A big stick is no way to fight drug use
By Rob Moodie
March 20, 2006
Prevention, education and treatment are the way to tackle cannabis.
What is the real dope on cannabis? Over the past year, the Prime Minister and other federal ministers have been calling for a tougher criminal approach to cannabis. The PM talks of "tolerant and absurdly compromised" attitudes towards marijuana use, sayingmarijuana had "caused a rise in mental illness and was a classic case of chickens coming home to roost".
The South Australian cannabis laws, using civil rather than criminal penalties, were an issue in the weekend's state election, with the Opposition reported as saying it will re-criminalise the growing or possessing of cannabis for personal use.
On the other hand, the Australia Institute's recently released report Drug Law Reform: Beyond Prohibition calls for a shift from law enforcement to treatment and prevention strategies, claiming that far too much of the funds for illicit drugs such as cannabis are spent ineffectively on law enforcement at the expense of treatment and prevention.
Are we right to be concerned about the harms of cannabis in our community? Absolutely. And one thing we can be sure of is the polarised views about cannabis in our community. Myths seem to abound at both ends of the spectrum. These range from the notion that any use will result in certain mental illness, to others who say there is no harm whatsoever associated with any level of use.
Well, who is correct?
The truth, not surprisingly lies between the two. Approximately 10 per cent of those who try cannabis will become dependent on it at some point in their lives, while nine in 10 don't.
The earlier you start, the more frequently you smoke it and the more of the active ingredient (THC) you take in, then the greater the harms. Daily users, for example, have a one in two chance of becoming dependent and showing a diverse range of physical, psychological symptoms such as anxiety, depression, and irritability, poor appetite and disrupted sleeping.
One in five teenagers have smoked cannabis in the past 12 months, with boys out-smoking girls. The good news is that recent use of cannabis among 14 to 19-year-old Australians has almost halved from 1998 to 2004, and has dropped from 44 per cent among 20 to 29-year-olds in 1998 to 32 per cent in 2004.
Regular cannabis use appears to increase the likelihood of psychotic symptoms occurring if the user also has a personal or family history of mental illness. Susceptible individuals who avoid cannabis have a 25 per cent chance of developing psychosis, whereas susceptible individuals who smoke cannabis have a 50 per cent risk.
But are the Prime Minister and others right when they say that cannabis has been the cause of rises in mental illness in Australia? While there was a marked increase in cannabis use among the Australian population from the 1970s to the end of the 1990s, there has been no change in the incidence of schizophrenia among the population during that time. Has it caused major increases in depression and anxiety? We simply don't know at this stage.
Is the Prime Minister also right to say that "re-criminalising" cannabis will result in decreased use?
The evidence, most recently reviewed by Associate Professor Simon Lenton, deputy director of the National Drug Research Institute in 2005, says no. Studies of 11 US states that decriminalised cannabis in the 1970s showed no increase in use nor more favourable attitudes towards cannabis. South Australia introduced the use of civil penalties, but the National Drug Strategy Household Surveys from 1985 to 1995 have shown that this approach has not resulted in increases in weekly use rates among young people any greater than in states that have not changed their laws.
So what approaches should we take to reduce harm? Last year in the Victorian Premier's Drug Prevention Council, we undertook research among 13 to 29-year-olds, both users and non-users. It showed that we should use graphic imagery and realistic situations to illustrate the physical side effects of long-term and heavy marijuana use. These include depression and anxiety, as well as the social downsides such as loss of friends and the effects on family.
And the research recommended against using the "just say no to cannabis" approaches, which stereotyped users with moralistic overtones. The research advised against saying using marijuana isn't fun or doesn't have upsides (because it can be and it does have upsides for many users), and said the messages shouldn't be delivered by medical professionals or government officials.
Our challenge is to ensure that the harm from drugs such as cannabis, just as with tobacco and alcohol, is reduced to the minimum possible. To do that we need broad prevention approaches focusing on the harms and links to mental illness.
These campaigns have to be credible, clever, and appealing. And they have to be repeated year in year out to have any effect. A "just say no" scare campaign every five years isn't good enough.
These broad approaches have to be complemented by targeted interventions that focus on vulnerable kids who are likely to drop out from school. We also need to ensure that people with a family or personal history of cannabis avoid use.
To be truly "tough on drugs" that is, to be effective in reducing harm, a lot more must be spent on prevention and treatment not just on law enforcement.
Dr Rob Moodie is chief executive of VicHealth and the chairman of the Premier's Drug Prevention Council.
