable of telling right from wrong or being able to control her actions at the time of the killings.  Assisting psychiatrist Dr Frank Varghese described the “unique” crime as “a horrendous case, the likes of which I have never seen before, and hopefully will never see (again).”   This is not ordinary schizophrenia,” he advised the judge.

“This is schizophrenia at its very depths and at its worst in terms of the terror for the patient as well as for the consequences for the individuals killed as a result of psychotic delusions.”

Mrs Thaiday had no psychiatric history or previous contact with mental health services outside of counselling at a local indigenous health service.  Independent psychiatrist Dr Pamela van de Hoef said there was some evidence that in 2007 she was also very disturbed.

“She had cut all her own hair off and threatened to kill one of the children with an axe.”

In 2011, she had ideas to drown herself and similar thoughts two weeks out from the 2014 killing, the psychiatrist said. The court heard cannabis was commonly linked to the onset of schizophrenia in those already vulnerable to the illness.

Ms Thaiday kicked a 10-20 cone a day habit in the months before the slaughter, leading psychiatrists to question whether her “psychosis” was a form of withdrawal, before mostly rejecting the notion.

Instead, Dr Jane Phillips and Dr Donald Grant agreed it was more likely the illness began to affect her while she was still using cannabis, causing to her to develop “religious delusions” that “forced her to live a clean life”.

“Altogether it amounts to a very convincing body of evidence that Mrs Thaiday was psychotic at the time of the killing,” Justice Dalton said.

She ruled Mrs Thaiday had the defence of unsoundness of mind available to her and issued a forensic order for ongoing mental health treatment.

Source: http://www.brisbanetimes.com.au/queensland/schizophrenia-at-its-very-depths-drove-mother-to-kill-eight-children-20170503-gvyf42.html   4th May 2017

VICTORIAN paramedics are being called to an average of almost 60 alcohol-related and 25 drug-affected patients a day.

A surge in ice-related call-outs is a main cause of an increase in attendances of almost 30 per cent on the year before.

Prescription medication — mostly sleeping tablets and anti-anxiety medication benzodiazepines — continue to be involved in more ambulance call-outs than illicit drugs.

But a Turning Point report shows that the proportion of illicit drug misuse has dramatically increased.

Attendances for crystal methamphetamine or “ice” almost doubled in 2014-2015. The 2271 attendances a year, or six a day, is an eightfold increase since 2010-2011.

The Ambo Project, a summary of Victoria’s drug and alcohol related ambulance attendances, shows that alcohol-related harm is the most common problem: there were 21,602 call-outs compared with 9038 for illicit drugs and 9941 for prescription medications.

The number of alcohol-related cases increased almost threefold in the past six years; paramedics now attend 57 cases daily; in 49, it is the only drug involved.

Turning Point lead researcher Belinda Lloyd said ambulance call-outs for prescription medications, including antidepressants, anti-psychotics and painkillers, were higher in regional areas per rate of population.

“This is no longer a problem for major cities and entertainment precincts,” Ms Lloyd.

“We need more awareness about how to minimise the harm from drugs.”

Ambulance Victoria general manager of emergency operations Mick Stephenson, said the increase in drug call-outs, particularly amphetamines, meant paramedics more frequently sedated patients to prevent self-harm and protect health workers.

“They take this stuff at their peril because they don’t know what’s in it and nor do we.”

Minister for Mental Health Martin Foley said training of almost 40,000 frontline health workers in dealing with ice-affected patients started today.

Opposition health spokeswoman Mary Wooldridge said alcohol and drug-fuelled harm continued to put paramedics and others at risk.

Source:  http://www.heraldsun.com.au/news/victoria/ambulance-callouts-soar  7th Nov 2016

International Narcotics Control Board report says US and Uruguay are breaking drug treaties and warns of huge rise in abuse of ADHD treatment Ritalin

The United Nations has renewed its warnings to Uruguay and the US states of Colorado and Washington that their cannabis legalisation policies fail to comply with international drug treaties.

The annual report from the UN’s International Narcotics Control Board, which is responsible for policing the drug treaties, said it would send a high-level mission to Uruguay, which became the first country to legalise the production, distribution, sale and consumption of cannabis for recreational purposes.

The UN drug experts said they would also continue their dialogue with the US government over the commercial sale and distribution of cannabis in Colorado and Washington state.

The possession and cultivation of cannabis became legal on 26 February inWashington DC. Voters in Oregon and Alaska have also approved initiatives to legalise the commercial trade in cannabis for non-medicinal purposes.

The INCB said it “continues to engage in a constructive dialogue” with the US government on cannabis developments and it is clear the UN is putting strong pressure on the US government to ensure that the drug remains illegal at a federal level.

The US government has issued new guidance to banks on their provision of services to marijuana-related businesses and all state attorneys have been reminded of the need to investigate and prosecute cannabis cases in all states.

The INCB said it was aware that the US government intended to monitor the impact on public health of legalising cannabis and has again reminded the Obama administration that the position in Colorado and Washington meant the states were failing to comply with the treaties.

Lochan Naidoo, the INCB president, said the limitation of use of narcotic drugs and psychotropic substances to medical and scientific purposes was one of the fundamental principles underpinning the international drug control framework. “This legal obligation is absolute and leaves no room for interpretation,” he said.

The UN body also renewed its call for the abolition of the death penalty for drug-related offences and voiced concern that Oman was proposing to make use of the death penalty for drug-trafficking offences.

The INCB’s annual report records a further rise in the number of new “legal highs” or psychoactive substances that have been identified. The number has risen from 348 to 388 in the past year – an increase of more than 11%. More than 100 countries are taking action against “legal highs” and the INCB has welcomed moves by China, considered by many to be one of the main sources, to start banning these synthetic substances that imitate the effects of traditional drugs such as cannabis and ecstasy.

The UN drug board also warns of a 66% increase in the global consumption of a stimulant, methylphenidate, which is primarily used in the treatment of ADHD or attention deficit hyperactivity disorder and is better known by one of its trade names, Ritalin. The rise has been seen in its use by teenagers and young adults in the US, Iceland, Norway, Sweden and Australia.

It also highlights the lack of access for 5.5 billion people to medicines containing drugs such as codeine and morphine, which means that 75% of the world’s population do not have access to proper pain-relief treatment.

Source: http://www.theguardian.com/society 3^rd March 2015

Tough new laws, a boost to police to crush ice drug labs and better access to rehabilitation and needle exchange programs are central to the Andrews government’s $45.5 million plan to tackle Victoria’s ice epidemic. The package has been widely applauded as a positive first step by police and frontline social workers.

Premier Daniel Andrews said 80,000 Victorians used the highly addictive drug in the past year, which has driven up crime and made attacks on frontline service workers more common. The previous government introduced tougher sentences for people convicted of attacking emergency service workers, and Labor will spend $1 million to better protect and train frontline staff to deal with ice users. Mr Andrews said workers, including emergency services, had been getting by “on their wits” when dealing with ice users .

Under the $45.5 million package, $18 million has been allocated for more rehabilitation services, particularly in rural areas which have been struggling to keep up with demand. More users are now injecting the drug so existing needle and syringe programs will also be bolstered to reduce the danger of disease.

Labour will pursue four new laws in parliament, including punishing those who publish ice “recipe books” as well as those who push drugs near schools. Dealers who use stand-over tactics to force buyers to sell ice will also be punished as will landlords who allow manufacturing or dealing on their premises. “If you are a landlord or a nightclub owner and you turn a blind eye to the fact this poison is being manufactured in your premises or being dealt in your premises you are part of the problem.”

The $45.5million will be in May’s budget and will be spent over the next four years.

Police will receive a $4.5 million investment to expand the Forensic Drug Branch which will crackdown on clandestine drug labs, as well as increasing drug profiling and intelligence. A further $15 million will be spent on new drug and booze buses. Families of addicts will also receive a $4.7 million fund to help people identify users and direct them to services. Support for families will also be expanded and a dedicated Ice Help Line will be set up.

Sam Biondo, executive officer of the Victorian Alcohol and Drug Association, said it was a “very positive move” to begin to address the complex problem. But Mr Biondo said there were still many issues that needed to be tackled, including looking at how the justice system approached the drug users.

He said the Napthine government’s  “tough on crime” rhetoric had helped exacerbate the problem, with Mr Biondo calling for a discussion on how people were rehabilitated. “There were a lot of words but the only actions were in corrections,” Mr Biondo said. He said diversion schemes would deliver far better outcomes than simply sending people into prison.

The Premier also flagged working with the Commonwealth and other states about stopping the importation of drugs as well as cracking down on “unexplained wealth” from suspected drug players.

The opposition welcomed the plan but also accused Labour of ripping out $5 million from community education forums and community grants programs.

“The fight against ice has bipartisan support, but Daniel Andrews’ record must be judged on his acts in cutting funding to ice programs,” opposition spokesman Tim Bull said. 

Source: http://www.theage.com.au/victoria/victorias-ice-crackdown 5^th March 2015

Nearly five young people are being admitted to hospital every day in NSW because of alcohol, exclusive data from NSW Health shows.

The figures show the huge toll alcohol is taking on children and young people in NSW, with a child aged between zero and four admitted to hospital almost every week because of injuries linked to their parents’ drinking. 

In total, nearly 1800 children aged between zero and 19 were so injured by their own drinking or that of others they were admitted to hospital in the 2012-13 financial year.

Experts say the government needs to urgently crack down on alcohol sales to children by introducing undercover stings, while parents need to heed the message that providing alcohol to their kids is dangerous.

The director of the McCusker Centre for Action on Alcohol and Youth, Mike Daube, said the hospital admissions were just the tip of the iceberg.

“This is only injuries so severe they need hospitalisation, and even then it is five a day in NSW alone,” he said. “This comes in a week when research has shown more than half of kids say it’s easy to buy alcohol.

“How many more wake-up calls do we need … state governments need to crack down on this issue.”

In the 2012-13 financial year, the last for which information is available, 1565 teenagers aged 15 to 19 year were admitted to hospital because of problems linked to alcohol. The overwhelming majority were male.

The injuries could involve problems directly caused by alcohol consumption, or injuries linked to alcohol, NSW Health said. Last month a 19-year-old student, Carl Salomon, died after falling from a crane into water in Balmain after a night out drinking.

And the harm doesn’t stop with teenagers. More than 50 children aged between zero and four and 70 aged five to nine were treated in hospital because of injuries linked to alcohol. Even more would have suffered from problems linked to foetal alcohol syndrome, which occurs in a baby whose mother drinks heavily while pregnant, that are not included in the data.

The chief executive of the Foundation for Alcohol Research and Education, Michael Thorn, said cheap, two-for-one and similar alcohol deals encouraged young people to binge drink. “Kids are very price-sensitive,” he said. “And they don’t take it home if they haven’t drunk it all”.

This week the foundation released a report into alcohol’s impact on children and families that found up to a quarter of people could be experiencing harm from the drinking of family members.

“Being raised in a harmful environment is very deleterious to a child, it affects their education, their development, their wellbeing, and it certainly increases their likelihood of health problems later,” he said.

Jo Mitchell, the director of the centre for population health in NSW Health, said dangerous drinking did not just occur among young people. “This is a serious public health issue across all age groups,” she said. “Often people think there’s a specific problem for young people … whereas the data shows that across the board there are high levels of risky drinking among adults as well.”

A new NSW Health data snapshot shows the rate of alcohol hospitalisations in NSW increased by 35 per cent from 1998-99, with nearly 52,000 hospital cases linked to alcohol in 2012-13.

But she said there had been some good successes in recent years in decreasing drinking rates. The department was also focused on delaying the age at which young people drank, and raising awareness among parents about the dangers of alcohol supply.

One such program, called “Stop the Supply“, has been run by the Northern Beaches Community Drug Action Team.

Team chairwoman Susan Watson said many parents were not aware of the dangers of youth drinking.

“We know that alcohol causes damage to [a growing] brain, and we didn’t know that years ago … so it’s really about starting conversations with parents about that,” she said. “It can be really difficult for parents to make these decisions when there is all this pressure out there, not just from themselves but from other parents.”

Source: http://www.smh.com.au/nsw/children-admitted-to-hospital-because-of-alcohol 1^st March 2015

The Northern Grampians Highway Patrol said roughly one in two drivers tested positive for drugs like cannabis or methamphetamines.

Acting Sergeant Shaun Allen said they were disappointed in the results.

“They’re certainly over-represented now in our statistics and especially in relation to serious collisions, we’re finding that more and more are positive in regards to drugs,” he said.

He is urging people not to get behind the wheel if they have been using drugs.

“We random drug test drivers and if they become positive with our tests, they get sent away for a proper laboratory test and then if it comes back then we prosecute on that,” he said.

“There’s no level with drugs, you’ve either got them in your system or you haven’t.”

Source:  http://www.abc.net.au/   Feb.2015

The following two articles come from Australia.  The co-author of the first, Alex Wodak is a world renowned activist in the movement to legalise drugs – in particular cannabis.  The carefully referenced response in the second article was written by Professor Dr. Stuart Reece.

Some frequently asked Q’s and A’s about medicinal cannabis

Prepared by Laurie Mather, PhD, FANZCA, FRCA, Emeritus Professor of Anaesthesia, The University of Sydney (lmather@med.usyd.edu.au) and Alex Wodak, AM, FRACP, FAChAM, FAFPHM Emeritus Consultant, Alcohol and Drug Service, St Vincent’s Hospital, Sydney, NSW, Australia (alex.wodak@gmail.com), 18 June, 2014

A History:

Q: What is cannabis?

A: Some people call it by its American name, marijuana. The name ‘cannabis’ describes its botanical origins and comes from the Latin word for hemp. The name ‘marijuana’ (or sometimes ‘marihuana’) is a contrived name given to associate it with African and Hispanic Americans who used it as a recreational drug in the United States during the 1930s.

Q: What has the cannabis plant been used for?

A: Cannabis is an ancient herb-like plant that has been used for thousands of years for fibre-making for products such as clothing and rope, for dietary ingredients, as an element of folk medicine, and as an agent to promote spiritual transcendence, particularly in the religions of South Asia. ‘Recreational’ cannabis use was uncommon in the West before the 1960s. A League of Nations meeting in Geneva in 1925 decided to ban cannabis internationally. Cannabis first started to come to the attention of law makers and enforcers in the USA in the 1930s. The Congressional Record from that time includes comments about perceived depravity attributed to cannabis use along with racial slurs. Progressively it became an illegal substance in many countries, including Australia.

Q: When did cannabis come into Western civilisations?

A: European venturers over many centuries, as judged by their writings, certainly encountered cannabis in their travels to exotic Eastern and Far Eastern lands. By the mid 19th century, cannabis, in one form or another, had become part of the medical-societal-experimental experience of many European societies.

Q: When did cannabis come into Western-style medicine?

A: Cannabis was adopted into British medicine from India in the mid-19th century having been observed there to relieve pain, muscle spasm, convulsions of tetanus, rabies, rheumatism and epilepsy.

B Cannabis as a medicine:

Q: How does cannabis work?

A: As a plant preparation, cannabis ordinarily contains many hundreds of chemical substances commonly found in plants (‘phytochemicals’), and a hundred or so unique substances commonly referred to as ‘phytocannabinoids’. A small number of phytocannabinoids are believed to cause the main pharmacological effects of cannabis in humans. Cannabis attaches to special receptors in the brain and some other organs in the body. This releases a special chemical that the body produces. The chemical acts as a transmitter.

Q: What is ‘medicinal cannabis’? Some people also refer to this as ‘medical marijuana’.

A: The ‘medicinal’ tag recognizes that cannabis, among many other uses, has the properties of a medicine.

C Benefits of medicinal cannabis:

Q: Why do some argue that medicinal cannabis be legalised?

A: It helps some people with distressing symptoms from serious medical conditions when they have not been sufficiently helped by the standard medicines. Cannabis is considered a ‘second line’ drug to be used when the first line drugs have been tried and have either not worked or had unacceptable side effects.

Q: What kind of evidence is there that cannabis can help some people?

A: The evidence is basically of three kinds. First, there is anecdotal evidence, usually provided by people who have experienced in themselves or observed in others some effect. Most information like this is hard to assess because it lacks corroborative documentation – and this is the kind of evidence that tends to appear in the lay press and on internet blog sites. This is not to say that the evidence is invalid – but only to say that the much of the vital information underpinning the claims is not available in a way that permits scientific scrutiny. The second type of evidence is papers published in reputable medical and scientific journals after peer-review. A third type of evidence is careful reviews of papers reporting the results of cannabis research.

Q: How good is the evidence that cannabis can help some people?

A: Randomised controlled trials (RCTs) are usually regarded as the best way of telling whether a medication is effective. In one recent review, for example, 82 RCTs showed that medicinal cannabis is effective in relieving distressing symptoms in about half a dozen conditions. 9 RCTs found that medicinal cannabis was not effective. This is quite an impressive result. There are at least half a dozen favourable reviews by prestigious organisations.

Q: What are the main medical conditions that might be helped by medicinal cannabis?

A: Severe nausea and vomiting after cancer chemotherapy, especially if no standard treatment has worked; severe chronic non cancer pain, especially if the pain is due to nerve damage; severe wasting in cancer or AIDS (though this is less common these days); stiffness due to multiple sclerosis. There are also some other conditions.

Q: Is cannabis a cure for any conditions or diseases?

A: Not as far as we know so far from scientifically assessed evidence.

Q: Can cannabis help young children with severe epilepsy resistant to all known treatments?

A: A number of people have claimed this. But this possible benefit has not yet been tested in scientifically assessable research.

D Potential risks:

Q: Are there any bad side effects from medicinal cannabis? People talk a lot about psychosis and marijuana: should we be worried about using a medicine that could cause schizophrenia?

A: Most of the assessment of side effects has been based on what is known from studying recreational cannabis. That’s like studying the safety of bootleg alcohol to estimate the safety of regulated alcohol. Used medically, cannabis can cause some mental disorientation, sleepiness, and dry mouth but these are typically less severe and troublesome than many of the medications that might be used to treat the same conditions. Besides, the effects of not treating the conditions also has to be considered. It has also been said that some of these side effects counteract the worse side effects of the other medications such as chemotherapy agents that cause serious side effects themselves. People distressed by severe symptoms unrelieved by conventional medications are unlikely to be concerned by the small risk of serious mental illness in a couple of decades time.

Q: Is there a risk that legal medicinal cannabis would increase the use of recreational cannabis.

A: Recreational cannabis use in those US states which allow medicinal cannabis is not greater than those states where medicinal cannabis is not permitted.

Q: Can’t people taking cannabis become addicted to it?

A: Dependence is a small risk with cannabis in the sense that it is not as severe as the dependence that occurs with tobacco, heroin or cocaine. What matters is not just the risks of cannabis but also its possible benefits and the benefits and risks of using other medicines or no medicines.

Q: Aren’t there more modern and more effective drugs than cannabis?

A: Yes there are. But these don’t work in every case and sometimes they too can produce nasty side effects. Many of the more modern drugs are also much more expensive and some require the patient to be kept in hospital while they are being administered.

E Taking medicinal cannabis:

Q: Are there alternatives to taking cannabis by smoking it? How else can medicinal cannabis be taken?

A: Cannabis can also be vaporised and the vapour inhaled. Devices are now available to make inhalation of cannabis vapour convenient and inexpensive. Oral forms of cannabis (dronabinol and nabilone, developed some 30 years ago) used to be available in Australia but are not available any more because they were expensive and not especially reliable, and they have been made obsolete. There is little scientific information available about other forms of medicinal cannabis given by mouth (such as tincture). Cannabis taken by mouth, although perhaps well-enough absorbed, is broken down in the liver before it gets into the main blood stream, making it hard to get the right dose in many people. Also, when cannabis is taken by mouth there seems to be an increased risk of anxiety attacks because there is no way to ‘stop giving it’ once it has been swallowed. Sativex (aka nabiximols) is a form of medicinal cannabis manufactured by a small pharmaceutical company. It is sprayed on the inside of the mouth. There are many attractive aspects of Sativex®, particularly convenience, but it is not readily available in Australia, and is only permitted in cases of stiffness (spasticity) from multiple sclerosis. Tincture of cannabis used to be legally available some 20 years ago. It has been made available by some individuals in Australia but its supply, these days, is not legal. If medicinal cannabis is allowed in Australia, some people with only a short time left to live and others who have been smoking cannabis for a long time are likely to continue to smoke the drug

Q: Aren’t Sativex and dronabinol available on the Pharmaceutical Benefits Scheme?

A: Neither Sativex (nabiximols) nor dronabinol are available on the Pharmaceutical Benefits Scheme.

Q: Is cannabis available medically in any other countries?

A: Medicinal cannabis is now available in about twenty countries including the USA (23 states), Canada, Switzerland, the Netherlands, and Israel.

Q: How is medicinal cannabis controlled in other countries?

A: In some countries medicinal cannabis controlled quite carefully with prescriptions by doctors and pharmacy dispensing. In some other countries, controls are much more relaxed and cannabis can be bought over the counter.

F Political and community factors:

Q: What’s stopping the government from legalising medicinal cannabis in Australia?

A: The main reason cannabis in not available in Australia is because of political impediments. Some Commonwealth and state/territory laws would have to be changed slightly. States make their decisions independently. Medicinal cannabis is allowed, in principle, under Australia’s international treaty obligations.

Q: How can we allow cannabis to be used medicinally while stopping it being used recreationally?

A: Easy. Australia allows morphine, cocaine, amphetamine and ketamine to be used medically while the recreational use of these drugs is prohibited.

Q: Is Australia doing enough research on medicinal cannabis?

A: Very little research on medicinal cannabis is carried out in Australia.

Q: What about people who might take medicinal cannabis and then try to drive a car?

A: There is an increased risk of a car crash if a driver has taken cannabis recently. This risk is much less than with alcohol but the risk if even greater after a combination of alcohol plus cannabis has been taken. A number of medicines which are prescribed today in Australia also increase the risk of a car crash.

Q: What is public opinion in Australia about medicinal cannabis?

A: In a community survey commissioned by the Commonwealth Department of Health in 2010, 69% of Australians supported medicinal cannabis with 75% supporting more research.

Q: Do many Australians take cannabis for medicinal purposes now?

A: Yes, but we don’t know how many.

Q: Will medicinal cannabis be allowed in Australia?

A: Possibly. But it’s very hard to predict this.

*         *        *        *        *         *       *       *       *       *       *       *       *

 

Response to Comments by Wodak and Mather

 

1.  One notes that Dr Alex Wodak is one of the key authors of this paper.  As the undisputed champion of drug decriminalisation in Australia for the last 30 years one must necessarily wonder what impact his personal views have on the advice he has provided to the parliament on this occasion.

 

2. The title of the paper uses the phrase “Medical cannabis”.  It is a matter of record that “medical cannabis” has been deliberately used as the “Trojan horse” or thin edge of the wedge which is strategically used to introduce cannabis decriminalization.  This has been true in many instances overseas, and the US states where it is now decriminalized.  Moreover this tactic was made explicit in NSW last year during the unsuccessful attempt to introduce what was popularly thought to be a medical cannabis bill, but it turned out was only for homosexual patients who liked to smoke cannabis.  In the GPSC2 report which was tabled before the parliament at that time, it was acknowledged that only patients who liked to smoke cannabis – and their friends and carers – would be likely to avail themselves of the alleged benefits of the then proposed legislation.  In other words the very use of the term “medical cannabis” is the standard misnomer for cannabis decriminalization 1 which it has been found to be the most successful way to introduce it in virtually every jurisdiction around the world, and has been repeatedly used in NSW.

 

3. As was noted recently by Dr Nora Volkow the Director of the NIH Institute concerned with drug addiction 2, cannabis has a well recognized withdrawal syndrome associated with it, which can be experienced by up to 50% of people who are exposed to it on a daily basis, particularly when that exposure occurs in adolescence 1.  In the fourth answer on page 1, the authors list a series of symptoms including pain, muscle spasm, agitation, fits, convulsions and rheumatics all of which are recognized presentations of cannabis withdrawal 3.  Since the pro-pot group acknowledged that only pot-smokers will want to smoke pot if it is legalized, what they are really saying is that they will be able to treat their cannabis dependence syndrome more easily if it is made more readily available.  Even the cannabis advocates acknowledge that more efficacious and safer treatments exist for every purported indication for which they suggest its use.

 

4. The first answer on page 2 is completely incorrect.  In this response Wodak et. al. appear to claim that smoked cannabis is a medicine.  As noted by Dr Volkow raw cannabis contains hundreds of chemicals and is an impure substance.  After burning as in smoking the products of full and partial oxidation form thousands of chemicals many of them highly toxic and frankly carcinogenic including similar tars, polycyclic hydrocarbons and aromatic amines as those found in tobacco smoke.  No regulatory authority in the world (e.g. FDA 4 in USA or TGA 5 in Australia) acknowledges any smoked preparation as a valid form of dosing of any medicine.  The term “medical cannabis” is therefore in strictly medical terms a misnomer which has been

strategically designed to confuse and mislead people as part of the clever public relations marketing campaign of the big cannabis industrial developers (by analogy with big tobacco interests), as have now developed in California, Colorado, Oregon, Washington state and elsewhere.

——————

1 Lonsberry B “Medical marijuana is a fraud.”  News Radio WHAM 1180.  http://www.wham1180.com/onair/bob-lonsberry-3440/medical-marijuana-is-a-fraud-12428431  Viewed 13th July 2014. 2 The Institute she directs is called the National Institute of Drug Abuse. 3 See Epilepsy Action Australia – http://www.epilepsy.org.au/living-with-epilepsy/lifestyle-issues/alcohol-and-drugs 4 Food and Drug Administration 5 Therapeutic Goods Administration

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5. The answer to the second question on page 2 is also incorrect.  Wodak et. al. claim that cannabis is a second line drug for various – unspecified – medical conditions.  This is erroneous.  As clearly stated on the Epilepsy Action Australia webpage cited 6 it is not indicated at all by reputable authorities in this country as it is not even legal!  The other point is that to achieve the so-called therapeutic effects one frequently has to achieve concentrations into the toxic range.  There are numerous other treatments for glaucoma, asthma, epilepsy, pain and nausea.  Were it legal and therefore ethical to list cannabis for these disorders, cannabis would be about 10th line, 20th line, 60th line, 80th line and 10th line respectively.  This is another way of – politely – saying that there are no valid clinical indications for cannabis at this time.  As Wodak and colleague correctly observe the indication for AIDS wasting has now become obsolete because of the great improvements in the treatments for AIDS.

 

6. Moreover in addressing this all important issue – the motivation for medical cannabis – Wodak and Mather appear to overlook the role of the pro-cannabis lobby in this campaign.  Indeed one wonders if there would be any campaign to legalize cannabis if those who do not like to use it themselves were excluded from advocacy roles.  One can only surmise at the relationship of the present advocates of the pro-pot position to the pro-pot practice.

 

7. Wodak and colleague’s answer to Question 3 on page 2 is also erroneous.  Anecdotal evidence is not considered evidence which is even evaluable by reputable medical authorities.  Wodak’s remarks do not state this clearly.  One notes – paradoxically – that Wodak is keen to discount such evidence in the case of implant naltrexone – even in anecdotal cases where implant naltrexone has been obviously enormously successful (such as five years heroin free).  At this point Wodak appears to be applying a double standard.  The third type of evidence cited by Wodak and colleague is vague and unclear.  The authors refer to “careful reviews of papers”.  This is not a medical term.  Modern Science considers “systematic reviews” and “meta-analyses”.  Wodak and Mather do not even use these terms. So their meaning is unclear.  In the context one must be concerned that this obfuscation of meaning may be deliberate.

 

8. Similar concerns apply to the fourth answer on page 2.  Wodak and Mather refer to “one recent review”.  The source is not even referenced!  There are many reviews in medicine and one needs to consider the whole of the literature.  Apparently this was not a systematic review or a formal meta-analysis as otherwise one would expect the authors of the present work to have cited this.  Moreover the results of meta-analyses are typically reported in very complex form – not the very simplistic format which seems to be indicated by Wodak and Mather.  The question is not  “What were the findings of one particular review?”.  The question in principle is “What does the totality of the literature say?”, or more formally “What were the findings of the largest, most comprehensive and most recent meta-analyses of the topic”.  Moreover one again notes that Wodak and Mather have reported only a fraction of the information required to form an evaluation.  How many of the patients involved in these un-sourced trials had to discontinue their trial medication because of toxicity?  How many were lost to follow up?  And particularly in how many patients who had not been previously exposed to smoked cannabis and who had been provided with access to all the usually recommended treatment options – was cannabis found to be the best therapy?  Wodak and Mather’s un-referenced material does not even consider these pivotal questions, much less provide the parliament with the sorely needed information to address them.

————-

6 http://www.epilepsy.org.au/living-with-epilepsy/lifestyle-issues/alcohol-and-drugs

————–

 

9. The fifth answer on page 2 realting to the alleged medical indications for cannabis is also highly suspect.  Let us review these conditions individually.

 

1) Nausea and vomiting with cancer chemotherapy can generally be controlled adequately with current methods.  The drugs most commonly used and often effective are prochlorperazine and metaclopramide.  Chief amongst the newer agents is the 5HT3 7 antagonists such as ondansetron, tropisetron and dolasetron, some of which can also be given as a sub-lingual wafer or by subcutaneous, intramuscular, or intravenous injection if needed so that vomiting itself does not preclude their administration.  Similarly prochlorperazine can be given by suppository.  These medications can all be given by many routes of administration.  Other medications can also be used including steroids where required.

2) Pain clinics have numerous ingenious ways to control pain.  Pain can also be induced by cannabis withdrawal, and cannabis use itself has been shown to be linked with chronic back pain, so beware the pain presenting in the cannabis addicted patient / advocate.  Nevertheless Wodak and Mather are correct that many patients are left in difficult situations by their chronic non-cancer pain.  This is an active area of research internationally, and one to which Australian researchers, particularly at the University of Adelaide, are making major contributions.  The recent demonstration that inflammatory activity in the brain and nerves is associated with pain generation and pain perceptual mechanisms has opened major investigative pathways for the development of several exciting new agents.  This is a project upon which some of the top medicinal chemists in the world are actively engaged, some of whom work intramurally at the NIH and NIDA 8 itself.  One notes in passing that Wodak and Mather have neglected to observe that D-naltrexone and D-naloxone show special promise for this application.

3) AIDS wasting – As noted by Wodak and Mather this indication is disappearing due to the efficacy of the newer treatments for AIDS.

4) There are other treatments for MS stiffness.  In particular recent advances in immunology have meant that the treatment of MS itself has dramatically improved in recent times with several newer options including teriflunomide, dimethyl fumarate, fingolomod and dalfampridine.  Benzodiazepines, Lioresal, several anticonvulsants and local Botox can all find application when spasm is a problem.

10. The sixth answer on page 2 is also erroneous.  Wodak and Mather claim that cannabis is not a cure for any described medical condition.  Cannabis dependence and withdrawal is a well described medical condition acknowledged both in DSM-IV and DSM-V 9 of the APA 10.  Administration of cannabis to patients in such states will produce a short term relief of symptoms, albeit with an exacerbation of its many long term toxic effects, oncogenicity, and gateway effects in other drug use, and likely damage to adolescent brain development 1-2.  There is no intention in making this point to be humorous.  This is very important because it is clear that many of the patients who are brought along to parliamentary enquiries, and who offer public testimony of the wonderful effects of cannabis are actually speaking from a background of pre-existing cannabis dependency and addiction.  Lawmakers need to keep this key issue always in the forefront of their minds.  As correctly identified by Dr Volkow, cannabis can cause many illnesses so the claim that cannabis relives a pain in whose aetiology cannabis was implicated, must be viewed with substantial circumspection by those charged with responsible decision making in our community.  Lawmakers should note that these disorders include chronic back pain 2.

—————

7 5HT is the standard medical abbreviation for serotonin.  This refers to the 5HT-3 ligand – receptor pair. 8 National Institute of Drug Abuse 9 Diagnostic and Statistical Manual IV and V respectively. 10 American Psychiatric Association

—————-

 

11. The purported answer of Wodak and Mather to the issue of cannabis related toxicity given as answer 1 on page 3 is not only erroneous but dangerous.  It is misleading and confusing.  Of course one can form an impression of the possible early toxicity of high level cannabis exposure by studying low level recreational exposure.

 

12. In addressing the subject of cannabis toxicity their answer actually acknowledges none of the key salient points made by Dr Nora Volkow in her leading article in the New England Journal of Medicine on June 4th 2014.  The interested reader is referred there for more information, and to Hon. Rev. Fred Nile’s speech introducing the subject to the Legislative Council of NSW. In particular, compared with the eminent work of Volkow and colleagues, Wodak and Mather overlook:

 

1) Known psychiatric toxicity – schizophrenia, anxiety, depression, bipolar disorder;

2) Effects as a gateway agent to other and hard drug use;

3) Damage to brain development particularly when exposure occurs in key developmental stages such as pregnancy, childhood and adolescence

4) Damage to attention, intellect, cognition, memory

5) Damage to long term lifetime trajectories including ability to form stable relationships and to gain useful employment;

6) Respiratory toxicity including chronic bronchitis and emphysema-like changes;

7) Driving related toxicity including fatal car crash, both alone and in combination with alcohol;

8) Cardiovascular diseases including stroke, and heart attack and transient ischaemic attacks;

9) Immunosuppressive actions particularly when given to AIDS patients, and especially when taken by the smoked route;

10) Real concern in many studies about the connections of cannabis to cancer.

 

13. Moreover as Dr Volkow astutely observes many of these old cannabis studies were done when the THC concentration of cannabis was 3%.  So the studies which found no ill effects in the 1970’s – 1990’s are likely out of date at this time.  Dr Volkow has noted that THC concentrations of cannabis are now reported in the USA commonly at 12%.  Indeed one cannabis shop is said to be opening in Colorado reporting a choice for patrons from 17% – 20% THC in its product!

 

 

14. Wodak’s answer in relation to side effects also reverses the true state of affairs.  Clinical reports of cannabis use cite a very high rate of unacceptable side effects, which frequently precludes is clinical application.  Such very elevated rates of discontinuation (often around 30-50%) of cannabis based treatments are rare with other treatments in the conditions under discussion.

 

15. The risks of mental side effects from cannabis are not distant and remote as Wodak and Mather claim.  Cannabis intoxication, dependence and tolerance in patients exposed to high levels of it – albeit for therapeutic purposes – are common, and

entail anxiety, paranoia, forgetfulness and depression, and at times psychotic disturbances and hallucinations as being not unusual.

 

16. The second answer on page 3 is misleading. There is extreme concern in the US now, and numerous on the ground reports that cannabis use in states permitting cannabis use has increased dramatically.  California tabled its first cannabis BILLIONAIRE in 2013.  Does anybody seriously believe that that is because nobody is buying his products??

 

17. It was estimated recently by official sources that Colorado will consume 130 tonnes of cannabis annually 11.  Selling at $220 per ounce 12 and with 35,274 ounces per tonne, this translates to $7,760,280 / tonne or $1,008,836,400 for the whole crop in that state alone.  Unfortunately, whilst tax revenues were cited as a major reason for legalization in Colorado, the simple expedient of not buying it from one of the state’s three registered recreational cannabis dispensaries which were more expensive than the medical pot shops, allowed taxation to be circumvented 13.  It is important to note that 67% of all the cannabis sold was used by the 22% of heaviest users, further confirming the addictive nature of the legally available weed 14.

 

18. The trade was also encouraging cannabis tourists to flow into the state, just as had happened in the Netherlands 15.  Indeed one court has ruled that the Dutch coffee shops be compensated for the reduction in their trade consequent upon a tightening of the laws which have now been put in place to restrict such cannabis tourism 16.

 

19. The US reviews cannabis consumption in numerous states.  The CDC have just published national figures however the data from two key states was not available.  The sample from Colorado was unusable, and Washington state did not participate in the survey at all 17.  In other words if official figures fail to show increased use in the states legalizing cannabis that is likely a direct product of the “Don’t’ ask, Don’t tell”  policy applied to addiction epidemiology by CDC.

 

20. The third answer on page 3 is also incorrect as judged by Dr Volkow’s article.  Even the baseline risk of cannabis addiction is high at 9%, particularly given that up to 40% of the community have been exposed to cannabis.  As Dr Volkow points out the addiction rate can rise up to as high as 50% in many groups.  If as is widely suggested cannabis is legalized, then heavily cannabis addicted patients will become much more commonplace.

——————

11 Silva R “Colorado marijuana market consumes estimated 130 tonnes of the drug annually.”  HNGN 12th July 2014.   http://www.hngn.com/articles/35958/20140711/colorado-marijuana-market-consumes-estimated-130-tonnes-of-the-drug-annually.htm  Viewed 13th July 2014. 12 Wyatt C., “Colorado Completed First Legal Pot Study.”  Associated Press.    http://hosted.ap.org/dynamic/stories/U/US_RETHINKING_POT_DEMAND?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT   Viewed 13th July 2014. 13 Wyatt C., “Colorado Completed First Legal Pot Study.”  Associated Press.    http://hosted.ap.org/dynamic/stories/U/US_RETHINKING_POT_DEMAND?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT  Viewed 13th July 2014. 14 Light M.L., Orens A.;, Lewandowski B., Pickton T.  “Market size and demand for marijuana in Colorado.” Prepared for Colorado Dept of Revenue.   http://www.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=Content-Disposition&blobheadername2=Content-Type&blobheadervalue1=inline;+filename%3D”Market+Size+and+Demand+Study,+July+9,+2014.pdf”&blobheadervalue2=application/pdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1252008574534&ssbinary=true  Viewed 13th July 2014. 15 Rodriguez C., “Marijuana for tourists, discord for the Netherlands.”  Forbes magazine 24th September 2013. http://www.forbes.com/sites/ceciliarodriguez/2013/09/24/weed-ghettos-for-tourists-anger-netherlands-neighbors/   Viewed 13th July 2014. 16 Kooren M, “Dutch Cannabis coffee shops to be compensated over tourist laws.” Reuters.  http://rt.com/business/shops-dutch-coffee-cannabis-303/   Viewed 13th July 2014. 17 CDC MMWR – Youth Risk Behaviour Surveillance – United States , 2013.  http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf   Viewed 13th July 2014.

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21. The fourth answer on page 3 is also misleading.  If one speaks with unbiased and independent respiratory physicians who treat asthma, ophthalmologists who treat glaucoma, neurologists who treat epilepsy, and pain physicians who treat pain, one hears the same refrain repeated over and over again that cannabis is not required as a treatment.  The treatments of today are in general more than sufficient for the clinical requirements.

 

22. The fifth answer on page 3 is strangely at variance with every drug regulatory agency in the world.  Oddly, Wodak and Mather seem to recommend the smoked route in direct contrast to every other medicinal chemist and regulatory agency the world over.  One can only wonder if this does not reveal their personal bias.

 

23. Australia is a signatory to the international narcotic conventions particularly the Single convention 1961.  Legalization would entail a major change in Australian society and Australian Law to allow legal cannabis.  We would be in breach of our international treaty obligations.  Amongst other things, these treaties allow us to participate in international policing operations to help to break up global drug running gangs, and to cooperate with law enforcement across national boundaries on many issues.

 

24. There is no question that Australia’s use of its presently legal drugs, tobacco and alcohol is responsible for an enormous public health burden.  Adding cannabis to this situation, when – paradoxically – Wodak has been one of the loudest voices opposing alcohol- and tobacco- related harms – would clearly compound this situation.  Moreover because of the well established gateway effect of cannabis, allowing cannabis would increase the use of the other illegal drugs.  Hence this change would signal Australia’s degeneration into an increasingly drug taking-culture.  We would become less employed and less employable; that is our welfare bill will inevitably rise. The rate of congenital abnormalities would rise so children would be borne with lifelong disabilities including mental retardation.  The rate of chronic disease in the community, including chronic back pain, would rise.  In other words legalizing cannabis will increase our physical and mental health bill and our long term welfare dependency bill, at the same time as reducing our taxation base and national income generating capacity.  This is an impossible cost squeeze and social dysfunction squeeze for any Government.

 

25. The fifth answer on page 3 relating to restricted use of cannabis is invalid.  Wodak and Mather claim that one could nevertheless restrict cannabis use if it was allowed medicinally by analogy with morphine, cocaine, amphetamine and ketamine.  40% of our population has not been exposed to these agents.  Moreover this is not the pattern which has been seen recently as medicinal cannabis is the all too obvious leading edge of cannabis decriminalization around the world.  One notes the very reverse of this in the Dutch experience alluded to above.

 

26. The sixth answer on Page 3 is also suspect.  Wodak and Mather have neglected to mention that  cannabis is the drug most frequently implicated in car crashes after alcohol, and the most frequently implicated of all the illicit drugs in motor vehicle crashes.  Legalizing it and increasing its use would obviously exacerbate this by an amount at least proportional to the amount of its increased use.

 

27. Moreover as the authors correctly observe alcohol is already legal, so that legalizing cannabis effectively legalizes the highly dangerous cannabis–alcohol cocktail.  This

has been shown to be very dangerous in many studies, as is acknowledged by the present authors.

 

28. Wodak claims that many Australians take cannabis medicinally at present.  He has not stated how many of these were previously habituated to cannabis.  He does not say how many of these are taking it for cannabis-induced diseases.  He does not give data on the overall physical or mental health of cannabis smokers, prior to the commencement of their supposed serious illness.

 

29. The other chestnut which Dr Wodak frequently mentions, although it is absent from the present paper, is that alcohol and tobacco are related to far more ill-health in the Australian community than cannabis.  In a simple quantitative sense it may or may not be correct.  In either event it is an appalling argument in that it fails to correct for the very different exposure patterns of the different agents.  The more frequent use of tobacco and alcohol in our community is directly related to their differing legal status.  Both the numbers consuming tobacco and alcohol and the relative amounts consumed, are greater for the legal drugs than any of the illegal drugs, precisely because of their legal status.  So whilst Wodak and colleagues frequently use this argument to ridicule genuine medical concerns in relation to the illicit drugs, in fact it is a potent argument in favour of retention of the present status quo, and the illicit status of the presently proscribed agents including cannabis.  Given what has now been established by medical researchers in relation to cannabis-induced toxicity it presumes far too much to suppose that cannabis is any less toxic than our presently legal intoxicants.  No reputable scientist who is unbiased and familiar with the published research in this area would support this liberalist position.

 

30. In fact detailed examination of communities where cannabis consumption is normative, such as the northern rivers district of NSW including the Nimbin-Mullumbimby area, show that the area is shockingly affected by unduly elevated rates of depression, suicide, murder, unemployment, family breakdown rates, poverty and general unhappiness 18, despite its being situated in some of the most fertile and productive rural landscapes in the country.  Given what is now known of the medical effects of cannabis, much of this social disadvantage and community repression which is reflected on every metric, can likely be related directly or indirectly to the known high cannabis consumption rate in the area, and the apparently legally protected status of the region’s not insignificant cannabis crop.

General Remarks

31. Overall one is left with the impression that the work that has been produced by Wodak and Mather is a thoroughly activist piece.  This document distorts and mishandles the truth at most points.  In short it is a document such as might be expected from Australia’s leading drug advocate.  In that sense it is highly predictable.

32. That it purports to be a reputable and scientifically reliable source of information for lawmakers is appalling.  It is neither scientific nor reliable.  In a scientific sense it is nothing less than a national scandal.  It is not so much a scurrilous abuse of scientific process and current evidence in regard to both the basic science of pathophysiology and applied clinical therapeutics, as a mockery, a debasement, and a frank abuse of science and medical data.

33. Given that Dr Alex Wodak appears to position himself as one of Australia’s leading national figures advising the nation on addictive drugs, the conclusion becomes inescapable that Australia has been ill-advised on illicit drug policy by this self-confessed drugs legalization activist, and that our policies in this area are therefore likely misinformed, ill-conceived and / or ill-constructed.

34. Given that the activist position adopted by Dr Wodak, speaking in the name of Science, is clearly at major variance with the contemporaneous pronouncement of acknowledged world leaders, sufficient evidence exists for a formal motion of censure against Dr. Wodak from this house for attempting to mislead the Legislative Council of NSW.

References

1. Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med 2014;370(23):2219-27.

2. Reece AS. Chronic toxicology of cannabis. Clin Toxicol (Phila) 2009;47(6):517-24.

An inquiry on Foetal Alcohol Spectrum Disorder (FASD) has been told men could be just as responsible for causing the condition as women.

A Northern Territory select committee inquiry into action to prevent FASD held public hearings in Alice Springs after visiting Katherine and Tennant Creek.

Criminal lawyer Russell Goldflam presented the People’s Alcohol Action Coalition’s submission and told the inquiry stopping men and women drinking alcohol is the only real solution to prevent damage to the foetus.

Outside the hearing he told reporters new research from South Korea shows an embryo can be affected at the time of conception by compromised semen from men who drink excessively.

“This is very early days. The research has only been done on animals at this stage and it was only published a few months ago,” he said.

What is FASD?

Foetal Alcohol Spectrum Disorder is an umbrella term given to a range of conditions caused by alcohol exposure during pregnancy. There is no agreed way of screening, diagnosing or even defining the condition.

Signs and symptoms of FASD:

• Low birth weight
• Small head circumference
• Failure to thrive
• Feeding problems
• Sensitivity to noise, touch and/or light
• Developmental delay.

In an older child:

• Learning difficulties
• Developmental delays
• Attention deficit/hyperactivity/ADHD
• Memory problems
• Difficulties with social relationships
• Impulsiveness
• Inappropriate behaviour
• Poor understanding of consequences
• Major organ damage.

Source: NT Centre for Disease Control, April 2014

“But it may well be that in some cases FASD is nothing to do with the drinking of the mother but may be from the drinking of the father who helped conceive that child.”

He said the research could have profound implications on policy responses to FASD.

“Instead of focussing on ‘irresponsible women who drink’ we need to cast our net more broadly and develop policies in the population overall, including men,” he said.

Push for a floor price on alcohol

The group has lobbied for years for the Northern Territory Government to introduce a floor price to control alcohol sales.

It has also urged the NT not to impose policies that criminalise the behaviour of women who drink when they’re pregnant.

“We’re now beginning to realise the enormity of the problem of children not even being born with a real chance in life because they’re afflicted with this inherited condition which stunts their growth, stunts their development as individuals, stunts their potential,” Mr Goldflam said.

“It may turn out that there are so many people in this category that it stunts our community as a whole.”

The Public Health Association’s Dr Rosalie Schultz told the inquiry by the time most women realise they are pregnant the baby is already affected by FASD.

She said this meant efforts to reduce the prevalence of the disorder needed to apply to the entire population, not just women who drink when they are pregnant.

Source: abc.net.au 1^st Aug.2014

Abstract

OBJECTIVES:

The online universal Climate Schools intervention has been found to be effective in reducing the use of alcohol and cannabis among Australian adolescents. The aim of the current study was to examine the feasibility of implementing this prevention programme in the UK.

DESIGN:

A pilot study examining the feasibility of the Climate Schools programme in the UK was conducted with teachers and students from Year 9 classes at two secondary schools in southeast London. Teachers were asked to implement the evidence-based Climate Schools programme over the school year with their students. The intervention consisted of two modules (each with six lessons) delivered approximately 6 months apart. Following completion of the intervention, students and teachers were asked to evaluate the programme.

RESULTS:

11 teachers and 222 students from two secondary schools evaluated the programme. Overall, the evaluations were extremely positive. Specifically, 85% of students said the information on alcohol and cannabis and how to stay safe was easy to understand, 84% said it was easy to learn and 80% said the online cartoon-based format was an enjoyable way to learn health theory topics. All teachers said the students were able to recall the information taught, 82% said the computer component was easy to implement and all teachers said the teacher’s manual was easy to use to prepare class activities. Importantly, 82% of teachers said it was likely that they would use the programme in the future and recommend it to others.

CONCLUSIONS:

The Internet-based universal Climate Schools prevention programme to be both feasible and acceptable to students and teachers in the UK. A full evaluation trial of the intervention is now required to examine its effectiveness in reducing alcohol and cannabis use among adolescents in the UK before implementation in the UK school system.

Source: PMID: 24840248 BMJ Open. 2014 May 19;4(5):e004750. doi: 10.1136/bmjopen-2013-004750.

A brief look at the confusing messages emerging from current ‘prevention’ application in Australian drug policy.

Shane Varcoe – Executive Director “Will the real ‘Drug policy’ please stand up!”

Dalgarno Institute | www.dalgarnoinstitute.org.au 2

QUIT – MODERATE – ACCOMMODATE? WHICH EMPHASIS ARE WE FOLLOWING?

What is going on with Australian Drug Policy Prevention application? It appears to be struggling with, what can only be described, as a Dis-associative Identity Disorder (D.I.D). The current interpretation continues to baffle the average Australian, and leaves many of us who are active in the Alcohol and Other Drug (AOD) field scratching our heads in bewilderment and sometimes utter disbelief!

SMOKING – The new leprosy?

The growing and relentless assault against tobacco via the QUIT campaign is something only ‘mushrooms’ would know little of. This vital and effective demand-reduction and education ‘war’ has been clear from its inception, and has continued to burgeon, evermore aggressively to the crusade we now see today.

The message is at the very least unambiguous, at times, bombastic! There is no guessing what the outcome of this endeavour is to be. The message and mandate is not ‘slow down’, it is not ‘moderate’ it is QUIT. The end game is the only game. There are no illusions about the time it may take to reach that goal, but that goal is the only target to aim at and as a consequence measures and outcomes are effective – more and more Australians are quitting!

Let’s commence by acknowledging the following principle, which is all but irrefutable… accessibility, availability and permissibility all increase consumption. When you reduce these, you reduce consumption. For example, the following details shows how education and legislation all reduced demand. Accessibility, availability and permissibility are all restricted and consumption drops.

In 1945 approximately 72% of Australian men smoked. The rate has been dropping ever since then. In 2007 only 18% of Australian males were daily smokers. In 1945 26% of Australian women smoked…In 2007 women were smoking at a lower rate than men with 15.2% still smoking daily. 1

• increases in getting help to quit smoking, especially use of the Quitline (2% to 4%) and nicotine replacement therapy (7% to 10%);

• increase in one year quit rate from 8% to 11% among smokers and recent quitters;

• a statistically significant reduction of about 1.5% in the estimated adult prevalence of smoking. 2

However, as successful as this message has been, the fight is not over yet, as the following excerpt so irrefutably affirms…

“ANTI-SMOKING campaigners have far from finished their battle with the tobacco industry, with some pushing for a ”license to smoke” and many predicting that cigarettes could be outlawed within a decade.” 3

Well so was the bold opening statement in recent article ‘Now butt out: new push seeks to outlaw cigarettes’ in The Age Newspaper.

Fascinating…outlawing cigarettes, even though around 17% of Australians are still smoking – outrageous! The article went on to note that if such a ban were to take place the government would stand to lose around $6 billion dollars in tax revenue, but save an estimated $31 billion dollars currently spent per annum on smoking related health problems.

No doubt to everyone who is not a smoker this makes good health and fiscal sense…maybe even to some smokers too?    So how is that we have managed to convince a society that a ban could actually be possible on a legal drug – tobacco, that in its boom era (during the 40’s, 50’s and 60’s) was a key social accessory, that a legal ban be actually possible? A quick inventory of the processes engaged may give us some insight…

§ A clear and uncompromising acknowledgement from health, government and fiscal sectors that cigarette smoking was damaging our community.

§ The ensuing resolve that this must change for both fiscal, but more importantly, health reasons.

§ The continuing single voice of disapproval of cigarettes from academics, politicians and health professionals. (Stopped the propaganda of the pro-smoking academics/doctors and started the recognition of the undeniable facts that ‘every cigarette is doing you damage’.)

§ The sustained political will to create and implement policies to bring about change, including increased taxation, total advertising ‘blackouts’ and bans on smoking in defined places.

§ These have been followed by the creation and implementation of Demand Reduction strategies that only grow in number and intensity and the relentless public education campaign on the dangers of smoking.

It would appear from both empirical data that such resolute policies work…even with a once widely accepted and socially palatable ‘legal drug’ like tobacco.   In a recent war of words over the zealous, if not poorly thought through, ‘plain packaging’ strategy, the Federal Minister for Health Nicola Roxon was quoted as saying…. “Big tobacco are fighting to protect their profits, but we are fighting to save lives.” 4 If that vitriol wasn’t enough, she was also quoted in the Australian Newspaper, again in regard to challenges to the plain packaging strategy …‘”We’re Australians. We can make laws in Australia to protect Australians…” 5     Feisty! I like it! However, comes the question… protect Australians from what? Well, Captain Obvious may answer that in this context it would be protection from the health and health budget destroying wrecking ball that is tobacco.

But is ‘health’ the real motivator that is underpinning this zeal for the wellbeing of Australians? I hope it is, but the utter inconsistency of this focused passion belies another agenda. Or is it that some people just can’t see the utter inconsistencies or, at worst, hypocrisies of this unbalanced policy focus?

“We’re Australians. We can make laws in Australia to protect Australians…” 

Nicola Roxon – Federal Minister for Health

If ‘health’ was the sole or main issue, then wouldn’t that same zeal, that same passion for justice of Aussie’s Health be mirrored in other areas of drug policy too? I mean, Roxon is pursuing a policy – plain packaging – that has a number of downsides to it, and only small possibility of a reduction in smoking – But that was enough, it seems, for her to implement the policy! Great I say, go for it, but why doesn’t this same ‘doggedness’ apply to the two other big monsters in the drug arena?

The Federal minister seems passionate about the anti-smoking message, passionate enough to make those sweeping statements we just read – ‘fighting to save lives!’ – ‘Making laws to protect Australians!’ and pursuing every possible vehicle to STOP people killing themselves (and our health budgets)on the way.

In a very recent interview published by the Financial Review, we get a glimpse into some of the motivators behind Roxon’s campaign against tobacco – ‘This is a defining moment for Roxon one that transcends politics and is deeply personal. Her father, a one-time smoker, died of oesophageal cancer at the age of 42…“All of us girls keenly felt the loss of not having our father as we grew up but that is not the same as being out on the street as some families are…it has made me very aware of the impact that smoking can have,” Said Roxon. This mother of a 6 year old daughter went on in the interview to declare that, ”This fight is about the past and the future. “We might be making the world a healthier place for our children, and that is very motivating. I don’t think the political gains will be very high or very quick, but the long-term health impact and feeling [that] you are in government to do some good is rewarding.”’*

I have no issue at all with this motivation from Roxon, I mean it is the personal encounter with tragedy and/or the grief of loss/dysfunction that adds undisputable weight to the abundance of health-destroying evidence that exists. But again, why isn’t this same passion for health/safety/future of children applied to the other life and health destroying drugs in the ‘recreational’ arena? Nicola would do well to spend time at Rehabilitation clinics, with families of alcohol and other drug using individuals who have not only shattered their lives but their families. Countless stories of lives and potential ruined at young ages because a drug was accessible, permissible, available and cheap. This very powerful evidence should also inform the prevention focused emphasis of alcohol and other drugs policy platform. All measures including high volumetric tax, plus clear and powerful warning labels should also be taken immediately to further ensure that children and families have the greatest protection from the damage of these drugs.

Alcohol – The protected substance? 

When it comes to the other ‘legal drug’ the (it would appear) culturally entrenched alcohol – options for management have one glaring omission. Can you guess what it might be? No prizes if you said ‘QUIT’. The conspicuousness of the absence of this goal in the strategy is probably the noisiest of all elephants in the ‘Drug policy’ room. So, why is that?

*’Where there’s smoke there’s fire’ – Financial Review 29/7/2011 http://afr.com/p/home/where_there_smoke_nFtdXlsglhsibzQQCzgyDM 

The Globe, Issue 2, 2011 

 

We seem to have no problems creating what ‘defenders of the right to self destruct’ call a ‘Nanny State’ posture when it comes to cigarette smokers or our indigenous communities for that matter – But when it comes to the rest of the population quitting or abstaining from alcohol, then howls of derision chanting anti-‘Nanny State’ mantras are deafening!

James Campbell in his article ‘wowsers enough to drive you to drink’ featured in Herald-Sun 6 drew out, in his classic libertine framework article, some of the same inconsistencies we are bringing to attention in this paper – but I’m quick to add, for very different reasons. (Of course James would never have used the term ‘wowser’ in his title if he had even an inkling of what it stands for – We Only Want Social Evils Rectified – This of course is what all socially responsible people want. Yes, a free society, but a freedom that doesn’t disregard a) the liberty, safety and wellbeing of others b) the protection of the young, and c) bestowal of dignity on every human being… all of which are casualties when the imbibing begins.)

In his article he noted the data and subsequent recommendations recently released by the Cancer Council, but also what he has interpreted their seeming ‘double standard’ on the ‘drink’ issue. Professor Olver was quoted in the Age as saying… ”If you want to reduce your cancer risk as far as possible [abstinence] would be the option you have.” 7     yet in his article, Campbell states they stopped short of recommending abstinence from alcohol and settled for NHRMC recommendations of ‘a couple of standard drinks at any time’.   ‘The point now is what do we do with that information? Certainly promoting abstinence as an option should be absolutely imperative, but that’s the problem, the ‘A’ word isn’t permitted, even in the ‘optional’ category!’

Now whilst I can see the point of incongruence, I would like to challenge Campbell’s ‘framing’ of the response. It is clear that not all cancers are caused or even added to, by alcohol, but it is equally clear, through evidence based science, that alcohol is carcinogenic.*  The point now is what do we do with that information? Certainly promoting abstinence as an option should be absolutely imperative…but that’s the problem… the ‘A’ word isn’t permitted, even in the ‘optional’ category!

Our culture is either so deeply addicted to this drug or so completely gripped by fear at being labeled something less than human because they don’t drink, that they actually cannot see the option of saying ‘No Thank you!’

Now if this was just, fully developed ‘grown ups’ who don’t care about their health or even worse, are self-medicating the vicissitudes of life with the grog, and never venture into the public space and expose others in the community to their less than sober persona, I suppose it would make less difference if one ‘partook’ (except for the medical and health bills the tax payer will have to fund)! However, it is the vulnerable in our society – the young (under 25 – still developing brains), the mentally ill, the socially and relationally isolated, the violent, the elderly, children and often women, who end up casualties of not only their own drinking, but that of others!

Whilst the link between cigarettes and disease is clear, it is no less clear with alcohol…

Alcohol consumption is the world’s third largest risk factor for disease and disability; in middle-income countries, it is the greatest risk. Alcohol is a causal factor in 60 types of diseases and injuries and a component cause in 200 others. Almost 4% (1 in 25) of all deaths worldwide are attributed to alcohol, greater than deaths caused by HIV/AIDS, violence or tuberculosis. 8

 

A couple of questions that are often conspicuous by their absence, when it comes to the inconsistencies in drug policy when dealing with tobacco and alcohol, are to do with impact on others. Yes, it is good to have gone to considerable lengths to minimise ‘passive smoking’, but what of the impact of what Professor Rob Moodie calls ‘passive drinking’? A couple of quick questions to ponder…

The real tragedy in all this ‘cultural reinforcement’ is that the imperative message for this demographic of abstinence, and delayed onset of drinking as long as possible, has completely disappeared.

When was the last time a cigarette caused a man to beat his wife to death?

When was the last time a cigarette caused an automobile accident killing two and disabling one for life?

When was the last time a cigarette caused a pub brawl or ‘glassing’ incident?

 

For the sake of brevity (and being seen to be too merciless on the sensibility of the Aussie imbiber) the following are just some of the long known, but only recently quantified data on this so called ‘social lubricant’….

 

a) Fiscal Cost: The research by the Australian Education and Rehabilitation Foundation (AER Foundation) has now put the total economic impact of alcohol misuse at $36 billion per annum which is over double 2005 estimates. This comprises $24.7 billion in tangible costs, which include out-of-pocket expenses, forgone wages or productivity and hospital and childcare protection costs. There are a further $11.6 billion in intangible costs, which includes lost quality of life from someone else’s drinking

b) Consumption: Drinking more than ever before, at least 10.2 litres pure alcohol per person per annum 10  , mouth, pharynx and larynx. 1 in 5 cases of breast cancer are linked to alcohol”. 11

c) Cancer: “Alcohol use has been linked to thousands of cases of cancers including bowel 9

d) Violence: There are more than 70,000 Australians who are victims of alcohol related assaults each year

e) Emergency Services: Ambulance Call outs in Greater Melbourne alone, for predominantly alcohol abuse have increased almost 600%: 1998-99: 1043 by 2008-09 it was 6924 13

f) Crime – In just one State alone, alcohol-related crime in Queensland has increased by 30 per cent, and public disorder offences by 65 per cent just in the past few years alone…Alcohol abuse in Queensland is now responsible for 100,000 crimes annually, or one-quarter of all offences.14

…alcohol-fuelled violence and abuse affects one in five people 12 You get the point! This is, if not worse, then at the very least as bad as the smoking issue…. So, why aren’t all zeal, all passion and all strategies being implemented to prevent or stop the impact of alcohol on the Australian people and the economy?

So entrenched is the alcohol culture that according to the Australian Drug Foundation, parental supply has eclipsed all other sources of supply of alcohol to children aged 12-17. Now the excuses  tabled for this kind of outrageous conduct are as follows…

a) Parents want to either, initiate their child into alcohol ‘wisely’ or at least ‘know’ how much they are drinking.

b) Parents want to be friends with their child and not parents. Believing they are avoiding stress at home by giving in to negative social influences.

c) Parents believe that if their children are going to ‘experiment’ then it’s better to do so with the legal drug.

d) ‘It’s part of being Aussie, it’s gunna happen, so might as well try and be ‘responsible’ and give them a hand in using this legal drug ‘properly’.’     So, how has that been working for us as a community? Well the evidence seems to correspond with the mindset. Again an Australian Drug Foundation recent release shows that by 16, one in five teenagers regularly binge drinks; by 18 it is 50 per cent.    It would appear this level of permissibility has only added to accessibility and availability and thus consumption has increased. I mean… ‘after all Mum and Dad are giving it to me and they use it, so it must be ok?’        The real tragedy in all this ‘cultural reinforcement’ is that the imperative message for this vulnerable demographic of abstinence and delayed onset of drinking as long as possible, has completely disappeared. All the scientific evidence reveals that their vulnerable developing brains need this option to be aggressively promoted as best practice and their parents, above all, need to get this reality check too.     Again, what continues to generate this disconnect between policy emphasis around the legal drugs of tobacco and alcohol? Both drugs are legal, but perhaps smoking an easy target now that fewer Australians do it, and is marginalised so much that scathing vitriol and uncompromising legislation will have little opposition?

But, not so with alcohol – Whilst approximately 14% of Australians who are legally permitted to drink, don’t, the amount of alcohol being consumed per person, per annum is near record highs. It would seem that challenging this second ‘monster’ can prove a difficulty, if a) votes matter b) the power brokers themselves are unable to say NO to alcohol; c) It has become the central and often sole ‘social amenity’ or even worse, d) it becomes the medication of choice for the ever growing epidemic of community wide psycho-social dysthymia.

Whatever the reason, a clear gulf exists in zeal, attention and endeavour when we juxtapose tobacco and alcohol. A gulf that screams, at best inconsistency, but at worst hypocrisy!

A quick recap… 

When it comes to tobacco the policy aim for smoking is ‘quit’, and we have no problem aggressively challenging ‘smoking’ as a reckless act that needs stronger management. We have used Prohibition in its legal context to prevent smoking in a number of places and breaches of such prohibitions have met with not only social censure, but a fiscal punitive response – fines. And in this framework there appears no fear about attracting the pejorative ‘nanny state’ label.

 

When it comes to Alcohol, the policy aim (at the moment at least) is to avoid the ‘nanny state’ label, calling instead for management, more like a caring friend provoking a peer to a healthier choice. So the push seems to be toward ‘moderation’.

 

But what is happening in the arena of current illicit drug policy?

We appear to be losing the plot – the pro-drug lobby is trying to take over the judiciary, if not legislature!

When it comes to illicit drugs there appears to be a departure from all regulatory sanity. The ‘State’, on whose advice we can easily guess (George Soros funded propagandists) works ruthlessly to assassinate, mutilate and bury all processes that are focused on prevention or abstinence. Such processes the patronizingly dump into the ‘Nanny-State’ model/basket . Nor, would it seem are they interested in a Good Parent model, or even the ‘caring friend’ model… No, it would appear from all current debate this confederacy has opted for the ‘go with whatever feeling grabs you; it’s your ‘right’ and let the State clean up the mess’ approach!

 

There appears little to no censure, no label of ‘bad’ or ‘harmful’ or ‘destructive’ to the conduct that is illicit drug using. In fact great pains are taken to remove all terms from public documents that could potentially ‘marginalise’ the drug user. Whilst ‘name calling’ should never be condoned, conduct that is illegal and destructive needs to be called for what it is and measures taken to change it. Whether the terms are legal or medical, they can never be ‘neutral’, or worse complimentary and condoning.

What is of greater concern is the tacit message oozing through the permissive interpretation of Harm Minimisation policy by the Harm Reduction Only Lobby, which is that the State sanctions and promotes – not challenges or changes – a drug user’s ‘habit’. (Yet it is the ‘habit’ that needs to change – more on that later.)

For example, they seem to be saying :

 

a) Please come to a special place with your illegal substance and we will assist you to take the drug of your choice (Medically Supervised Injecting Centre – MSIC). At no point will anyone ‘judge’ you for your ‘lifestyle choice’. Instead we will ensure you are comfortable and enabled in your drug taking activity whilst funding this process with tax-payer’s money. (No matter that this process breaks international laws on illicit drug use)

 

b) We will give you as many clean ‘needles’ as you like and will not hold you accountable for the return of used ones. In fact we will pay someone to go around and pick up your discarded syringes so you can continue to be free (not irresponsible, that would be pejorative)to continue, unhindered in your substance use, wherever and whenever you choose.

 

c) If the substance user opts to seek a change in conduct, only then may we humbly recommend a referral to a treatment facility. However, after we have just enabled you to continue your substance abuse (in our MSIC) and you are ‘feeling’ better (yet getting worse) after your State assisted ‘fix’, then it is unlikely that you’ll ‘feel’ the need for detox, let alone rehabilitate. So, the passive referral is ignored or forgotten.

 

d) If you are one of the single digit percentage of substance users that actually ‘follows through’ on referral, then no requirement will be placed on you to become drug free. No, we are only interested in trying to minimise your potential to kill yourself and make you as comfortable as possible. We will introduce you to other substances that may, or may not lead you to drug free recovery, but again, that is NOT our aim. This, after all, is only for the ‘problematic’ drug user and we must not have anyone feeling discomfort or distress from the withdrawal from drug use, even if is for a week – That would be ‘unkind’. So rather than treat you like a precious, intelligent, whole human being, we’ll simply treat you like a wounded pet and only treat the symptoms and not address the real problem.

 

e)  The recent aggressive upsurge of promotion and use of, so called, ‘legal highs’ has produced an even clearer manifestation of this policy D.I.D/hypocrisy/inconsistencies. As these synthesized ‘designer’ concoctions started getting a more public profile, several States in Australia were quick to react by imposing age restrictions and then applying significant financial penalties (six figure fines) for those involved in distributing/using these products. Yet in some of these same States the use of current illicit drugs such as cannabis (and other currently illicit drugs that have clearly documented health damaging properties) attracts no more than a slap on the wrist for use and little more for trafficking!

It would seem no effort is spared, to ensure the drug user is rarely, if ever, is called to make changes. More than that, and at any point, an act of horrendous nature can be perpetrated against another citizen as we saw recently in the senseless murder of a deaf octogenarian pensioner, murdered by yet another (it would appear by the new label) ‘problematic drug user’. Diminished responsibility, mitigation, equivocation, even obfuscation, are employed to avoid ownership of the issue by the substance user. What’s more disturbing is that at no point is the abysmally interpreted Harm Minimisation Policy used to bring about change, let alone drug free wellness of these dysfunctional people.

The following (conveniently) long forgotten words of the remarkable Statesmen, Edmund Burke, are even more appropriate today than at any other time in recent history…

 

“Men are qualified for liberty in exact proportion to their disposition to put moral chains upon their own appetites… Society cannot exist, unless a controlling power upon will and appetite be placed somewhere; and the less of it there is within, the more there must be without. It is ordained in the eternal constitution of things, that men of intemperate minds cannot be free. Their passions forge their fetters.” Sir Edmund Burke

 

The very thing that is needed as outlined by Burke is the very thing the pro-drug lobby works tirelessly to negate. Morality is ‘off the table’ in this arena (The only time morality is invoked these days is when it comes to climate change; nowhere else is this allowed in the public discourse) In this ‘amoral’ space all attempts to impugn drug taking are perceivably removed. Terms like ‘wrong’, ‘bad’ ‘irresponsible’ are no longer permitted. So, if it is no longer referred to as ‘wrong’ then comes the next manipulative question: on what grounds should substance use still be illegal? The next step is to turn the debate into a purely ‘health’ issue. It is true, it is also a health issue, but, it is still a social, psychological and moral issue as well. But even just at the level of health policy, would think that all measures should be taken to rectify the dysfunction /disorder/ailment in order to remove the health damaging substances at least from the patient, even if not the community. Ah, but no, that’s not the agenda of this lobby faction is it!

 

The health issue is invoked only to manage some of the damage of substance taking and other second tier outcomes of these bad health choices, such as blood borne infections and or death. The call now in this decriminalised, so called amoral and consequence avoiding space, is that all health measures be taken to keep the patient alive and as healthy as possible to continue their ‘lifestyle choice’ of drug consumption.

 

This is not Australian – Time to Stand up!

At the moment the vast majority of Australians are still smart enough to know (perhaps drug free enough to know) that ultimately there I absolutely no gain/benefit in illicit drug use for individuals or society;

Ø The current National Household survey (2007) has the vast majority of Australians declaring their disapproval of illicit drugs and their use.

 

99% don’t want use of hard drugs accepted 

95% don’t want hard drugs legalized 

94% don’t want use of cannabis accepted 

79% don’t want cannabis legalized 

Most Australians want tougher penalties for drug dealers.15 

 

Ø The largest youth survey done in our nation with a sample of around 50,000 young people saw alcohol and others drugs as the second highest on ‘what is an important issue for Australia’. This issue is the most worrying to the youngest in this most susceptible to damage of Australia’s demographic – the ones we need most protect – our children 16

 

When the overwhelming majority of people disapprove of illicit drugs, it might just be a cue to do something more significant than concede ground to it. You’d think that even the process (let alone value) of democracy, had any weight then the above mentioned majority opinion would mandate all and every action be taken to eradicate illicit drug use from society. According to collected data, around 6% of the world’s population aged between 15 and 64 currently use illicit drugs. 17 Australia’s stats are only a little higher than that. So here we have a user group that is arguably (at most) between a half or a third of current tobacco users, who are involved in a wilful breaking of the law to their own and the wider community’s detriment generating an exorbitant cost to our community.

So what has the response been to this? Well, it depends on where you look, who you talk to and who is playing the strings of the propaganda harp.

 

In recent years there has been a rising noise, about the need for illicit drug policy change. The standard mantra has been ‘the war on drugs has failed!’ Consequently we need to stop and rethink our processes and priorities.

 

What ‘war on drugs’? Where did this notion come from?

Well, let’s pretend for a moment there actually was a ‘war on drugs’. How could it possibly be won? Well, again it depends on how this ‘war’ was fought and what priorities were set. If the war on drugs simply attempted supply removal and arrest, then it will have limited success. However, as with most ‘battle strategies’, if they only have one tactic, then success will always be limited or the potential for failure increased. If a ‘war on drugs’ isn’t really waged as it should be then it is locked into only limited success and more likely subject to criticism of its limitation. However, as in all wars the first casualty is always truth and that is no different in this theatre of combat, as the following reveals…

The term “war on drugs” was not used in 1971 and is not used today by anyone except those who mischaracterize history and current drug policy in the US. However, if one were going to connect the term to President Nixon, then it would be more accurate to say that Nixon ended, rather than launched, the “war on drugs.”

The Nixon Administration repealed federal mandatory minimum sentences for marijuana, and on June 17, 1971, for the first time in US history, the long-dominant law enforcement approach to

drug policy, known as “supply reduction”, was augmented by an entirely new and massive commitment to prevention, intervention and treatment, known as “demand reduction”. President Nixon announced this new, balanced approach to drug policy and it received full bipartisan support. Since that time, the idea of taking a balanced approach has enjoyed strong and sustained support through the terms of the seven US Presidents that followed. The US drug prevention policy, fully described in the annual National Drug Control Strategy published by ONDCP, maintains this twin-commitment to supply reduction and demand reduction, with the aim of reducing illegal drug use and the corresponding medical and social burdens that drug abuse imposes upon our nation.18

Supply reduction remains a key tactical component and criminalisation will always lend weight to that vital strategy component. Time and space here will not permit us to go into all the local and national impact on drug use that supply reduction has facilitated, but just two examples will give us a clear indication

a) ABS 2000 death stats collection: Heroin: 417; methadone: 118;Benzos: 403; anti-depressants: 268; Cannabis: 49 Note the reduction in Heroin deaths the following year when the heroin drought (for whatever reason) caused availability to dry up, the ABS 2001 death stats collection showed: Heroin: 113; methadone: 107;Benzos: 252; anti-depressants: 194; cannabis: 28!

b) According to the Australian Institute of Criminology, the four top reasons why detained illicit drug users had not used in the previous month 19 was in order of main reason to least.

1) Dealer didn’t have drug of choice (highest reason by far)

2) No Dealers available

3) Poor quality product

4) Police presence

 

 

“When you reduce permissibility, accessibility and availability you reduce consumption.”  

I want you to notice that supply reduction elements are the key factor in reducing illicit drug consumption. Again, when you reduce permissibility, accessibility and availability you reduce consumption. This is why complementary Supply Reduction strategies are imperative in conjunction with Demand Reduction strategies and compulsory detox and rehabilitation strategies.

When Ethan Nadelmann and Dr. Alex Wodak, the well-known supporters/ purveyors of the George Soros brand of cultural chaos, were on the media stage peddling their brand of harm ‘reduction’( (including the decriminalisation of illicit drugs), the voices of dissent from any other quarter were hard to hear, but not because they don’t exist considering over 90% of Australians disapprove of illicit drugs. It was the classic situation where the sane majority simply expect the government to do all that is necessary to eliminate drug use without bothering to mobilise against that small, but very ‘squeaky wheel ‘of pro-drug propaganda at legislators doors. Consequently, the long standing anti-drug movements were given no space at all.

The Nadelmann/Wodak ‘spin’ had people believing prohibition drug policy had failed and therefore the only option left was to decriminalise or legalise. They even used cleverly spun unrelated science and misrepresented data from other nations and calling that ‘enlightened’ (Such as the so called Portugal decriminalisation ‘success’). Or they hijacked the debate away from drug use and placed it in the framework of management of damage caused by drug use, which actually increases dysfunction.

 

It is remarkable that few clinicians or policy makers care to see or even acknowledge that the current illicit drug policy in Australia (among other western nations) has be completely hijacked by the single dimensional ‘harm reduction’ element and that has distanced them even further from the problems of drug use.

This one dimensional focus has barely anything to do with drug use and absolutely nothing to do with reducing drug use. ‘Harm Reduction’ as it currently stands, when it is all distilled down to its core (a one step process) is only focused on the attempted prevention of death and blood borne infections. Whilst this may be a noble aim, we need to move drug policy back to the forgotten reduction or prevention of drug use in our society. We are all for having a policy for reducing the spread of blood borne infections and death, but let’s call it that and move drug policy back to what drug policy is supposed to be about – the prevention and reduction of drug use in our society. Of course, even a ‘blind man’ could see, that if you prevent and/or reduce drug use, you reduce the incidence of the other damage so focused on – but that is the very thing the pro-drug lobby doesn’t want to happen, the reduction of drug use! They advocate continuation of drug use, funded by tax-payer’s who keep them alive and pay for their treatment.

 

So in our mind, an unavoidable question is – Where was Federal Minister for Health, Roxon on these issues? Where was the same zeal that was focused on cigarettes? At the time where this ‘drug reform’ lobby has used special arguments to remove the protection, where was the declaration, ‘making laws that protect Australians’ from substances that have long been banned because of the undeniable damage they do?

 

Is it utter ignorance that generates this silence? Or is it as one prominent AOD Clinician once said ‘Harm minimisation is just a euphemism for ‘we don’t know what the hell to do, so we’ve just given up!’. Or is it, reason spare us, a tacit yet wilful pursuit of cultural sabotage foisted on society because a minority of drug users who believe they can control their ‘habit’ have ‘friends’ in high places?

 

Prohibition is a word that has been marginalised and disparaged, again by hijacking the meaning and reinterpreting it in a different context – the context of purely a moral control of a majority. However, prohibition is, in this context, a matter of law and not a simple moral based endeavour. We prohibit by law things that are injurious to individuals and the community. With Tobacco law, cigarette smoking is prohibited in restaurants, government buildings, some public spaces, inside cars and so on. Illicit drugs are prohibited at a higher level because of the health, family and social damage and the impediment of function and increased danger they that create. The prohibiting is based on minimising the harms done by these toxins to the community and individuals. Decriminalisation will only lead to greater substance use and experimentation and simply bolsters well the ranks of the damaged and dysfunctional. It will perpetuate this damage in an emerging generation that has little capacity to handle it. This is a crime!

Will the real drug policy emphasis, please stand up and will it stand for health, justice, responsibility and protection of the young?

Shane Varcoe – Executive Director, Dalgarno Institute.

*“Alcohol and Cancer in the spotlight: Studies in Europe and Australia confirm alcohol as a cause of cancer, but role of moderate drinking controversial”, The Globe, Issue 2, 2011

 

 

Endnotes

1 http://www.cancercouncil.com.au/editorial.asp?pageid=371

2 CHANGES ASSOCIATED WITH THE NATIONAL TOBACCO CAMPAIGN PRE AND POST CAMPAIGNSURVEYS COMPARED by Melanie Wakefield http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-publicat-document-metadata-tobccamp.htm/$FILE/tobccamp_c.pdf

3 Stark , Jill The Age, 22.5. 2011 http://www.theage.com.au/victoria/now-butt-out-new-push-seeks-to-outlaw-cigarettes-20110521-1ey2s.html#ixzz1OBTg5SRQ

4 http://www.smokernewsworld.com/market-cheap-cigarettes/

5 Nicola Roxon solid on cigarette packaging Sallie Don and Sue Dunlevy From: The Australian May 27, 2011 http://www.theaustralian.com.au/national-affairs/nicola-roxon-solid-on-cigarette-packaging/story-fn59niix-1226063781056

6 James Campbell – wowsers enough to drive you to drink, page 78, Sunday Herald-Sun May 28, 2011,

7 http://www.theage.com.au/lifestyle/wellbeing/quit-drinking-to-cut-cancer-risk-20110501-1e38g.html

8 Global Status Report on Alcohol and Health. Taken from Introduction page x, ISBN 978 92 4 156415 1 (NLM classification: WM 274) © World Health Organization 2011

9 Alcohol Education and Rehabilitation Foundation – Range and Magnitude of Alcohol’s Harm to Others August 2010

10 Wine link to rise in alcohol intake, Sikora, Kate; Page 16, Herald-Sun Edition 1 – 2/11/2010

11 Medical Journal of Australia (published May 2011)

12 Alcohol Education and Rehabilitation Foundation – Range and Magnitude of Alcohol’s Harm to Others August 2010

13 http://www.heraldsun.com.au/news/more-news/mateship-abandoned-drunks-left-behind/story-fn7x8me2-1226063706968

14 “Punch Drunk Campaign”, QLD Courier Mail – July 2009

15 The 2007 Illicit Drug Strategy Household Survey of Australian attitudes to illicit drug usage and “Drugs and suicide main worries for the young, says survey, The West Australian, 26/11/2009

16 National Survey of Young Australians 2010 – key and emerging issues; Mission Australia. 2011

17 ‘Should drugs be legalised” by Dr Ian OLIVER is a former Chief Constable of Grampian Police, 2009

18 Global Commission on Drug Policy Offers Reckless, Vague Drug Legalization Proposal; Current Drug Policy Should be improved through innovative linkage of Prevention, Treatment and the Criminal Justice System

(Commentary – IBH (Institute for Behaviour & Health) July 2011

19 Crime Fact Sheet No 152 ‘Reasons for not buying drugs’ ( July 2007)

 

 

 

 

University of Otago, Christchurch researchers have for the first time quantified exactly what damage alcohol abuse is inflicting on 20-somethings, and in turn society.

The Christchurch Health and Development Study researchshows up to a quarter of New Zealanders aged 21 to 30 have a problem with alcohol (classified as a subclinical alcohol problem) which affects their daily life to some extent.

More than 5 per cent of this age group met the clinical criteria for alcohol addiction.

Researchers were able to account for factors such as family background or previous substance abuse issues to shine the spotlight on the exact role alcohol plays in creating multiple serious social and personal issues. The study shows those with clinical alcohol addictions are:

* Almost nine times more likely than those with no alcohol problems to inflict physical violence on others.

* Three times more likely to commit property crimes such as burglary, car theft or vandalism.

* Almost 11 times more likely to have ten or more sexual partners and twice as likely to have a sexually transmittedinfection (STI).

* Almost seven times more likely to contemplate suicide.

* Almost three times more likely to be the victims of violence.

Those who have some problem with alcohol, or a subclinicalcondition (typically those whose drinking has some negative effect on their job, family, friends or criminal behaviour but who have not been diagnosed as an addict) are:

* Three times more likely to commit a violent crime and twice as likely to commit property crime.

* Twice as likely to commit family violence.

* Almost twice as likely as those with no problem to have an STI.

* Most three times more likely to contemplate suicide.

* Almost twice as likely to have been the victim of a violent crime.

Researcher Dr Joe Boden says much attention has been paid to the effects of the effects of problematic youth drinking but little on those aged in their 20s.

This study shows this group is still very much at risk, despite perceptions their drinking may be tapering off.

Dr Boden says the study showed the wide-ranging effect of alcohol misuse in 20-somethings on themselves and society.

“It seems that young people don’t need to misuse alcohol for a long time before they experience some serious negative outcomes, and often multiple serious outcomes.’’

“There could be great benefits to society in addressing alcohol misuse in those aged in their 20s.”

For example, the study showed that people aged in their 20s did not abuse alcohol violent crime committed by that age group would drop by almost half.

Dr Boden says becoming a parent has the biggest effect on minimising drinking. Many adults today however were having children later and experiencing an ‘extended adolescence’. This may have some impact on the reasonably high number of people in their 20s with drinking problems.

The research was recently published in the prestigious Drug and Alcohol Dependence journal.

This study was funded by the Health Research Council of New Zealand.

 

Source:  healthcanal.com  3rd Sept.2013

A report by the B.C. Centre for Excellence in HIV/AIDS on harm reduction programs and Insite released last month is not science; it’s public relations.  Authors Drs. Julio Montaner, Thomas Kerr and Evan Wood have produced nearly two dozen papers on the use of Insite. They boast of good results in connecting addicts to treatment but convincing evidence is lacking.

The current campaign reports significant reductions in drug overdoses, yet the Government of British Columbia Selected Vital Statistics and Health Status Indicators show that the number of deaths from drug overdose in Vancouver’s Downtown Eastside has increased each year (with one exception) since the site opened in 2003. In addition, the federal government’s Advisory Committee on Drug Injection Sites report only five per cent of drug addicts use the injection site, three per cent were referred for treatment and there was no indication the crime rate has decreased, as well as no indication of a decrease in AIDS and hepatitis C since the injection site was opened.

Claims of success for Insite made in The Lancet, the British medical journal, in 2011 were challenged in a 15-page, heavily-documented response penned by addictions specialists from Australia, the U.S. and Canada, and by a former VPD officer who worked the DTES for years.

In A Critical Evaluation of the Effects of Safe Injection Facilities for The Institute on Global Drug Policy, Dr. Garth Davies, SFU associate professor wrote: “The methodological and analytic approaches used in these studies are compromised by an array of deficiencies, including a lack of baseline data, insufficient conceptual and operational clarity, inadequate evaluation criteria, absent statistical controls, dearth of longitudinal designs, and inattention to intrasite variation. None of the impacts attributed to SIFs can be unambiguously verified.”

The doctors evaluating Insite are the same people who created Insite and who have been awarded more than $18 million of taxpayers’ money for their initiatives in recent years. Dr. Colin Mangham, on our Board of Directors, has been a researcher in this field since 1979.

“The proposal for Insite was written by the same people who are evaluating it – a clear conflict of interest. Any serious evaluation must be independent. All external critiques or reviews of the Insite evaluations, there are four of them – found profound overstatements and evidence of interpretation bias. All of the evidence – on public disorder, overdose deaths, entry into treatment, containment of serum borne viruses, and so on – is weak or non-existent and certainly does not support the claims of success. There is every appearance of the setting of an agenda before Insite ever started, then a pursuit of that agenda, bending or overstating results wherever necessary.”

Our President, Chuck Doucette, asks to see an independent and unbiased cost/benefit analysis.

“The four pillar approach only works when each pillar is properly funded. Prevention reduces the flow of people into addiction. Treatment reduces the number of addicts including those living in the DTES. Policing keeps a lid on the open drug dealing and the

affects of the associated problems on the community. Only after these three pillars are properly funded can we afford to spend money on Harm Reduction initiatives that do not encourage abstinence. Putting HR first is like running up debt on your credit card and never paying more than your minimum payments.”

No one would object to free needles, crack pipe kits, methadone, heroin and places to shoot up if only they were the side show and not the main event, if only they ever led to real health.  Harm reduction and Insite are palliative. They both spring from a deeply cynical and arrogant world view: You are an addict and you are hopeless. We will keep you “comfortable” while you continue to die.

This is a curious position considering the millions of men and women who admit they are addicts and choose every day not to pick up their poison. I know many such clean and sober citizens.  We owe one another a chance at dignity. To offer less is not only costly, it is monstrous.

David Berner is the executive director of the Drug Prevention Network of Canada.

Source:  Vancouver Sun July 19, 2013 

‘‘One drink’s too many and a thousand’s never enough.’’

This has been the mantra for people struggling with alcoholism, warning them against the dangers of having ‘‘just one’’. But what if you had a drink problem and could still have the occasional beer? Could a heroin addict continue to shoot up and consider themselves on the road to recovery?

As Australia grapples with the rise in illicit drug use and a binge drinking culture that shows no signs of abating, a new breed of addiction specialists are reshaping the way we view this complex and insidious problem. Born out of the United States, and also burgeoning in Britain, the ‘‘recovery’’ movement aims to challenge community perceptions of addiction by not only publicly celebrating those working their way out of it, but by redefining what it means to be substance dependent. While still in the fledgling stages in Australia, it’s already causing division within the drug and alcohol treatment sector.

Its most controversial tenet is that abstinence is a personal choice not a necessity. What it means to be recovering from drug or alcohol abuse is, according to the movement’s guiding principles, ‘‘experienced and defined by the individual’’. In essence, recovery is a journey not a destination.

Proponents say it’s a fresh, non-proscriptive approach that takes addiction out of the shadows and offers more chance of success through empowerment and self-determination. But some addiction doctors are concerned that this ‘‘recovery is what you want it to be’’ notion is an ill defined philosophy that undermines traditional medical treatment by letting addicts set their own recovery agenda.

‘‘A big risk of this approach is that the patient no longer becomes a patient, they become a willing servant of their own outcome and therefore if they don’t do well it’s their fault and so you then have a situation where you blame the victim,’’ says Professor Jon Currie, one of Australia’s most prominent drug and alcohol specialists, who is the former head of addiction medicine at St Vincent’s in Melbourne, and now works in private practice. ‘‘It moves away from a medical health model and towards an idea that everyone can do this if they try hard enough. But addiction has complex neurobiology behind it, so for a lot of people if they could have stopped using they would, but they have a brain structure that doesn’t allow them to do this.’’

David Best, a recently emigrated Scottish addiction specialist now working with Turning Point Drug and Alcohol Centre in Melbourne, is leading the recovery movement here. He says critics misunderstand the model and place too much focus on the abstinence-as choice ethos. ‘‘We still say that your best bet is to be abstinent from your primary drug of choice, and if you possibly can be completely sober from psychoactive substances apart from medications, but it’s a personal journey so everyone will be different,’’ Associate Professor Best said. ‘‘The best evidence we have is the length of an addiction career is typically around 27 years from age of first use of psychoactive substance to five years in stable or sober recovery, so it’s a long journey and it’s really more about the journey and the quality of life than whether you happen to be abstinent at a particular time.’’

Kim Riley’s path out of addiction was a long and arduous one that she traces all the way back to that first sip of alcohol, aged 10. At her lowest point she was waking up in the middle of the night for a fix. The three bottles of wine she’d start drinking from breakfast time were never enough. Now a drug and alcohol counsellor, the 40-year-old from Parkdale has been sober for 3 1/2 years, and is an advocate of the recovery approach.

After trying moderate drinking following stints in rehab she ultimately decided abstinence was her best option, although she says she respects those who take a different path. ‘‘I still had in the back of my mind that I would have a champagne on New Year’s Eve. Some people might be able to be that social drinker but I couldn’t,’’ she says.

One of the approach’s other key principles is encouraging those who have struggled with addiction to go public with their experiences. Advocates believe that while traditional Alcoholics/Narcotics/Gamblers Anonymous 12-step programs have helped countless people, the insistence on anonymity may also have inadvertently exacerbated the shame and silence surrounding addiction.

Indeed, when Fairfax Media approached Alcoholics Anonymous Australia’s general services officer for an interview, he agreed but only if his name was not published. ‘‘We don’t want to be known as some secret, unknown society that doesn’t celebrate that we’ve found a solution that works, but we do ask that members don’t get in front of a television camera recognisable or nominate their name in a radio or newspaper interview. AA has a spiritual approach and we don’t want to big note ourselves,’’ he said.

Ms Riley believes sharing her story has played a key part in her conquering her addiction. ‘‘Not only does it make your own recovery stronger but it instils within other people the idea of hope, and as you watch them get better it reinforces the belief that your life is just going to continue to get better,’’ she says.

Recovery proponents say secrecy surrounding drink and drug problems, while arguably vital in the early stages of treatment to build trust among members at ‘‘tell-all’’ support group meetings, has also helped entrench stereotypes.

“The old guy on the park bench drinking whisky from a paper bag is the visible alcoholic, everybody sees him. The guy who’s a professional and living in Toorak is invisible but there are just as many of them, they’re just being hidden by their families,’’ says George Thompson, program director of Recovery Foundation, a Melbourne addiction treatment program that embraces aspects of the recovery approach. ‘‘The AA model works and it has helped millions of people, but one of the biggest drawbacks of those 12-step groups has been anonymity. Alcoholism and addiction in general is an illness. It’s a serious mental disease. Why are we anonymous about somebody who has a mental health problem?’’

The success of organisations such as beyond blue and headspace in de-stigmatising depression and mental illness has largely been driven by their ability to put people with lived experience in front of journalists and TV cameras. The subsequent shift in public consciousness has inspired those in the addiction space.

David Best hopes to have a similar effect with Recovery Academy Australia – an organisation he set up to support and celebrate people dealing with addiction. Based on events he staged in Glasgow, he started an annual ‘‘recovery walk’’ in Melbourne last year to publicly celebrate the journeys of those navigating the addiction pathway, and the friends and family who support them. The inaugural event attracted 400 people, and today the second walk from Federation Square is expected to draw an even bigger crowd.

This public affirmation is part of the recovery movement’s core belief that messages of hope have a social contagion effect. The visible presence of recovering alcoholics, gamblers and drug users coming together in a major city centre also challenges stigma and discrimination, he said. ‘‘It makes it apparent that yeah, addiction is a terrible blight but people do overcome it, they do get on with their lives. . .The notion of it somehow being this chronic relapsing condition that leads to degradation and death is unhelpful, for family members, and for the people who are going through it.’’

Another concern in the treatment sector is that governments will capitalise on the recovery model’s growing popularity by cutting back on addiction services in favour of cheaper recovery-based approaches. Already, there are signs that the Victorian government has been captivated by the approach. In its recently released four year plan to tackle the state’s alcohol and drug toll it promised to deliver a ‘‘redeveloped, recovery-oriented alcohol and drug treatment system’’. ‘‘So you get a relatively cheap service which provides some support and the rest is up to the family and the person and their support group,’’ Professor Currie says.

For Kim Riley, recovery is, above all, about hope. ‘‘It’s time to break that stigma and this is an opportunity for people to say you don’t have to keep going down that same path, you can turn things around and find success. I feel just really a part of life now, which is a feeling that I’ve not ever experienced before.’’

Source: jstark@fairfaxmedia.com ? Melbourne Age May 2013

The NDPA notes that there is more drug use in USA schools since the legalisation of marijuana in two states. This item from Australia on drug use amongst students is shocking; in the UK we need to continue to keep firm drug laws and to promote drug prevention to our youth in order that the same situation does not occur in our schools.

THE Gold Coast region is the booming drug school capital of Queensland, according to confidential data. Exclusive statistics provided to the Bulletin show the number of students excluded from southeast district schools have more than doubled in the past three years. Those figures threaten to triple this year as the region — from the tourist strip, west to Beaudesert and north to Beenleigh and Logan — overtakes Brisbane’s combined northside and southside suburbs for young “stoners”. Police and welfare workers are convinced the Coast’s alarming youth drug trend is fuelled by the economic downturn. Unable to get work in the construction or hospitality industries, former students who began their dope habit back in the early years of secondary school are now returning to their old campuses to deal drugs. “They have fallen back on the only commerce they know — the drug trade,” a police source said. Welfare workers are aware of principals in the Beenleigh region who are banning ex-students from returning to the grounds in a bid to stop school-gate drug deals.. Documents obtained by Right To Information laws reveal many of the offenders are in Year 8, and more than 250 pages of “suspension” reports show increasing numbers of them are bullying females. They use either their mobile phones or Facebook to obtain “the happy drug” from dealers in houses near their schools. In a shocking incident, a student sold 160 tablets, suspected to be speed. Another student who took the tablets overdosed and was taken to hospital, authorities writing that his life was placed at risk. Other reports show students obtain drugs from dealers at Pacific Fair and other shopping centres, skate parks and train stations. However, most students are aware of the CCTV cameras at major business centres, and prefer carparks, skateparks, drains, hidden areas under bridges or bushland near schools to set up their bongs. The young dealers boast about selling weed for as little as $5. A bag of pot is worth $60. Police keeping watch on hotspot schools have found female students smoking an hour before classes. When a female student refused to get inside the police car, an officer was forced to “put her in a wrist lock” as they struggled to get to the deputy principal’s office. Student intelligence being fed to welfare workers suggests criminals are buying or renting homes near schools so “stoners” can gain easy access during lunch breaks. School suspension reports show students arriving at school preparing to party. They bring water-pipe bongs, grinders, clip-seal bags, scissors, pliers and garden hoses. Boys are hiding “the happy drug” in their shoes and toothpick holders, while girls place lighters down their bras. Glassy-eyed, barely able to stand, sometimes with their heads resting on their desks, they are nonchalant about their drug habit interfering with their education.
Asked why she squatted on a netball court to smoke weed, a female student told her deputy principal: “I’ve had a bad week.” A student who arrived at a new school after being excluded from another for drug-related activities brought “weed” on his second day. Before excluding him, his new principal told him: “You admitted to bringing a lunch box-size container of marijuana to school on the second day of attendance at our high school and daily thereafter. “You admitted to supply marijuana … you admitted to asking a student to hide your stash. The behaviour is so serious that suspension would be inadequate to deal with this behaviour.”

Source: www.goldcoast.com.au 13th March 2013

WHILE some still want marijuana made legal, there are signs that use of Australia’s most popular illicit drug is already falling.

MORE than 30 years after the peace and love revolution when marijuana was the hippy’s drug of choice, everything has changed. It is grown differently, it is stronger and more dangerous and – despite South Australia’s reputation as the pothead state – its use is falling.

It was once thought rather daring to raise over-cultivated “pot” plants for private use. The flowering head of the plant was mixed with cannabis leaf and ordinary tobacco and smoked in an elaborately rolled joint. Today, no one bothers with anything but pure head. Police drug squads often find dumped bags of cannabis leaves that no one can be bothered with. “They (dealers) throw it out. They can’t sell it, no one will buy leaf,” says Professor Jan Overton, who directs the National Cannabis Prevention and Information Centre.

Some experts believe this preference for only the strongest part of the plant explains why the drug is more potent. Others say the hydroponically grown plant is simply stronger. “That’s the widely held urban myth,” says Robert Ali, who heads Drug and Alcohol Services South Australia. “I think what has changed over time is the quantities people consume, and what they consume. In the 1960s and ’70s, when people passed a joint around, that joint typically had leaf, it might have had a little bit of head, it may have had stalk.”

But there is evidence that cannabis itself is becoming stronger in Australia. The Australian Federal Police is working with NCPIC to compile data on the comparative strength of cannabis seized in Sydney and the NSW North Coast. Overton says the study is not final but it is confirming the relative strength of hydroponically grown marijuana. “I think it is certainly revealing what we expected: that growers here get their seeds from Europe where the potencies are higher, and as a result they are growing high-potency cannabis in Australia as well,” she says.

A recent study published in the Lancet medical journal all but named Australians as the biggest cannabis users in the world. The report says that in 2010, almost 15 per cent of 15 to 64-year-olds in the Oceania region – which includes Australia, PNG and New Zealand – used cannabis the previous year, double the rates of North and South America. That would put South Australians among the heaviest users of a drug with links to mental illness.

According to Overton, the World Drug Report figures on which the Lancet report was based were distorted. While Australian usage rates are high, other countries are higher, like North America where 35 per cent of 17-year-olds had used cannabis in the past year compared with 21.6 per cent here. The trend among young people is slowly – if irregularly – falling.

Even on a national level, South Australians are not the worst offenders. SA’s 11.3 per cent rate was well behind Western Australia (13.4 per cent) and the Northern Territory (16.5 per cent). This compares with 1998 when 17.6 per cent of South Australians used cannabis in the previous 12 months. SA is no longer the marijuana state.

Marijuana is still the most widely used illicit substance in the world. The number of people who had used cannabis at least once in 2008 was between 129 and 191 million, or 4.3 per cent of the world’s population. While many people experiment and move on, marijuana has been convincingly connected to mental illness, particularly schizophrenia. A single bad cannabis episode can trigger lifelong schizophrenia, particularly in teenage boys.

“Certainly it’s not for everyone,” says Michael Balderstone, who heads the Hemp Embassy in Nimbin, NSW. “If you’ve got mental health problems you should be careful with every drug, although historically cannabis was used for mental health problems.”

There is hard evidence that in some circumstances, cannabis destroys lives. An Australian and a New Zealand study that followed babies for almost three decades found that young people who use cannabis before the age of 15 increase their risk of schizophrenia six-fold. Later in life, the risk is doubled. The teenage drop-out syndrome has also been verified, with a causal connection established between cannabis use and school failure. “It accounts for about 17 per cent of the risk of someone leaving school without any qualifications,” says Overton. “That is over and above everything else – the unique contribution of cannabis use.”

The one aspect of drug culture that seems not to have changed is the polarity between anti-drug campaigners who oppose cannabis in any form, and those who want it legalised. According to Family First MP Robert Brokenshire, cannabis is a gateway drug to more serious drug abuse, and trafficking. Random dog searches at Adelaide’s Franklin St bus depot frequently turn up small-time dealers taking advantage of the absence of bag screening to traffic across the border, he says.

In the other corner, cannabis activist and blogger “Ree Hash” wants cannabis use made legal. She argues there will always be people who use it and they should not be treated as criminals for choices that affect no one but themselves. She says the link with mental health can work both ways, and cannabis can help as well as harm. Besides, she says, legalisation does not mean that more people would use it. “If heroin was legal tomorrow, does that mean you would go out and try it?” says Ree Hash “Most people would probably say no.”

And more people are saying no. Robert Ali says the Australian Institute of Health and Welfare’s national household survey on drug use showed substantial and persistent reductions since the 1990s. Why this is happening no one is quite sure, although it may mirror a health-related shift away from smoking in general. Ali says awareness of the risks may have risen. “I think those harms were dismissed by many people throughout the 2000s, but in recent times the mental health disorders associated with heavy, intensive cannabis use have become a lot clearer,” he says.

NCPIC says it has had “incredible success” aiming its mental health messages at 14 to 19-year-old boys. The campaign in Australia seems to have worked, while the cannabis lobby in the US has moved the other way by persuading authorities of the benefits of “medical marijuana”, effectively legalising its use for some people. So while rates among young people in Australia are going down, those in the US are going up.

“It’s a public perception issue,” says Overton. “In Australia, the mood has switched against cannabis.”

Source: The Advertiser, Australia May 19th 2012

A large international study led by University of Adelaide researchers has found that women who use marijuana can more than double the risk of giving birth to a baby prematurely.

Preterm or premature birth – at least three weeks before a baby’s due date – can result in serious and life-threatening health problems for the baby, and an increased risk of health problems in later life, such as heart disease and diabetes.

A study of more than 3000 pregnant women in Adelaide, Australia and Auckland, New Zealand has detailed the most common risk factors for preterm birth. The results have been published online today in the journal PLoS ONE.

The research team, led by Professor Gus Dekker from the University of Adelaide’s Robinson Institute and the Lyell McEwin Hospital, found that the greatest risks for spontaneous preterm birth included:

* Strong family history of low birth weight babies (almost six times the risk);
* Use of marijuana prior to pregnancy (more than double the risk);
* Having a mother with a history of pre-eclampsia (more than double the risk);
* Having a history of vaginal bleeds (more than double the risk);
* Having a mother with diabetes type 1 or 2 (more than double the risk).

The team also found that the greatest risk factors involved in the preterm rupture of membranes leading to birth included:
* Mild hypertension not requiring treatment (almost 10 times the risk);
* Family history of recurrent gestational diabetes (eight times the risk);
* Receiving some forms of hormonal fertility treatment (almost four times the risk);
* Having a body mass index of less than 20 (more than double the risk).

“Our study has found that the risk factors for both forms of preterm birth vary greatly, with a wide variety of health conditions and histories impacting on preterm birth,” says Professor Dekker, who is the lead author of the study.

“Better understanding the risk factors involved in preterm birth moves us another step forward in potentially developing a test – genetic or otherwise – that will help us to predict with greater accuracy the risk of preterm birth. Our ultimate aim is to safeguard the lives of babies and their health in the longer term,” he says.

This study has been funded by the Premier’s Science and Research Fund (South Australian Government) and the New Enterprise Research Fund, Auckland NZ.

Source: University of Adelaide 7/17/2012

Australians are the world’s highest ecstasy users in the world.
 (Source: U N Office of Drugs and Crime, World Drug Report June 2009).
 
Ecstasy is the second most commonly used illicit drug in Australia.
 (Source: Australian Institute of Health and Welfare 2008)
 
A third of all ecstasy seized globally in 2008 was destined for Australia.
 (Source: International Narcotics Control Board annual report 2010)
 
DRUG ADVISORY COUNCIL COMMENTS-
 
Australia has a culture of illicit drug use which is attracting supply.
 
This culture is supported by policies of syringe distribution, drug maintenance  and drug substitution. Celebrities because of their high public profile highlight this drug culture and the effects on them and their families.
 
Whilst public debate on the effects of illicit drugs is useful, these drugs are
illegal because they are PROVEN dangerous. The violence, mental illness, psychosis and chaos of all illicit drugs are well documented and scientifically proven.
 
The drug culture can only be changed with policies that REDUCE demand and
divert illicit drug users into rehabilitation that produce abstinence from
future use.
 
Court ordered and supervised illicit drug orders should be used to divert all
identified illicit drug users into rehabilitation. Only reduced demand by rehabilitation will starve international criminals of  funds from illicit drugs.
 
THE DRUG ADVISORY COUNCIL OF AUSTRALIA SUPPORTS:

More detoxification & rehabilitation that gets illicit drug user’s drug free.
Court ordered and supervised detoxification & rehabilitation.
Less illicit drug users, drug pushers and drug related crimes.

 
Source:  Drug Advisory Council of Australia  (DACA) August 2010

A 14-YEAR-old manages to get both the Prime Minister and Kevin Rudd’s wife Therese Rein on the phone, and the media flocks to his home in a bid to be the first to tell his side of the story.

This is not a child protege, nor is it a 14-year-old whose talents will deliver Olympic glory.

This Year 9 teenager is a convicted drug felon, having been caught buying 3.6g of marijuana on the streets of Kuta, and the fact that today he is at home is testament to the narrow escape he’s had from the claws of the Indonesian legal system.

His get-out-of-jail-free card is not a good luck charm he is likely to ever try again, but why after all the publicity generated by the cases of Schapelle Corby and the Bali Nine do so many continue to dice with death in Bali?

The answer is two-fold. Firstly, our acceptance of drugs inAustralia has now reached the point where we think it is relatively “normal” for a 14-year-old to have an addiction to a drug he has been smoking for two years.

A 2008 survey of 24,000 Australian high school students found that 14 per cent of students aged 12-to-17 years used cannabis, peaking at 26 per cent for 17-year-olds.

The Australian Secondary Students Alcohol and Drug survey found 80 per cent of pupils between 12 and 17 had tried alcohol. Eleven per cent of 12-year-olds had used inhalants in the previous month, and by the age of 17, seven per cent of students had used amphetamines.

So why would we raise our eyebrows when a 14-year-old Australian school student conducts a drug deal on the streets of Indonesia?

The catch here relates to where he bought the drugs and the penalties for drug-taking inAustralia, compared to our close neighbours – who make no secret of their bid to stamp it out.

Many, perhaps most, Australians are angry at Schapelle Corby’s on-going punishment, believing she has been unfairly treated. Thousands have signed petitions or offered prayers for those members of the Bali Nine who decided to wrap drugs to their bodies and smuggle it back home. Didn’t they think that other young Australians would use it – and possibly die?

Instead of ongoing outrage, we sympathise with those caught and point the finger of blame at Indonesia.

We have to change that psyche. Drugs are deadly. And in Indonesia the punishment for using them can be deadly too. It’s not a secret. And disagreeing with it doesn’t change it. In fact, in this part of the world,Australia is the odd one out, with other countries mirroring Indonesia’s stance.

So if we are serious about tackling drug use, we need to look at whether we should be ridiculing another country’s policy, or adopting tougher penalties here. Instead, we give movie-star status to a teenager who should know better. We protect him getting from the airport to his home, we don’t use his name, and his family breathes a sigh of relief that he’s relatively unscathed “considering what he went through”.

The next 14-year-old won’t receive the same easy ride, and this one is lucky authorities did not want to make an example of him – particularly at a time when we are laying down tough laws netting Indonesian teenagers lured into people-smuggling rackets in a bid to feed their families.

The problem with drugs is not Indonesia, or how it punishes users. The problem is with us, and how we have “normalised” drug use here – to the point where we’re told experimentation is typical in teenage years. To that extent, it’s not this lad’s fault either. The problem is bigger than he is, and will only grow while we accept its use and refuse to confront the consequences. The Courier-Mail spelt this out graphically in its Drug Scourge investigation, which showed greater crime, a bigger road toll and increasing mental health issues.

Several weeks ago on the Gold Coast, I walked into the female toilets used by diners of an upmarket restaurant to see a well-dressed young man sniffing cocaine off a toilet seat. He apologised – for using the female toilet not the drug-taking – and continued on his high. No shame, but is there any wonder?

Source:  Courier Mail Australia.  Dec. 2011 

mk@madonnaking.com.au.
On Twitter: @madonnamking

May 2, 2011

CANCER COUNCIL AUSTRALIA has revised dramatically upwards its estimate of alcohol’s contribution to new cancer cases and issued its strongest warning yet that people worried by the link should avoid drinking altogether.
New evidence implicating alcohol in the development of bowel and breast cancer meant drinking probably caused about 5.6 per cent of cancers in Australia, or nearly 6500 of the 115,000 cases expected this year, a review by the council found. This was nearly double the 3.1 per cent figure it nominated in its last assessment, in 2008.
The council’s chief executive, Ian Olver, said the updated calculations revealed breast and bowel cancer accounted for nearly two-thirds of all alcohol-related cancers, overtaking those of the mouth, throat and oesophagus.
”The public really needs to know about it because it’s a modifiable risk factor,” said Professor Olver, calling for awareness campaigns to alert people to the link. ”You might not be able to help your genes but you can make lifestyle choices.”
Professor Olver said public advice should not conflict with the National Health & Medical Research Council’s 2009 recommendation people should drink no more than two standard alcohol units daily, already half the previous safe threshold for men.
But people should also be told there was no evidence of a safe alcohol dose below which cancer-causing effects did not occur – either from direct DNA damage, increased oestrogen levels or excessive weight gain. ”If you want to reduce your cancer risk as far as possible [abstinence] would be the option you have,” he said.
Public advice was especially important, Professor Olver said, because studies that suggested alcohol could protect against heart disease were increasingly being challenged by new findings that people gave up drinking when they became ill or old – meaning any potential benefits of moderate alcohol use for cardiovascular health had probably been oversold.

Source: : http://www.theage.com.au/lifestyle/wellbeing/quit-drinking-to-cut-cancer-risk-20110501-1e38g.html#ixzz1LTPjlgEi May 2011

Many mothers and fathers think that allowing their children to have a supervised drink is a good way of exposing them to alcohol safely and taking away its illicit thrill. But new research suggests it sends mixed signals that result in them being more likely to abuse alcohol as they enter their core teenage years.
A joint American-Australian study of more than 1,900 12 and 13-year-olds found that those whose parents took such a “harm minimisation” approach were more likely to have experienced “alcohol-related consequences” – such as not being able to stop drinking, getting into fights, or having blackouts – two years later than those whose parents had a “zero-tolerance” strategy.
A year into the study, almost twice as many Australian teenagers (67 per cent) had drunk alcohol in the presence of an adult than their American counterparts (35 per cent), reflecting general attitudes in Australia and the US when it comes to supervised underage drinking.
The following year, just over a third (36 per cent) of the Australians had experienced alcohol-related consequences compared to only a fifth (21 per cent) of the Americans.
While cultural differences alone could feasibly account for the disparity, the results also found that teens who had been allowed to drink while supervised were more likely to have had such experiences regardless of which country they were from.
The results of the study, conducted by the Centre for Adolescent Health in Melbourne, Australia, and the Social Development Research Group in Seattle, USA, are published today in the Journal of Studies on Alcohol and Drugs.
British attitudes to teenage drinking are more similar to those in Australia than America, a matter reflected in law. While in the UK and Australia one can buy an alcoholic drink in a pub or off-licence from the age of 18, in the US the minimum age is 21. However, two years ago Sir Liam Donaldson, then England’s chief medical officer, said children under 15 should never be given alcohol, even though it is legal for parents to give a child over five alcohol in the home.
A separate Dutch study of 500 12-to-15-year-olds, also published in the JSAD today, found that it was the amount of alcohol available at home, and not how much parents drank, that determined teenage drinking habits – suggesting parents should keep their drinks cabinets locked.
Dr Barbara McMorris, of Minnesota University, who led the first study, said: “Both studies show that parents matter. “Despite the fact that peers and friends become important influences as adolescents get older, parents still have a big impact.” She added: “Kids need parents to be parents and not drinking buddies. Adults need to be clear about what messages they are sending. Kids need black and white messages early on. “Such messages will help reinforce limits as teens get older and opportunities to drink increase.”

Source: www.telegraph.co.uk/health 28th April 2011

Irreversible harm… a scan of the brain of a healthy six-week old (left) next to a scan of the brain of a baby of the same age who is suffering from foetal alcohol syndrome.

Photo: National Drug Research Institute

AUSTRALIA has fallen behind in recognising and diagnosing ”completely preventable” foetal alcohol syndrome and wider spectrum disorders, researchers warn.

The federal government has so far failed to respond more than a year after a monograph – an extensive gathering of available studies – was submitted to the Health Minister, Nicola Roxon, recommending favourable treatments.

There are a growing number of intervention treatments for children born with the illnesses and researchers advocate a renewed effort to help pregnant women who suffer chronic alcohol dependence.

Foetal alcohol syndrome causes serious primary structural brain damage, sometimes shown at birth in facial deformities such as a small head, flat mid-face, underdeveloped jaw and a short nose with a low bridge, but just as often in learning and behavioural problems.

More broadly, foetal alcohol spectrum disorder occurs in up to 1 per cent of live births and includes foetal alcohol syndrome and other central nervous system birth defects attributable to alcohol consumption by the mother. US research suggests sufferers are disproportionately likely to face the juvenile justice system.

Early intervention can help but ”Australia is well behind other countries in recognising or diagnosing” the disorders, says Nyanda McBride, a researcher with the National Drug Research Institute at Curtin University.

If no alcohol is consumed during pregnancy – and, some suggest, during preconception and breastfeeding – there is no risk of the ”completely preventable” disorders, Dr McBride said.

Women with chronic alcohol abuse problems needed ”much more treatment and care”, said Lucy Burns, a senior lecturer with the National Drug and Alcohol Research Centre at the University of NSW.

”We have virtually no treatments available for alcohol dependence in pregnant women,” Dr Burns said.

Although the National Health and Medical Research Council guidelines recommend women abstain from alcohol during pregnancy, ”we still don’t know the cut-off point at which alcohol starts to have this problematic effect”.

She said she had no date for the release of the monograph.

Elizabeth Elliott, a paediatrics researcher at Sydney University, said the monograph was submitted ”a long time ago”. The conditions had been under-recognised ”partly because health professionals are unsure about how to make the diagnosis”.

A spokeswoman for Ms Roxon said the Australian Health Ministers Conference would respond later this year. The issues were a ”priority” and the government had funded research for screening and diagnosis.

Source: www.smh.com.au July 21, 2010

The State Government figures show that out of 4619 drivers pulled over, one in 73 tested positive to either cannabis or methamphetamines. This compared to an average of one in 250 drivers testing positive for alcohol. The results surprised police.

The results come just two days after research by the National Drug and Alcohol Research Centre showed 57 per cent of clubbers admitted driving under the influence of alcohol and 52 per cent under the influence of cannabis. The VicRoads-commissioned study reported that just under half of those surveyed admitted driving soon after taking other drugs.

43% said they had taken ecstasy and 42 % speed.

Source: Minister for Police & Emergency Services. Victoria. Australia. April 15 2005

Media reports on illicit drugs “reduce acceptability and increase perception of risk” among young people, study finds.
Mainstream media reporting is far more likely to deter young people from using illicit drugs than encourage their use, a new Australian study has found.
But the study also found that types of reports most likely to have the strongest impact on young people – those on social and health consequences of drug taking – were underrepresented in the media.
The study by the Drug Policy Modelling Program at the National Drug and Alcohol Research Centre at the University of NSW, and funded by the Commonwealth Department of Health and Ageing, measured the impact of media reports on illicit drugs on the attitudes of over 2,000 young people aged 16 – 24.
The study also analysed 4,000 newspaper reports referring to illicit drugs and found that just over half focussed on criminal justice and legal issues, while only 24 per cent highlighted the health or social problems associated with drug taking.
Participants were shown eight different types of reports and their responses were measured.
Chief Investigator of the study Dr Caitlin Hughes, a Research Fellow at NDARC’s Drug Policy Modelling Program (DPMP), said that while drugs are one of the most common motifs in popular culture and one of the most frequently reported on there is very little research anywhere in the world on how media reporting on illicit drug issues influences attitudes or behaviour on illicit drug use..
“We know from related fields that media messages can influence people’s knowledge, attitudes and behaviour.
“It is commonly assumed that news media can incite drug use,” said Dr Hughes.
“Our research has found that the opposite is the case. Most media portrayals appear to reduce interest in illicit drugs, at least in the short term.
“They increase perceptions of risk, reduce perceptions of acceptability and reduce the reported likelihood of future drug use,” said Dr Hughes.
”But the irony is that the messages that are most effective at deterring youth interest in drugs are currently under-represented in Australian news media,” said Dr Hughes.
News items which focussed on the health and social issues – for example evidence about cannabis and psychosis or cannabis and poor educational outcomes – were more likely to have a deterrent effect than reports on drug busts and arrests.

“Our results show clearly there is an opportunity to better harness the media to shape young peoples’ attitudes to illicit drugs.
We are not saying news media is the silver bullet in drug prevention, but given news media is so pervasive we do think it ought to be recognised, both within Australian and internationally, as a potentially powerful tool for preventing illicit drug use.”

Key points:
• A total of 2,296 youth aged 16-24 years completed the survey
• All youth were shown 8 different media messages about drugs (on the two most commonly used drugs in Australia – cannabis and ecstasy)
• 66.4% and 86.5% of participants had weekly or more frequent contact with television news, online news, radio news and/or print newspapers
• Most news media messages elicited moderate to large impacts on youth attitudes. Negative health or social messages elicited large impacts on youth attitudes.
• Messages on ecstasy had greater impact on youth than messages on cannabis
• Females more likely to be deterred from use than males
• People who have never used drugs more likely to be deterred than current users
• Reports on criminal arrests significantly less persuasive than reports about negative health or social consequences
• Across all drugs, criminal justice/law enforcement topics accounted for 55% of all topics
• 60% of articles emphasised that illicit drugs lead to legal problems. 14% health problems, 10% social problems, 10% cost to society and 6% other (4% neutral and 2% benefits)
• Tabloids were more likely to emphasise legal problems: 71% compared to 61% for broadsheet
• 11 newspapers, one national, seven major metropolitan, in Sydney, Canberra, Melbourne, Brisbane and Perth and three local in Geelong, Newcastle and Sydney were reviewed

What they said: (comments from the focus groups).
Re power of media to dissuade youth drug use:
“Media is probably one of the few ways that prevention message(s) can keep being pushed.” (20 year old female)
“When I was younger… the way that that was portrayed in the media totally shaped the way that I saw drugs.” (22 year old female)
Re fatal overdose of a young person:
“I think that would convince me not to take drugs. Just „cause……I feel sorry for her.” (17 year old male)

Source: Media reporting on illicit drugs in Australia: trends and impacts on youth attitudes to illicit drug use. Drug Policy Modelling Program, September 2010. It can be accessed through: http://www.dpmp.unsw.edu.au

A TENFOLD increase in hospital treatment for cannabis poisoning or dependence among people in their 30s and 40s suggests the habit has run out of control for a hard core of long-term users.
Australian research shows that while cannabis consumption overall decreased during the past decade, the rate of hospital treatment rose. Treatment rates are highest among people in their 20s, but the steepest increase has been among older people, with those in their 30s only slightly less likely to seek help than younger people by 2007, the study shows.
Seven years earlier, people in their 30s were being treated at only half the rate of their younger counterparts, according to the findings of the National Drug and Alcohol Research Centre at the University of NSW. Their faster rise in cannabis-related health problems coincided with greater frequency of daily use.
“These people started their use early and have [in some cases] then gone on to develop problems,” the study leader, Amanda Roxburgh, said. “They might not necessarily think that they have a problem with their use until it kicks into crisis mode.” People in their 20s were about 50 per cent more likely to have used cannabis during a one-year period compared with those in their 30s. But of those who did so, nearly 20 per cent of the older age group had developed a daily habit, against about 15 per cent of the younger adults.
Ms Roxburgh, whose results are published in the journal Addiction, said the rise in problematic use might reflect increased cannabis potency, though there was no formal evidence the drug had become stronger. Its falling price suggested it was being produced more efficiently – perhaps through indoor hydroponic cultivation – and this might have made it more accessible.
Jan Copeland, who heads the National Cannabis Prevention and Information Centre, said older people were more likely to consider cannabis safe. “These people come from age groups where cannabis is a benign herb and natural,” she said. “But when you are doing something every day you don’t realise the difficulties when you try to stop”.
Cannabis use among people aged 14 to 19 more than halved between 1996 and 2005, but the study also found pockets of harmful use in that group. Nearly two-thirds of young daily cannabis users reported difficulties controlling their use.
Members of this group were also more likely to report smoking 10 or more cones or joints a day, and if they were treated in hospital for their cannabis use were more likely to be treated for psychosis than older users.
Professor Copeland said young people now understood cannabis could be dangerous, and fewer were experimenting, but dedicated treatment programs were still needed for young people with a serious habit.
Will Temple, chief executive officer of the Watershed drug and alcohol recovery and education centre in Wollongong, said his centre had gone from treating almost no cannabis users to in the past six months treating 30 per cent of clients for cannabis use.
Source: The Sydney Morning Herald 29th March 2010

Drug users who can’t kick the habit can blame a dysfunctional brain for their addiction, according to new research.
A study by the University of Melbourne has found long-term drug users have more difficulty controlling impulses because their frontal cortex is impaired.

The two-year study found opiate users needed to use more of their brains to resist impulses in a test of self control than those who were clean. The findings shed new light on why drug addicts find it so hard to quit, despite the health consequences.
“Drugs can capture and hijack some parts of the brain,” said Dr Murat Yucel, a lead researcher in the study. In this study we found the frontal cortex, an area that is essential for exercising control over thoughts and behaviours, was working inefficiently. These findings may help explain why it takes addicted individuals enormous effort to exercise control over their drug taking behaviour in the face of adverse consequences and why they are vulnerable to relapse back into uncontrolled, compulsive patterns of use.”
The study – published in the journal, Molecular Psychiatry, last month – also found drug users’ brain cells in the frontal region were less healthy than normal. The research shows drug taking is not a matter of choice for long-term users, who have a reduced biological capacity to stop, Dr Yucel says.
Researchers will next examine whether reduced brain function is a consequence of addiction or a contributing factor that makes some people more vulnerable to drug abuse. Co-researcher Dan Lubman said the study would likely lead to the development of new strategies for the treatment of addiction.
“These findings tell us that we need to provide a combination of pharmaceutical and psychological treatments that will help bolster the efficiency of the frontal cortex and hence the individual’s ability to stop their urge to use drugs,” he said.

Source: www.yahoo7News.com Aug. 2007

DRUG addicts using the controversial Kings Cross injecting room are taking advantage of the safe environment to test their tolerance to higher doses of heroin and other cocktails of dangerous illicit drugs.
The claims were made during interviews with the peak body Drug Free Australia and were repeated in Parliament by Christian Democratic Party MLC Reverend Gordon Moyes late on Tuesday night during debate over a possible four-year extension of the injecting room.
Mr Moyes told the Upper House the injecting room “has encouraged (users) . . . to try wilder mixes of drugs” after he read aloud a transcript of a recorded conversation between Drug Free Australia secretary Gary Christian and a former injecting room client.
During the interview, the man claimed there was widespread dangerous mixing of heroin and pills including Benzodiazepene, Normasin, Oxycodone and Xanax.
“I have seen that they are going in for one thing but really they are going in for two (or three), with the heroin on top of the pills, but they won’t (tell anybody that),” he said.
“They feel a lot more safer, definitely because they know they can be brought back to life straight away. They know . . . they can, like some people go to the extent of even using more. So in a way they feel it is a comfort zone, and no matter how much they use if they drop (die) they (might) be brought back.”
Drug Free Australia had sought answers as to why the injecting room had “massive” numbers of heroin overdoses, measured between 36 and 42 times higher than normal rates of overdose in the community.
“In 2003 our expert committee analysing injecting room data found that clients of the injecting room were recording a prior history of one overdose for every 4380 injections on average in their intake questionnaire,” Mr Christian said.
“But inside the injecting room, there was an extraordinary one overdose for every 106 injections, 42 times higher than the client’s previous history.”
The former injecting room client said the rife experimentation was done behind workers’ backs.
“You can hide anything from everybody,” he said.
“It is not the workers’ (fault) . . . they try their best, it is just (that we) are (all) sneaky people.”
Mr Moyes told Parliament a second former client revealed users were using the safety of the room “to get the biggest rush they can, even if there is the risk of overdose”.
“Consequently, far from combating the problem and helping these people to stop harming themselves, the injecting facility has actually encouraged them to try harder, to try wilder mixes of drugs, and to push themselves right to the point of death,” Mr Moyes said.
“For six years the NSW Government has funded a drug experimentation laboratory where users can push their boundaries and where they have medical help immediately on hand from a nursing sister if they go too far.”

Source: The Daily Telegraph (Australia)June 28, 2007 12:00am

By: Ross Goodridge, Sydney, Australia
This year I published a paper entitled “The Methadone Conspiracy – Can Addicts Sue?”, highlighting the fact that Australia currently has approximately 24,000 people on long-term methadone maintenance programs. Patients receive daily methadone, which is ultimately supplied by the Federal Government of Australia. The methadone is often provided without any attempt to control long-term use or to restrict the addict’s use of other illicit drugs. Most methadone is provided by way of “take-away doses,” and thus an estimated 29 percent of methadone in Australia is re-sold on the black market. Methadone has become a substantial primary drug of addiction.
Methadone is a synthetic opiate, developed in Nazi Germany in 1941, in an attempt to replicate heroin for relief of pain. Methadone acts upon the body in a manner very similar to heroin, attaching to the same brain receptors and creating euphoria by the same chemical process.
In Australia, like most western countries, there are often many views expressed as to how society should deal with illicit drug users. There are those who promote a tougher on drugs policy, while others promote legalisation.
Since releasing “The Methadone Conspiracy,” I have personally attracted much criticism by those who promote legalisation. They believe that narcotics should be available either freely or by prescription. They already have one drug available on this basis – methadone.
On receipt of this criticism I posed the question for myself, “Can methadone maintenance be considered a successful drug treatment program?”
The starting point in answering this question is, “What is meant by success?”
If one starts with the position that no drug addict will ever be cured, and there is no point in trying, then I suppose it could be considered a success to provide clinically pure amounts of narcotic each day to that addict each day. This will provide lower risk of harm to the addict of HIV infection, criminal behaviour, etc.
From my prospective, I cannot, and do not, accept that the best outcome that can ever be achieved for any one addict is a lifetime of addiction.
Australia has a rapidly rising number of drug addicts, a rapidly rising number of methadone addicts, and rapidly rising crime. Australia’s prisons are over-flowing, and it is estimated that 80 percent of all prisoners have a drug addiction, which was a cause of their criminal behaviour. The direction must be changed.
Methadone programs do little to reduce the demand for heroin. An estimated 72 percent of people on long-term high dose methadone programs are also frequent heroin users.
Methadone addicts regularly sell part of their take-away doses in order to obtain money for heroin purchase.
Trading in methadone occurs directly outside of the methadone clinics in Australia.
Nobody involved in the field can be unaware of this fact; it is obvious and patent.
Heroin addicts buy methadone because one “done” (usually 20 or 40 millilitres), will help sustain a heroin addict until he or she can buy more heroin. Teenagers use methadone because of a perception that it is a “safe drug.” It is less daunting to take a sip than it is to inject, and teenagers experiment with methadone as a first drug.
Notwithstanding that there are now over 24,000 long-term methadone addicts in Australia, the Government does not offer any programs to help people overcome their methadone addiction. Drug addicts are placed in jail or given free drugs, and historically almost no funds are available to overcome drug addiction!
I am not opposed to methadone per se. I am opposed to methadone as the first and only option provided to people who would otherwise achieve abstinence.
Ross Goodridge is a senior Barrister-at-Law practising in Sydney, Australia. He is credited with the Australian introduction of Drug Courts and was responsible for the endorsement of Drug Courts by the AMA, most political parties and the broad community. Mr. Goodridge has been a keynote speaker at a number of conferences and an active supporter of the Australian Cities Against Drugs movement.

HEROIN is set for a devastating comeback on Sydney streets and could trigger a major surge in overdoses, drug experts warned yesterday.
While a recent heroin drought led to a drop in overdoses in Australia, an influx of pure heroin from East Asia is expected to flood the local market, sparking grave fears of more drug deaths.
The quantity of heroin imported to Australia has almost doubled in the past two years, jumping from 40kg in 2005-06 to about 70kg last financial year, the latest statistics show.
A dramatic increase in poppy production in Afghanistan and Burma due to favourable weather conditions has been blamed for the increased supply of pure heroin, which experts say is destined for Sydney, which is renowned as Australia’s heroin capital.
The Australian National Council on Drugs yesterday warned low grade heroin supplies were being supplemented by higher concentrations.
“The increase in purity has a potential problem for more overdoses,” the council’s executive director Gino Vumbaca said.
“Sydney is the market where it comes to and there’s an increase in usage patterns.”
The UN has recently confirmed Burma had dramatically increased poppy yields.
“They’re expecting a lot of heroin to be produced and sold and the destination will be Sydney and Melbourne,” Mr Vumbaca said.
The trend has angered Australia’s leading drug support group which held a memorial service in Canberra this week – attended by more than 100 people – to pay tribute to family members lost to drug overdoses.
“We haven’t solved the problem, we haven’t done anything to make long-term solutions,” a Families and Friends for Drug Law Reform spokesman said.
The heroin issue was also raised at a national drug strategy conference on the Gold Coast yesterday with experts saying supplies were certainly on the rise.
National Drug and Alcohol Research Council spokeswoman Louisa Degenhardt said internal research showed drug users confirmed that heroin supply was increasing.
“A greater proportion said it was very easy to get compared to last year,” she said.

Source www.news.com.au Oct 2007

A new Australian study suggests that parental encouragement leads to alcoholism in teenagers. The latest MBF Healthwatch survey found that 63percent of Aussies in the higher income bracket approve of alcohol consumption by 15 to 17 year olds at home under the eyes of parents.
“Our survey suggests many Australians believe it’s acceptable to buy alcohol for teenagers and allow them to drink under parental supervision at home,” Bupa Australia Chief Medical Officer, Dr Christine Bennett, said.
Dr Bennett continued: “Some parents may think this is harmless; some may see this approach as a way to teach their teenage children about socially responsible drinking. But we want parents to understand that early exposure may actually be doing them damage. “Evidence suggests that the earlier the age that alcohol is introduced, the greater the risk of long-term alcohol related health problems.
“Binge drinking in young people is on the rise. Too much alcohol impairs young people’s judgement, which can lead to violence, injury and build a pattern of use that leads to lifetime dependence. “It’s shocking to think that one teenager a week dies of alcohol abuse. We teach children about the harmful effects of smoking, unsafe sex and taking illicit drugs, but we also need to teach them about the damage that alcohol can do.”
The survey also found that people’s acceptance of supervised underage drinking was closely related to their income levels. Nearly 63percent people earning over 100,000 dollars approved supervised drinking; 53percent people with incomes between 70,001 to 100,000 dollars were comfortable with the idea followed by 48percent people getting paychecks ranging from 40,001 to 70,000 dollars.
Dr Bennett added: “Given that social drinking is a common part of the Australian culture, our challenge is to help our young people learn how to enjoy alcohol in a socially responsible way and protect them from harm now and in the long-term.
“That will mean educating young people about the risks of underage drinking and, as parents and a community, being good role models.”

Source: Health News Dec. 3rd 2009

Australia’s drinking, smoking and drug-taking caused a lot of sickness, disease, premature death, reduced productivity, crime and accidents in the year to July 2005. The report shows costs were up to $56 billion, from about $34 billion when the estimate was last made in the late 1990s.
The latest estimate puts the cost of alcohol-associated problems at $15 billion. It estimates Illicit drugs cost Australia about $8 billion. But by far the biggest problem is tobacco. The report says it cost $31.5 billion – 56 per cent of the total.
“The smoking rates are reducing but the delayed health effects of past smoking are still being seen,” Health Minister Nicola Roxon said. “So we do hope that in the future, pretty long term in the future, that the lower rates of smoking will see a decline in this social cost.”
Professor Simon Chapman from the School of Public Health at the University of Sydney says Australia is a world leader in anti-tobacco campaigns, but more practical steps need to be taken to make smoking history. “We could begin by putting all cigarettes under the counter in the way that pharmaceutical, ethical drugs are not displayed,” he told AM.
“We could put them in plain packaging rather than the really enticing attractive boxes which are highly market researched to appeal to young people. We could put the price of cigarettes up a lot more and we could regulate the product itself. It’s the only product that is taken into the body which is not subject to, sort of quality controls, safety controls.”
The Labor Party says it is taking a different approach to the previous government in health policy, putting more emphasis on prevention. The director of the Australian Institute of Health Policy Studies, Professor Brian Oldenburg, says there is little detail so far.
“I think at least compared to the previous government, there is the expressed intent to really put more effort into prevention, but we are still waiting to see how that is going to work its way through the system,” he said. Ms Roxon will release the figures on the social costs of drugs and alcohol at the first ever national illness prevention summit, which begins in Melbourne today.

Source: ABC News April 9th 2008

In different forms it’s been sold as plant food, but little is known about a new recreational drug hitting Australian streets, other than it prompts acts of horrendous self-mutilation by some users. Within the past few months in Sydney there have been reports one user tried to castrate himself while under the influence of the drug. Another severed half a finger using a kitchen appliance and degloved his penis in an apparent circumcision attempt.

The drug in question is 4-methylmethcathinone or mephedrone – but more commonly known as 4-MMC, MMCAT, bubbles, megatron, bath salt or miaow miaow. As a derivative of methandienone, the drug is a prohibited substance in Australia.

Continuing to prove hugely popular on the UK clubbing scene, the drug is believed to be partly responsible for the deaths of a woman in Sweden in 2008 and a 14-year-old girl in England in November. It has since been made illegal in some European countries.
The psychoactive drug creates a state of euphoria similar to, but not as extreme as cocaine, with an ecstasy-like hit at the end. Reports of little after-effects and a mild “come-down” have made the drug popular among young professionals who like to party at the weekend before having to return to work.

Since September 2008, the Australian Federal Police (AFP), along with Australian Customs and the Border Protection Service, have detected 25 attempts to import a combined total of more than 20kg of the drug. An AFP spokeswoman confirmed that mephedrone “is a new drug that has emerged in Australia”. While prohibited here, the drug is readily available for legal purchase abroad, predominantly in China and Israel.

In Tasmania, police have labelled the drug “Israeli’s”, because of its country of source, and report its popularity with people who believe it’s legal to possess. “We conducted an investigation at the start of the year and a number of persons were charged with trafficking,” Tasmanian Police Detective Inspector Ian Lindsay told The Mercury newspaper in October last year. He added that since those charges were laid there had been a “dramatic reduction” in the amount of mephedrone seized across the state.

In a report from the Tasmanian Department of Police and Emergency Management, the drug is said to have been possessed “in an attempt to circumvent existing legislation”. In the Northern Territory, a 16-year-old boy faced Darwin Youth Justice Court on January 15 for allegedly importing 1kg of mephedrone, ordered online from a legitimate chemical company in China. The court heard the boy paid $8,000 and was expected to pay an additional $12,000 when the drug arrived, the NT News reported. The matter is ongoing.

Brisbane-based Rave Safe project coordinator Michael Brennan said use of the drug in Australia was “worrying” and people continued to consume the substance without knowing its effects or what’s used in its production. Typically, mephedrone is mixed with caffeine and the compound can take effect very quickly. However, for users of other recreational drugs, Mr Brennan said the effect may not be as strong as that to which they’ve become accustomed. “Reports are that it’s incredibly more-ish, which can be a concern in itself,” he said. “It is one thing to pop one or two tabs of ecstasy, but taking this stuff, they could be inclined to take several hundred milligrams.

“In a way these things are more dangerous because people will take one or two doses and not get the effect they want so then they take a lot more of them. When a substance like this comes up that was really only invented only a few years ago, it’s hard to say what the effects will be, so it’s really worrying to me. It’s just a real unknown at this stage.” Typically, the drug is purchased in crystal form and snorted for quick effect, but can also be taken orally.

Mr Brennan said mephedrone had proven popular among ecstasy users, but added that few seemed to move onto long-term use. “I think some people are quite happy with that effect, that you don’t get this terrible after-effect with it,” he said. “A lot of ecstasy users have been taking it for a try, but a lot of long-term users have gradually lost the attraction to it. And I would bet that 4M CC will slowly disappear into the background.”

As a stimulant, the drug affects the human cardio system and users have experienced varying symptoms including palpitations, paranoia, anxiety, depression, insomnia, headaches and short-term memory loss. In one case, documented in an online forum, following the consumption of about 100mg over a week, a male user noticed his fingers and knees turn a dark red to purple colour before he passed out. After about six months, including a short stint in hospital, the discolouration disappeared, but the symptoms returned after again trying a small amount of mephedrone.
In the Sydney cases, it’s unknown whether the male users were also under the influence of other substances, but online discussions about the drug frequently list paranoia as a common side-effect. Both men were hospitalised for their injuries, but NSW Health does not have a system in place to record how many patients have been admitted to hospital due to the drug.

Nor is the use of mephedrone recorded by major agencies, including the National Drug and Alcohol Research Centre, the NSW Bureau of Crime Statistics and Research, or the Centre for Population Health. The Australian Injecting and Illicit Drug Users’ League in Canberra has only anecdotal data about the drug. All agencies report having been made aware of the drug’s existence in Australia since about 2008, but concede there is little or no information about mephedrone.
Online forums suggest Australian use or sampling of the drug is most popular in states along the eastern seaboard. Part of the drug’s appeal is its relative cheapness, with online advertisements for various forms of mephedrone available from $170 for 100mg.

Source: www.smh.com.au 29th Jan 2010

Exclusive data reveals 134 people died of heroin-caused deaths in Victoria last year – the most annual fatalities since 2000 when the drug rivalled the road toll. Already this year, 59 heroin deaths have been verified – taking the total to almost 200 in less than two years – with 2009’s figure expected to rise dramatically as investigations into causes of death are completed. With heroin caps now selling for as little as $40 to $50 – about the same as a slab of beer – and police warning heroin purity and volumes are on the rise, experts predict scores more will die.
A Sunday Herald Sun investigation into drugs on Victorian streets reveals:
Drug detectives are battling Vietnamese organised crime syndicates which are using teams of mules to transport “alarming” quantities of heroin into Melbourne.
Victoria Police has compiled a hit list of more than 100 names of suspected couriers who will be detained if detected at airports.
While heroin is booming, an amphetamine drought has more than doubled the price of “ice” to up to $1000 a gram.
And, according to authorities, new groups are “champing at the bit” to fill the void in the speed market vacated by the execution and imprisonment of figures in the gangland war.
In an exclusive interview, one of the state’s top anti-drug enforcers, detective Sen-Sgt Dale Flynn, revealed the international heroin wave had started to break locally.”We’ve been anticipating some type of flood into Australia, into Victoria, and we’ve really just seen signs of that in the past six to 12 months,” he said.
Forensic, toxicology, police and corrections sources have noticed a rapid increase in heroin and its attendant harms in Victoria in recent months. “Identifying factors for us are we’re seizing more and the purity has increased and we’re getting more intelligence about heroin,” Sgt Flynn said. “If there was an increase in any particular drug, that would be a concern to us. Heroin is the one that has probably the most fatalities connected to it, so when that starts to increase that is a concern.”
A Victorian Institute of Forensic Medicine report on heroin deaths, obtained by the Sunday Herald Sun, details the startling rise in fatalities. A further analysis shows that including the part-year figures for 2009 from the National Coronial Information Service, there have been 2414 heroin deaths in Victoria since 1991.
Figures also show those who died in 2008 ranged from a 15-year-old female to a 57-year-old male, with increasing numbers of female victims. And ambulance officers had attended 614 non-fatal heroin overdoses in the first six months of this year, the Turning Point Alcohol and Drug Centre revealed.
VIFM chief toxicologist Dimitri Gerostamoulos said the increase was mirroring the spike that happened in the late 1990s. “There’s more heroin being produced nowadays than ever before, so there is quite a lot of heroin available,” he said.
Police said the amount of heroin being produced in Afghanistan and South-East Asia was significant. In recent years, brown heroin from Afghanistan had appeared locally as well as Asian white. “Probably the main issue at the moment is Vietnamese organised crime groups,” Sgt Flynn said. “They obviously have the contacts in Vietnam and South-East Asia that can get it here initially. They’re the ones that we seem to be targeting at the moment. We have a problem at the moment with Australian nationals getting paid to fly over to Vietnam, stay for a couple of days, receive some pellets of heroin that they insert internally then come back over.”
He said several heroin couriers had been arrested in Melbourne and around the nation in joint ventures between Victoria Police, Customs and the AFP. “But we don’t believe we’re getting all of them. Obviously there’s some that’s getting through,” he said. The deadly drugs are cut and processed locally, often in industrial areas, factories and homes. In September, heroin worth $5 million was seized from a West Footscray house. Victoria Police drug investigators have compiled a “hit list” of more than 100 names of suspected couriers who will be checked if detected passing through airports. “We don’t always just look at taking them out at the border, but we look for the Melbourne-based offenders to try to gather evidence and put them before the courts as well,” Sgt Flynn said.
Melbourne’s heroin hot spots include the CBD, St Kilda, Richmond, Footscray, Frankston, Collingwood, St Albans, Deer Park, Boronia, Dandenong, Reservoir, Fitzroy and Carlton. During the week the Sunday Herald Sun found used syringes dumped in city alleyways, car parks and near a needle exchange program just metres from a primary school.
The broad availability of heroin is causing its price to fall, while ecstasy and amphetamine stocks are falling, pushing up their street prices. A gram of smack can cost as little as $260, while a gram of ice, or crystal meth, now sells for $750 to $1000. A smaller cap of heroin costs between $40 and $50.
Needle exchange group ANEX said the heroin boom would bring a tide of disease if the right steps were not taken. “We need millions more needles in the needle exchange services to prevent HIV and hepatitis C,” ANEX chief John Ryan said. Overall, about half of injections are made without a clean syringe. More than 40,000 needles are distributed to drug addicts every month as part of a Frankston program – one of 19 needle and syringe programs throughout Victoria.
An analysis of Pharmaceutical Benefits Scheme data has found the number of prescriptions for methadone and other heroin recovery drugs in Australia almost tripled from about 2.4 million in 1992 to almost seven million in 2007. Victoria has recorded the greatest increase in addicts of any state, with almost 12,000 – more than double since 1998 – costing the taxpayer more than $22 million in treatments.
Source: Heraldsun.com.au 23 Nov. 2009

A ground-breaking report into the use of the stimulant MDMA has revealed it claimed 82 Australians over five years from 2000 – and the number fatalities is increasing.
The National Drug and Alcohol Research Centre’s study into MDMA-related deaths is the most comprehensive examination to date, and has prompted calls for more research. Last year, Perth teenager Gemma Thoms collapsed at the Big Day Out and died in hospital. She swallowed three ecstasy pills at the festival gates to avoid being caught by police.
Her mum, Peta, is planning to hand out leaflets at today’s Big Day Out warning revellers about the dangers. Concert organisers had promised to design and print flyers for all the 40,000 people expected to attend the festival.
Additional figures obtained by The Sunday Times this week show 23 people died as a result of taking ecstasy in Australia from 2006 to 2008. There could be more, with a number of cases still under investigation. Of those, 10 deaths were reported in 2006, seven in 2007 and six in 2008, with 65 per cent of victims aged 20-29 and more than 70 per cent male.
More than 80 per cent of the deaths were unintentional and 15 of the 23 victims took other drugs with the MDMA, including cannabis or alcohol. In the earlier cases examined by the National Drug and Alcohol Research Centre, 91 per cent of the deaths were directly caused by drug toxicity and MDMA was the sole drug involved in a quarter of cases.
It also contributed to a number of drownings, cardiovascular problems and car crashes. Last week, The Sunday Times revealed that ecstasy had never been cheaper in Perth, with the street price dropping for the first time last year.
A survey by the National Drug Research Institute also found that young users were taking the party drug more often and in bigger quantities. The number who binged on the drug rose from 22 per cent in 2008, to 40 per cent in 2009.
Funded by the Federal Department of Health and Ageing, a separate National Drug and Alcohol Research Centre report found the median age of ecstasy fatalities was 26, with the youngest victim 17 and the oldest 58.
“There are a lot of accidental deaths where MDMA is thought to have played a role . . . and this seems to be a more prominent and prevalent concern,” the centre’s assistant director Louisa Degenhardt said. “A lot of bad things can happen when combining drugs because accidents happen when people are intoxicated with any drug.”
Royal Perth Hospital emergency 2medicine specialist Daniel Fatovich warned that cheaper prices meant more West Australians could afford more pills, increasing the risk of overdoses.

Source www.perthnow.com.au January 30, 2010

THE serious consequences of long-term cannabis use in indigenous communities are beginning to show, with an alarming surge in the rate of chronic mental health conditions among those who started smoking the drug at an early age.
James Cook University researcher Alan Clough, who has been looking at the issue of indigenous drug use for the past five years, found cannabis use in remote communities was now as high as 70 per cent of people, with almost 90 per cent of users claiming to be addicted.
Since the study began in 2004, the bulk of users surveyed reported continuing heavy use. “After 15 years of a cannabis epidemic we’re really starting to see the chronic mental effects appearing,” Professor Clough said.
“We’ve seen acute psychosis that is irreversible, as well as depression and dependence. Unfortunately we also have the situation where suicide is linked not just with cannabis use but also through withdrawal. The other worrying trend is the declining age of people trying it for the first time. Some kids are starting at 10.”
In a recent study of three remote Arnhem Land communities, Professor Clough and a team of researchers found that cannabis use exceeded six “cones” daily in almost 90 per cent of users. This was about twice the consumption of regular users elsewhere in Australia. The study also found people spent more than 60 per cent of their income on cannabis.
Professor Clough denied that alcohol bans under the intervention had forced people to switch to drugs. Senior Arnhem Land elder Bakamumu Marika said young people were turning to cannabis out of boredom. “People just get bored stiff. They’ve got no work to do, no training, no jobs,” he said.
Source:www.theaustralian.com 9th Nov. 2009

September 29, 2009

A recent analysis of official reports on the Sydney Kings Cross injecting room confirmed that unavailability of heroin is of far greater significance in preventing heroin deaths than the availability of injecting rooms.
Less than 9,800 drug users were registered at Kings Cross, a small number of illicit drug users in New South Wales. Most drug users lived well away from Kings Cross and used the rooms only occasionally so most drug use was elsewhere.
The severe heroin drought at the end of 2000 led to the reduction in drug deaths. In fact, timely ambulance attendance is more likely to prevent a drug death than any other factor.
Source: Kings Cross Injecting Centre Fails to Reduce Overdose Deaths, Dr Sullivan PhD. Click here for the research.
DRUG ADVISORY COUNCIL OF AUSTRALIA COMMENTS
This study confirms overseas research that indicates that injecting rooms are a failure and are being closed down. Restriction of illicit drug supply is effective in reducing use and deaths.
Reducing the demand for illicit drugs is a key to successful drug policy.
Drug policy should divert identified drug users into court ordered and supervised detoxification and rehabilitation to get them drug free.
THE DRUG ADVISORY COUNCIL SUPPORTS:
• More detoxification & rehabilitation that gets illicit drug users drug free.
• Court ordered and supervised detoxification & rehabilitation.
• Less illicit drug users, drug pushers and drug related crimes.
Posted at 10:40 AM in News, Policies, legislation | Permalink
Comments
A very good point. So let’s destroy the heroin fields in Afghanistan!
Posted by: Frugal Dougal | September 29, 2009 at 04:54 PM
There were 2,106 overdose “events” treated at the Centre during the trial period. Nobody died during this time and yet, according to the study, no deaths were necessarily prevented, because these people could have been treated by paramedics or in a hospital ED.
True – as long as they were using with a responsible friend who could call out an ambulance. But the target group, street injecters, often don’t.
It is impossible to say exactly how many of these 2,000+ events would have been fatal had they happened elsewhere, but to choose instead to look for the effect of a single clinic by using overall population data is misguided, or just plain dishonest.
What this study shows most clearly is that people will take the evidence that suits their ideology and use it to attack the good work that is being done by others, simply because, in their opinion, it is “wrong”. Whether lives are saved, or not, is secondary.
Posted by: Adam Baxter | September 30, 2009 at 10:59 AM

“Drug driving tests have been an outstanding success in reliably identifying drivers whose capacity to drive is dangerously compromised,” Mr Holding said. “There can be no mistake that driving under the influence of illicit drugs is just as dangerous as driving while affected by alcohol and is a major contributor to death and trauma on Victoria’s roads.

“The first four months of the saliva drug testing program have identified a worrying level of substance use among drivers that will not be tolerated.” Mr Holding said a three-step process ensured the integrity of the tests. Drivers are initially asked to provide a saliva sample by placing a small absorbent pad on their tongue for a few seconds.

Drivers who return a positive test are then asked to accompany police into a drug bus, similar to a booze bus, for two further saliva samples – one to be kept by the driver and the other for further on-the-spot analysis. If this indicates a positive result, the sample is sent to a laboratory for verification. Motorists who return positive laboratory results for cannabis or methamphetamines are fined $307 and lose three demerit points, or are prosecuted in court. If the offence progresses to court, the maximum penalty for a first offence is $614 and three months’ licence cancellation. Subsequent convictions can result in fines of up to $1227 and up to six months’ licence cancellation.

Mr Holding said in the four months to 17 March 2005, a total of 4619 drivers were tested, with 63 drivers testing positive for drugs. He said 21 drivers tested positive for cannabis and methamphetamine-based drugs. Five drivers tested positive for only cannabis, with 37 testing positive to only methamphetamine-based drugs.

Of the 3488 car drivers tested, 47 returned a positive result. Sixteen out of 1131 truck drivers tested positive for drugs. Eight preliminary tests were not confirmed by the drug bus.

Mr Holding said test handling procedures had been reviewed after three drivers’ final tests ultimately came up negative in the very early stages of the program. “Independent laboratory tests since have conclusively verified the accuracy of saliva drug testing,” Mr Holding said.

 

Australian Premier John Brumby’s promise to battle the social ills of alcohol has been undermined by inaction on the expansion of big discount liquor stores and bottle shops, often in socially disadvantaged areas. The State Government has accepted only two of the 27 recommendations from its Liquor Control Advisory Council on how to control the booming retail liquor market and its impacts on binge and under-age drinking.
The council’s report found the number of retail liquor stores had increased more than 60% in Victoria in the past decade — to 1851 outlets. The report also revealed the dominance of the state’s biggest purveyor of alcohol — Woolworths.Since the Government lifted the cap on big players in the liquor market five years ago, Woolworths, which owns the Dan Murphy’s chain, has boosted its outlets from 135 to 233 stores. Coles liquor group owns 178 licences.
Woolworths has recently been involved in several cases where communities and local councils, concerned about a saturation of liquor stores, have fought to stop the company establishing new Dan Murphy’s outlets. In September, residents and Manningham City Council lost its bid to stop Woolworths turning a Doncaster Safeway supermarket into a Dan Murphy’s. Last year, against the wishes of police and the Darebin Council, a Dan Murphy’s was approved next to a Salvation Army alcohol treatment centre in Preston. (if ever there was a case of big business succeeding over a community need this must surely be it NDPA)
In its submission to the council’s review of the liquor store market — or packaged liquor — the Liquor Stores Association of Victoria said the state’s saturated market would lead to irresponsible discounting “in direct conflict with the principle of harm minimisation”. Most submissions to the inquiry, including some from the liquor industry, said communities should be given more power to object to new liquor store licences, and community or social impact statements should be included in the application process.
The council, however, did not recommend giving more power to communities. It did say the State Government should review home delivery of alcohol with takeaway meals and groceries because it was concerned the practice gave minors easier access to alcohol. The council, which advises the Government on alcohol issues in the community, is made up of community, police and alcohol industry representatives. The State Government, after sitting on the report for seven months, recently adopted two of the council’s recommendations: one that requires outlets to have extra shelf signage about under-age drinkers, and another about applicants advertising their intentions in local newspapers.
A spokeswoman for Consumer Affairs Minister Tony Robinson said the other recommendations would be looked at during a review of all categories of liquor licences, as outlined in the Victorian Alcohol Action Plan. Two recommendations have been referred back to the council. Mr Robinson said the Government was committed to reducing alcohol abuse in the community. He denied that the community had little say in fighting liquor store applications. Input was also sought from local councils and the police.
“Each application is judged on its merits, and the director of Liquor Licensing’s decision may be challenged at the Victorian Civil and Administrative Tribunal,” he said. But Mary Wooldridge, the Opposition’s community services spokeswoman, said the minister was doing nothing to curb the saturation and inappropriate location of liquor stores, despite evidence linking them to a range of social problems, including property damage.
The Government’s alcohol plan only briefly mentioned packaged liquor, she said.
In its battle against booze culture, the State Government has been accused of unfairly focusing on nightclubs. A recent government report into the regulatory impact of increasing licence fees shows that although packaged liquor licences have massively increased over 10 years, the bigger growth has been in “on-premises” licences for bars, clubs, restaurants and cafes. The overall growth in new licences peaked in 2002-03 and has since been in decline.
The report, released last month, shows the number of offences recorded at licensed premises in Victoria has actually decreased from 8166 in 2002-03 to 6835 in 2006-07.
But total police incidents where the offender was alcohol or drug-affected (including those on licensed premises) rose from 11,808 to 14,556 in the same period.
A spokesman for Woolworths declined to comment for this report.

Source: TheAge.com.au Sun 2nd Nov.2008

Harm reduction, which has been the central focus of drug policy in this country since 1992, by its very definition does not focus on getting drug users off drugs. ‘Harm reduction’ is defined by the International Harm Reduction Association as ‘efforts to reduce the health, social and economic costs of mood altering drugs without necessarily reducing drug consumption’.Alarmingly, leaders of the harm reduction movement want Australia to move on to the next step, getting rid of the prohibitions against drug use, prohibitions which the Australian
community support so strongly.

Dr Alex Wodak, Australia’s most prominent proponent of harm reduction both nationally and internationally, responsible for introducing it to Australia in 1985, wants currently prohibited
drugs made legal for personal use. He says,

“In many countries it is time to move from the first phase of harm reduction – focusing on reducing adverse consequences – to a second phase which concentrates on reforming an ineffective and harm-generating system of global drug prohibition.”

Dr Alex Wodak; Paper presented to the 15th InternationalConference on the Reduction of Drug Related Harm

Many leaders of the harm reduction movement in Australia are seeking government support for new harm reduction interventions which show little interest in getting users off drugs,
but rather perpetuate their drug use while spending large amounts of tax-payer funds for programs to keep them safe while their use continues.

Injecting rooms
The Kings Cross injecting room does little to get users off drugs, with less than 4.5% of clients being sent to detox or rehab. Rather it spends $2.5 million per year saving clients from overdoses. The 2003 evaluation showed there was 36 times more overdoses in the
injecting room than on the streets of Kings Cross, despite injecting room clients injecting 97% of the time on the streets of Kings Cross rather than in the room. Proponents are working for multiple injecting rooms in every Australian city. Injecting rooms are very ineffective in reducing drug use.

Heroin On Prescription
It is not legal in Australia for the government to provide heroin to heroin users, with methadone being substituted instead. However many harm reductionists want an expensive program providing heroin on prescription to heroin users. Heroin on prescription focuses most on maintaining a user’s addiction. Other agendas that perpetuate drug use are the decriminalisation or legalisation of cannabis, the legalisation of raw cannabis for medical purposes, and pill testing at RAVEs.

EX-INJECTING ROOM CLIENT TELLS WHY INJECTING
ROOMS HAVE SO MANY OVERDOSES
“They feel a lot more safer, definitely because they know they can be brought back to life straight away. They know that they can, like some people go to the extent of using even more. So in a way they feel it is a comfort zone, and no matter how much they use if they drop they just get brought back. What users look for is in heroin and pills is to get the
most completely out of it as they can, like virtually be asleep but awake for 4 – 5 hours. For instance to get that you have to test your limits. And by testing your limits that is how you end up dropping.”
desire for a society free of illicit drugs
CHRISTOPHER
I became addicted and it took seven years for me to realise that I had to stop .In those seven years . . . I would get windows of opportunity to get out. I would feel like I could go to rehab or detox and everything like that but, when I would get on the phone to get in contact with [a treatment agency],there would not be a place available. The feeling of ‘okay, I’ve had enough, Ican get out’ would disappear. I would go back into it.

Christopher, transcript, 7 April 2007 p 68 – cited in Winnable War on Drugs, House of Representatives Standing
Committee on Family and Human Services. p209

TIM
With early inquiries in September 2006, and desperate to rid himself of drugs, Tim was assessed and approved for suitability to participate in a drug rehabilitation program at the Woolshed Drug Rehabilitation Community, Adelaide. Elated at such an opportunity he diligently marked off the list of preparatory requests made, he telephoned regularly as required on 22, 26 and 29 September, and 3, 6, 10, 13, 17 and 20 October for a period
extending five weeks, hoping and waiting desperately for a placement, for an opportunity to learn how to live without drugs.

Throughout this time, Tim had returned to live with us. He had stated that it was a particularly difficult time as not only did he have to deal with the long-term effects of taking drugs and withdrawal, he had to deal with the loss of autonomy in living in his own place of residence. He felt unable to apply for employment outside of the family business, because of his commitment to securing a placement at the Woolshed. Rehabilitation could take as long as six months, with then ongoing support required. On Sunday, 22 October 2006, in a desperate bid to end his pain and suffering, Tim committed suicide in our family home. I have been informed by the Woolshed that there is only accommodation for 24 participants, with up to as many as 34 waiting for a bed at one time for periods as long as 12 weeks. As of 24 May this year, 30 people were waiting. Tim could wait no longer.

Drug Free Australia Ltd

A Review of Australian public opinion surveys on illicit drugsA strong trend since the 1998 NDSHS (National Drug Strategy Household
Survey) has been a hardening in attitudes towards cannabis, a review from Australia revealed. The review, published by National Drug and Alcohol Research Centre in December 2008, analysed a range of illicit drug opinion surveys conducted in the country.

Cannabis is now more associated with “a drug problem”, is a greater concern to the general community, its use is approved of less than in 1998, and there is also less support for cannabis legalisation and decriminalisation, it is pointed out in the review.

In 2004, 25 per cent of Australians approved use of cannabis compared to 10 per cent in 2007.
The strongest support for legalisation of cannabis was observed around
1998 and since then the support has been declining down to 19 per cent in 2007.

Certainly there has been an increased interest in the link between cannabis and mental health, with new evidence showing the link between cannabis use and disorders such as schizophrenia; It is possible that an increased research and policy focus on cannabis and mental health has affected public opinion on this matter, says Pr Ritter from the Drug Policy Modelling Program at the University of New South Wales, one of the authors of the review.

The change in attitudes to the cannabis legalisation has not resulted in support for increased penalties. The majority of the Australians would like to see increased spending for education and treatment.

Source: ECAD Newsletter, 26. Jan. 2009

The effects of cannabis use on health and social adjustment are profound.
Substance misuse by Indigenous people has long been recognised
as one of the devastating consequences of contact with
Western culture. Misuse of tobacco, alcohol and petrol
among Indigenous Australians has received much attention. Cannabis,
by contrast, has not been viewed as a major problem. But
since the 1990s, it has become apparent that heavy cannabis use is
common in some remote Indigenous communities.1 The associated
health and social burdens are now being recognised.
Indigenous Australians, whether living in urban or rural
settings, are more likely than other Australians to report cannabis
use. Recent reports suggest that cannabis use is also relatively
high among Indigenous populations in New Zealand, Canada
and North America. Limited data are available on patterns of
cannabis use among Indigenous Australians. However, a recent
5-year study of adolescents and young adults in three remote
communities in Arnhem Land in the Northern Territory has
found that not only is cannabis use common in remote Indigenous
settings, but its effects on health and social adjustment are
profound. These three communities are close to one another but very
isolated, being over 550 kilometres from the nearest city. There is
one local Indigenous language, and English is a secondary language.
Tobacco use was found to be the norm in these communities,
with over 90% of adolescents and young adults smoking.
Because of restricted access to alcohol, problem drinking was
uncommon. In contrast, cannabis use was endemic, with over
70% of males and 20% of females being current users. Cannabis
was typically consumed mixed with tobacco and smoked using a
locally fashioned “bucket bong” that gives the user a rapid and
intense dose with little smoke lost. Regular heavy use (_6
“cones” daily) was found in almost 90% of users. This is around
twice the consumption of regular cannabis users elsewhere in
Australia. Furthermore, about 90% of the Indigenous users
reported symptoms of cannabis dependence. This compares with
about 20% of users aged 18 or over in the general Australian
population.3 Of even greater concern was a suggestion that, for
most Indigenous users, cannabis was not a passing adolescent
phase. After 5 years of follow-up, the great majority reported
continuing heavy use.
Cannabis use was linked to substantial health problems and
social burdens in these communities, which are already disadvantaged
by isolation and poverty. Up to 10% of the communities’
total income and between 31% and 62% of a user’s median weekly
income was spent on cannabis. Cannabis users were less likely
than non-users to participate in education or training and more
likely to report auditory hallucinations, suicidal ideation, symptoms
of depression, and having been imprisoned. Community
violence increased when cannabis supplies were scarce. The
effects on traditional life were described by one NT Indigenous
mental health clinician in the following way:
Too many of my people are chained to [cannabis]. They don’t
go out hunting or spend time by the river with their family.
They just sit and smoke [cannabis], then look for money to buy
more [cannabis] and get into fights when they can’t get any
(Muriel Jaragba, personal communication).
What accounts for the unusual patterns of cannabis misuse in
these remote Indigenous communities? There is little evidence that
cannabis is grown locally, but much anecdotal evidence that
market networks supplied by dealers based in urban or regional
centres are extensive and resilient, making cannabis readily available
(A R C, unpublished observation). Alcohol restrictions have
been effective in reducing problem drinking within communities,
but may have had the undesirable consequence of encouraging an
increase in cannabis use where it could be easily obtained. As
with risks for other forms of substance misuse in these communities,
the social context is important. Limited employment and
education opportunities; crowded, poor-quality housing; community-
wide feelings of disempowerment; and grief and loss related
to high mortality, morbidity and incarceration rates are all likely
risk factors for substance misuse. Cannabis misuse is likely to be
both a consequence of this type of social disadvantage and a
perpetuating influence.
Cannabis misuse in remote Indigenous communities has been
overlooked for too long. It is now clear that it is yet another major
problem for these already disadvantaged communities, with evidence
of cannabis misuse across a broad area of northern Australia.
As well as in the NT, concerns about the level of cannabis
use have recently been noted in Cape York and anecdotally in
other parts of remote and regional Australia. Further research is
needed to investigate the impact of cannabis use on urban
Aboriginal and Torres Strait Islander Australians.
Effective responses will not be easy. Controls on supply by
state- or territory-based police are one of the few available
measures. In order to be effective, policymakers and service
providers would need to work collaboratively with local communities
to tie in local prevention and treatment initiatives with
existing supply control initiatives. Such programs would need to
use Indigenous language and cultural frameworks, build capacity
of local Indigenous professionals, and improve understanding of
the harms associated with cannabis misuse. Ultimately, tackling
the misuse of cannabis and other substances in remote settings
will depend on creating opportunities for social development
and for continuing education, training and employment of
adolescents and young adults.

Source: 228 MJA • Volume 190 Number 5 • 2 March 2009

In 2008 organized crime in Australia is estimated conservatively to cost $10 billion according to the Australian Crime Commission.
The estimate includes the loss of legitimate business revenue, loss of taxation revenue, law enforcement expenditure, regulation and social harms where criminal activity compromises the health, safety and wellbeing of individuals and communities.
Illicit drugs account for at least 50 per cent of the costs of organized crime which are conservatively estimated at $5 billion per year.
As the illicit drug profits are repatriated overseas the costs involving money laundering will add to the cost of organized drug crime.
The Australian Crime Commission believes that organized crime gangs are highly efficient, use the latest technology and employ highly paid professionals to protect their activities.
(Source: Organised Crime in Australia, Australian Crime Commission, February 2009).

DRUG exporters are turning to the postal system in a bid to get illicit drugs into Australia.
And border authorities admit they face a challenge to detect the substances amid the estimated 160 million pieces of mail to be sent into the nation this year.
The Courier-Mail has learnt that drug dealers are sending small parcels through the post, fully expecting to lose some to border authorities but expecting they will get enough through to make a profit. Ecstasy traffickers were keeping parcels to between 300 grams and 500 grams and were increasingly sending through MDMA powder because it was more difficult to detect than pills.
Australian Customs national intelligence manager Andrew Rice said MDMA or ecstasy detections in the post were rising, with more than two every week in the past financial year. “The detections in the post are going up in their sheer number, not necessarily in weight,” Mr Rice said. “There is no pretence from us that we do miss things just because of the volumes. Even in that environment of mass input, we do quite well in terms of significant proportion of drugs being sent through the postal system. But we do see criminals moving between different importation methods and the significant shipments are still likely to be attempted by sea cargo.”
Australia is obliged under a United Nations charter to accept mail from across the world. This year, Customs expects 120 million letters and 40 million parcels to be sent from overseas to the checking points in Brisbane, Sydney, Melbourne and Perth.
Mail is screened by Customs or the Australian Quarantine and Inspection Service, through the likes of sniffer dog patrols and X-rays, before being handed to Australia Post for distribution. “We think about every item of mail. Some items are given different treatment based on the different risks that we assess,” Mr Rice said.
The figures for ecstasy busts in the last three years have been distorted by the monster find of 4.4 tonnes or 15 million pills in a shipping container in Melbourne in June 2007. The container, sent from Italy, was stacked with tinned tomatoes but Customs authorities were suspicious when X-rays revealed inconsistencies in the tins’ contents. Customs alerted the Australian Federal Police, which decided to seek more information by following the drugs. They opened each tin and replaced the ecstasy with harmless tablets and then followed the trail. An investigation lasting more than a year, involving 400 AFP agents and 20,000 hours of surveillance, resulted in 20 arrests.
In the last financial year, Customs detected 172kg of MDMA/ecstasy and a further 260kg of amphetamine-type stimulants among mail and cargo. This compares with 611kg of cocaine, 72kg of heroin and 49kg of cannabis.
Customs also made large detections of precursor chemicals to methamphetamines, including 105kg of pseudoephedrine in air cargo 18 months ago.
Mr Rice said the criminal networks that controlled much of the world’s illicit drug trade had “access to specialist knowledge around the import and export fields”. “The game is all about concealment,” he said.
Source: www.couriermail.com.au 31st March 2009

A new Australian study has found that the number of newborns suffering serious drug withdrawal symptoms is now more than 40 times higher than in 1980.

The research, published in the latest edition of the international journal Pediatrics, also found that these infants were at greater risk of neglect and of being taken into care.
The data analysis revealed that of 637195 live births in Western Australia between 1980 and 2005, 906 were diagnosed with Neonatal Withdrawal Syndrome. For every year, there was an average 16.4% increase in children born with the syndrome.
Report co-author, Professor Fiona Stanley from Perth’s Telethon Institute for Child Health Research, said the study identified a range of factors that should assist with the early identification of children at risk.
“It is clear that if we are to reduce the number of these children suffering from abuse and neglect, then there is a need to start working with their mothers before these babies are born, and ideally, pre-conception,” Professor Stanley said.
“Our data show that the majority of the mothers had already had contact with hospitals for mental health and substance use issues which suggests there could have been numerous opportunities to intervene to prevent unplanned pregnancy and provide intensive support with antenatal care and substance abuse treatment.”
“A multidisciplinary team that includes obstetricians, social workers, drug and alcohol workers, and welfare workers is required to case manage and support the women through the complex issues that they face. However it is imperative that this support continues long term.”
Professor Stanley said the increase in babies suffering NWS reflected the overall rise in substance abuse within the community and the increased recognition of NWS by health professionals. While this study was in WA, it is likely that it reflects a national trend.
“We now have the situation where 4 babies out of every 1000 births are born suffering the effects of illicit drugs — that is over 1000 newborns per year in Australia. This has serious implications for the child, the family and the whole community and is an issue that must be tackled well before these children suffer potential harm.”
The study was made possible by a groundbreaking agreement by the Western Australian Government Departments of Health and Child Protection that allowed health and welfare records to be linked and the de-identified information given to researchers for analysis.
The research was supported by an Australian Research Council Linkage Project Grant.

Source: Telethon Institute for Child Health Research (2009, April 24). Alarming Increase In Drug-affected Newborns. ScienceDaily. Retrieved April 27, 2009, from http://www.sciencedaily.com¬ /releases/2009/04/090423100821.htm

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AUSTRALIA is in a mental health crisis. It’s not impending. It’s here. Government figures show one in four people under 25 will suffer a mental illness.
While we’re worrying about lifting the retirement age and caring for our ageing population, it will cost billions to treat people who develop mental illness in their youth. This bill will soar if we don’t act now.

The ready availability of alcohol and its enthusiastic promotion to make it a normal part of society are major contributors to the youth mental health problem.
According to the 2007 National Drug Strategy Household Survey, more than 20 per cent of 14 to 19-year-olds drink alcohol weekly. A third of boys aged 12-17 downed seven-plus drinks at a time and one in three girls put away five or more in a session.
One in 20 students put away 50 standard drinks or more in a month. An Australian study published in international medical journal The Lancet found that alcohol caused 27 per cent of deaths involving 15 to 29-year-olds in 2002.
That’s tragic, but the physiological effects of drinking on young, developing brains are much more insidious. Brain development continues until the age of 20. Damage from alcohol during this time can be long-term and irreversible. Adolescents need only drink half as much as adults to suffer the same memory loss.
Kids who binge once a week, or increase their drinking between the ages of 18 and 24, increase their chances of not attaining the goals of young adulthood like marriage, educational attainment, employment and financial independence.
While alcohol consumption rates among young people have remained stable for 30 years, what’s really disturbing is the rising intensity of drinking in a small proportion of young people, especially girls.
TV networks have profited tremendously from aggressive alcohol industry ads. The Australian Medical Association has called for a ban on cable and free-to-air TV alcohol ads before 10pm but why not go a step further and ban all alcohol marketing?
Alcohol is a legal product, but why allow it to be marketed so aggressively when the Government is spending millions telling Aussie kids not to binge?
Parents set an example, but an Australian Childhood Foundation report in 2004 said 60 per cent of parents felt they could do better. About 75 per cent said being a mother or father did not come to them naturally. That tallies with research this year by Generation Next, the parenting education group that I will represent in a town hall-style seminar at the Melbourne Exhibition Centre on Saturday.
The Generation Next survey of the parents of 500 children found half were worried or concerned by the challenge of raising children and one in five felt overwhelmed.
When we give them a no-nonsense helping hand and take away the alcohol marketing that makes their job harder, they may become confident enough to take the next step of talking to their kids.
Dr Michael Carr-Gregg is a Melbourne adolescent psychologist. More information about the Generation Next seminars at www.gennext seminars.com.
Source: heraldsun.com.au 9th June 2009

ROUGHLY one-third of Australians have tried it. Half of all people aged 20 to 29 have used it and some of those, like Jade, have smoked so much cannabis that their mental health has crumbled, triggering depression, psychosis, panic attacks, paranoia and even suicidal thoughts.
Former cannabis user Jade experienced paranoia and psychosis before she successfully sought treatment. “It was very scary. I thought people could read my mind. I was getting messages from watching TV. I was very paranoid. I felt like there was a big conspiracy and that everyone was in on this agenda and it was all about me. Cameras were on me. It was something I’ll remember forever and I wouldn’t wish it on anyone,” recalls Jade, now 29, off “bongs” and studying for a career in youth work.
Jade — who began smoking when she was only 13 — says the psychosis she experienced from using and eventually abusing cannabis landed her in Melbourne University’s Orygen Youth Health in-patient clinic for eight days. She wishes someone had helped her recognise that she had a serious cannabis use problem before she hit the wall. Unfortunately, if anybody noticed, they did nothing.
Now somebody is doing something, if not for Jade then for other young people at risk of cannabis-induced mental health problems. The Orygen Youth Health Research Centre has teamed up with the National Cannabis Prevention and Information Centre — based at the University of NSW — to produce the first evidence-based guidelines to help people such as Jade’s friends and family identify and assist users who may be sliding down the slope to mental illness. The so-called “first aid” guidelines reflect NCPIC’s job description, says its director Jan Copeland. “There’s a lot of community misinformation about cannabis and only a small proportion of people with problems seek treatment”. And that’s a worry, claims Copeland, a research psychologist specialising in drug and alcohol addiction: “The earlier the intervention the better the outcome.”
Not only can heavy cannabis use lead to the kind of mental illness Jade suffered, it can worsen problems associated with the use of alcohol and other illicit drugs. The resulting emotional cocktail has a host of consequences: impaired judgment, breakdown of families and social connections, legal problems and injuries from car crashes and other accidents. While many of such difficulties can be alleviated by getting off cannabis, others may persist for years, or even life. That’s especially true if people being using very early.
Neuroscientists have learned that different parts of a young brain develop at different rates. Final “wiring” is not complete until the mid-20s, addiction psychiatrist Dan Lubman says. According to Lubman, with Orygen and Melbourne University, that discovery goes a long way to explain why 75 per cent of mental disorders commence before age 25. “It’s a time of huge developmental growth,” he says, noting that stress, drugs and genetic predispositions can make developing brains even more vulnerable.
Most experts agree that developmental mis-wiring involves the brain’s endocannabinoid system. That’s so, as it appears to modulate brain chemicals called neurotransmitters, which relay and regulate signals between brain cells. Lubman says: “Certainly, there’s some evidence from animals that early use of cannabis can cause cognitive problems and problems with social interaction that persist and aren’t seen in adult animals.” There’s also solid evidence that young humans with abnormal brain development often experience a cascade of problems. For instance, cognitive difficulties may lead to poor school performance which may drive poor self-esteem, mixing with other uses, dropping out of school, multi-drug problems and so it goes.
Moreover, Jade’s raging paranoia may have been heightened by the increased potency of cannabis. Unlike the pot smoked by 60s hippies, today’s plants have been selectively bred to increase the amount of the active ingredient of euphoria and mood alteration, tetrahydrocannabinol, or THC. In a gardening twist, the rise in THC has been accompanied by a reduction of another cannabis ingredient, cannabidiol. Lubman says cannabidiol reduces anxiety and has been trialled as an anti-psychotic drug for conditions such as schizophrenia.
Little wonder that Jade found herself going from “giggling on the floor for hours” at 13 to full-blown psychosis at 20. As she escalated her intake of cannabis from light use to “a gram or two per day shared between friends”, her brain and behaviour went haywire. It’s quite possible that people close to Jade noticed that she had a problem. It’s also likely that they didn’t want to get involved, wished to keep the matter quiet or simply believed, incorrectly, it was a matter of morality. “A problem is the notion of hedonism, that users should be punished. They brought it on themselves and they don’t deserve help,” Lubman says. Hence, “Helping Someone with problem Cannabis Use: Mental Health First Aid Guidelines”. As well as simple information about cannabis abuse problems, the guidelines provide practical advice about issues such as approaching a person about their cannabis use, what to do if the person does not want professional help, how to find professional help and where to go for support.
Critically, every bit of information was identified and scrutinised for effectiveness and accuracy by 87 participants, divided into three panels: clinicians, carers of users and former users. Co-ordinated by Lubman’s group, the experts came from Australia, Canada, New Zealand, the US and Britain. Copeland claims this extensive process was necessary as much of the advice online and in books and other literature is inaccurate, useless or in some cases downright dangerous. While many suggestions are very specific — stay calm, don’t criticise the persons’ cannabis use, don’t bully or nag, ask about the person’s use instead of making assumptions, offer to help find professional help and the like — there are key things to keep in mind, claim both Lubman and Copeland. The key one being that many good treatments are available, from counselling to self-help groups.
Lubman ticks off important basics: “Be realistic about the outcomes. It may be the first time a person has been approached or thought about a problem. Be aware of local options. “Be prepared that the person may not want help and decide how you’ll respond, and understand what you will and won’t do to support the person.” Do the guidelines make sense? “Absolutely,” says Jade. In fact, right now she’s doing a placement with Orygen, working as a peer-support person. “When you’ve got somebody who’s been through it it’s good. They know what’s in your head. That’s why I’m here at Orygen. I’m trying to give back and be here for anyone else going through it.”
Source www.ncpic.org.au, www.mhfa.com.au 19 June 2009

EMERGENCY departments in Queensland public hospitals are being strained by hundreds of thousands of drunken and violent patients.
Almost one person a minute is thought to be attending the state’s emergency departments for alcohol-related reasons, but experts fear that could be a conservative estimate. Australasian College for Emergency Medicine chairman David Rosengren said studies showed alcohol was a factor in 25-30 per cent of presentations at emergency departments.
The latest figures produced by Queensland Health showed that 373,000 people presented at its emergency departments in three months.
“Alcohol is such an insidious undercurrent in a lot of other presentations,” Dr Rosengren said. “It can be one of three things – the cause of that presentation, someone intoxicated or on the receiving end of intoxication. The vast majority of what we see in an emergency departments from the violence of alcohol is people who have been in fights punched up.”
Dr Rosengren said the true extent of the problem was unknown because alcohol was not recorded in emergency data. “It’s a very big issue, but we can’t actually record that because there’s no system in place,” he said. So any figure that we’re going to see is going to be a gross underestimate of the actual true incidents of alcohol-related problems. All we can do is correlate from other data sets that exist but we work on specific studies that are published, which indicate 25-30 per cent of all ED presentations have alcohol as a factor in some manner – either the primary or secondary cause.”
Dr Rosengren, a staff specialist at Royal Brisbane Hospital, said Friday and Saturday nights were the busiest times for the hospital. “A hospital such as Royal Brisbane, which is close to the nightclub spots in the Fortitude Valley, just fills up,” he said.
Since October last year, RBH, Gold Coast and Cairns hospitals have been part of a Queensland Health trial targeting people presenting for alcohol and drug problems. Addiction Psychiatry director Mark Daglish said it saw up to 480 people a month and 80 per cent of those cases were because of alcohol.
“We know we’re missing a significant proportion because there are those ones who come in, particularly on a Friday and Saturday night, who have been discharged,” he said. “We reckon it’s usually about a third of all inpatients usually have drug and alcohol problems – so it’s big numbers. The common ones we see in the morning are losers of fights.”
Dr Daglish said three-quarters of people presenting in emergency for alcohol or drugs were males and almost all were under 45. “If you’re talking about alcohol and violence, you’re generally talking about men unless they’re taking it out on women,” he said.
“Alcohol and testosterone is a dangerous mix – it really is. On the Gold Coast, they’re seeing a younger population than we’re seeing, which would be in keeping with their demographic on the Gold Coast.”
Dr Daglish said people needed to be made more aware of the acute impacts of binge drinking, and recommended rolling the intervention program across all Queensland hospitals. “The impetus for the service came from this realisation that a lot of the problems from alcohol and drugs come from the early users who are often not yet dependent or not yet in treatment but are still causing themselves and other people a lot of damage,” he said.
“A lot of them were young and not in treatment, but one place they did go was the emergency department, usually on a Friday and Saturday night, usually intoxicated at the time, and there’s a fair few frequent attendees. If you intervene in their drug and alcohol use early, you can shorten the duration of their admission, which means they’re spending less time in the hospital and they’re in treatment towards their substance abuse as well as the trauma.
“Once they’re dependent, you need a lot more.”
Source www.couriermail.com.au 21st July 2009

The Government is echoing alarmist reports of a cannabis and mental health crisis.

Abstinence or harm-minimisation? A clash of values is emerging, writes Bill Bush.

Police coming down hard to solve a health problem? This is just what the Commonwealth Government is calling for to improve mental health.

Even though the use of cannabis has declined by 37 per cent, the Prime Minister asked heads of Government at Friday’s COAG meeting to toughen their laws on the drug.

The signs are that this is the vanguard of steps to reverse Australia’s harm-minimisation drug policy in favour of one that puts a premium on abstinence and stronger law enforcement.

Other indicators of this shift are:

• Financial support for naltrexone implants that focus on abstinence combined with criticism of methadone maintenance therapy that focuses on stabilisation.

• A $600,000 grant over three years to Drug Free Australia to “advocate abstinence-based approaches to drug issues” while cutting the grant of the peak harm reduction focused Alcohol and Other Drugs Council to just one year.

• The enactment of harsh comprehensive Commonwealth criminal drug law overshadowing that of the states. It includes even minor possession offences under the label of serious drug crimes.

Since the Prime Minister vetoed the heroin trial in 1997, the rhetoric of his Government has been unfriendly to harm minimisation. He has said that he does not believe in it and his Government has played language games with the term.

Only last year the Commonwealth reaffirmed its commitment to “the principle of harm minimisation” in a further extension of the National Drug Strategy. This is defined so broadly that its three poorly integrated components of “supply reduction”, “demand reduction” and “harm reduction” allow governments much room to manoeuvre. Only the last component embodies the essence of harm-minimisation as it was originally conceived: “Strategies to reduce drug-related harm to individuals and communities.”

Nevertheless, the Commonwealth continued to support key aspects of harm-minimisation such as the provision of sterile syringes and methadone maintenance. This now seems to be changing.

For example, the Government is echoing alarmist media reports about a cannabis and mental health crisis.

Health Minister Tony Abbott and parliamentary secretary Chris Pyne have expressed alarm. Employment Minister Kevin Andrews wants to “explore its links with welfare dependence”. The PM has warned that “mental illness and homelessness was the price the nation was paying for ‘lax attitude’ towards cannabis”. “The time,” he says, “has arrived for us – legislators and parents – to get tougher.”