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Slide1
ACT Alcohol, Tobacco and Other Drug Information and Harm Reduction Training Module
September 2012 (Version 1)www.atoda.org.auSlide2
About ATODA We acknowledge the traditional owners and custodians of the land on which we meet, and pay respect to their Elders, families and ancestors. Acknowledgement of Country
Slide3
About ATODA This training module was developed by Annie Bleeker in collaboration with the ACT alcohol, tobacco and other drug sector.
Additional thanks are owed to: Amanda Bode, ATODACarrie Fowlie, ATODAKathryn Sequoia, ATODADeb Smith, Mental Health Services, ACT Government Health DirectorateNicole Wiggins, Canberra Alliance for Harm Minimisation and Advocacy
Denise Ryan, AOD Policy Unit, ACT Government
Sally
Billington
, Alcohol and Drug Services, ACT Government Health Directorate
Jo Smith, ACT Hepatitis Resource Centre
AcknowledgementSlide4
About ATODA Introduction to psychoactive drug use in Australia
Part 1Slide5
About ATODA Illicit drug consumption*
*Over 14 years - 2010 National Drug Strategy Household Survey (NDHS), Australian Institute of Health and Welfare Slide6
About ATODA Percentage of Australians who used drugs ‘last year’ 90% used alcohol 15
% smoked nicotine (daily) 10% used cannabis 3% used ecstasy 2% methamphetamines 2% cocaine
Australians’ drug use
*Over 14 years - 2010 National Drug Strategy Household Survey (NDHS), Australian Institute of Health and Welfare
Slide7
About ATODA Most popular drugs ever used by Australian secondary school students (12-17yrs)
8 in 10 had even used alcohol (1 in 5 use alcohol weekly)1 in 2 had ever smoked a cigarette
1
in 5 have ever used
inhalants
1
in 7 have ever used
cannabis
1
in 14 have ever used
amphetamines
1
in 25 have tried ecstasy
1
in 33 have tried
hallucinogens
1
in 50 have ever tried cocaine
Young people
Cancer Council, (2009)
2008 Australian secondary school students use of tobacco, alcohol and over-the-counter and illicit substances
, Victoria.Slide8
%Changes in drug use
*Category of ‘ever used’ - 2010 National Drug Strategy Household Survey (NDHS), Australian Institute of Health and Welfare Slide9
About ATODA Alcohol use 86% adults report having used alcohol 5% daily drinking (below national average) 20% risky drinking (according to NH&MRC guidelines)
Tobacco use 11% of adults report smoking (below national average 15%) 7% female and 6% of male secondary students Illicit drug use 14% of adults reported using an illicit drug in previous year 10% reported cannabis use 2.9% non medicinal use of pain killersTrends suggest psychoactive substance use is stable – falling
Drug use in the ACT
McDonald, D
. (2012)
The extent and nature of alcohol, tobacco and other drug use, and related harms, in the ACT.Slide10
About ATODA Which drugs kill the most Australians?
Who dies from what drug? And when?Drug related deaths Slide11
About ATODA In 2000, approximately 23,300 Australians died due to alcohol, tobacco and other drugs: Tobacco deaths 19,000 (81%)
Alcohol deaths 3,271 (14%) Illicit drug death 1,023 (5%)Australians’ deaths
Miller and
Draper
(2001)
Drug Use in Australia
2000
. Australian Institute of Health and Welfare:
CanberraSlide12
About ATODA The onset of effects differ according to the route of administration – each presenting different harmsSmoking
InjectingSnortingShelving / shaftingSwallowingTransdermal (skin)
How are drugs used?Slide13
About ATODA Psychoactive drugs primarily fall into 3 classifications:
Stimulants Depressants HallucinogensDrug classificationsSlide14
About ATODA EffectsIncrease the activity of the central nervous system (CNS)Speeds up messages between the brain and the body
Blood pumps faster - increases heart rate and breathing, etcSpeeds up mental processes - making people alert and energeticLarge doses can cause over-stimulation - causing anxiety, panic, seizures, headaches, stomach cramps, aggression and paranoia. Can also be the effects of long term use.TypesCaffeine, nicotine, amphetamine type stimulants, cocaine, Ritalin, dexamphetamine, etc.
Stimulants
Levinthal
,
C.
(2002)
Drugs,
Behavior
and Modern
Society
.
Boston, MA : Pearson/
Allyn
and Bacon
Australian Drug Foundation (2012)
Drugs the Facts. www.druginfo.adf.org.au/drug-facts/drugs-the-facts
Slide15
About ATODA EffectsDepressants do not necessarily make a person feel depressed. They affect the central nervous system, slowing down the messages between the brain and the body. Slows down the activity of the CNS (breathing, heart rate)
Makes people more relaxed - less conscious of their surroundingsEffect concentration and coordination - slow down the person’s ability to respond to unexpected situations. In small doses they can cause a person to feel more relaxed and less inhibited. In larger doses they can cause drowsiness, vomiting, unconsciousness and death.TypesAlcohol, Valium, Rohypnol, Serapax
,
Temazapan
, codeine,
Panadeine
, heroin, opium, morphine, gamma-
hydroxy-butrate
(GHB), petrol, inhalants, etc.
Depressants
Levinthal
,
C.
(2002)
Drugs,
Behavior
and Modern
Society
.
Boston, MA : Pearson/
Allyn
and Bacon
Australian Drug Foundation (2012)
Drugs the Facts. www.druginfo.adf.org.au/drug-facts/drugs-the-facts
Slide16
About ATODA EffectsCan significantly alter and distort our perceptions, moods, thoughts and surroundings They can make people see or hear things differently (or that aren’t really there)
TypesLysergic Acid Diethylamine (LSD), magic mushrooms, mescaline, ketamine, peyote buttons, etc.Note: cannabis and ecstasy can also have hallucinogenic qualities
Hallucinogens
Levinthal
,
C.
(2002)
Drugs,
Behavior
and Modern
Society
.
Boston, MA : Pearson/
Allyn
and Bacon
Australian Drug Foundation (2012)
Drugs the Facts. www.druginfo.adf.org.au/drug-facts/drugs-the-facts
Slide17
About ATODA CannabinoidsAre a unique class of chemicals that bind to specific receptors in the brainTypes include: hash, cannabis
EntactogensAre unique in that they are ‘modified’ stimulants that also have hallucinogenic propertiesTypes include: MDMA, MDA, ecstasy, etc.
Other classifications
Levinthal
,
C.
(2002)
Drugs,
Behavior
and Modern
Society
.
Boston, MA : Pearson/
Allyn
and Bacon
Australian Drug Foundation (2012)
Drugs the Facts. www.druginfo.adf.org.au/drug-facts/drugs-the-facts
Slide18
About ATODA Using two or more drugs at one timeIncreases chances of things going wrong (i.e. overdose)Places a lot of strain on the central nervous system
Most dangerous combinations are two depressant drugs (i.e. combining heroin and/or alcohol/benzodiazepines, alcohol/GHB, etc.)What happens if you combine a stimulant and a depressant drug together? What about two stimulant drugs?Poly drug use
Levinthal
,
C.
(2002)
Drugs,
Behavior
and Modern
Society
.
Boston, MA : Pearson/
Allyn
and BaconSlide19
About ATODA Estimated fraction of drug users who have become drug dependentTobacco – 1 in 3
Heroin – 1 in 4-5Crack – 1 in 5 (??)Cocaine – 1 in 6Alcohol – 1in 7-8Stimulants other than cocaine – 1 in 9
Cannabis – 1 in 10
Anxiolytic, sedative and hypnotic drugs – 1 in 11
Drug dependence
Adapted from Anthony et al., 1994; Chen and Anthony, 2004Slide20
About ATODA Estimated fraction of drug users who have become drug dependentAnalgesic drugs – 1 in 11Psychadelic
drugs – 1 in 20Inhalant drugs – 1 in 20Drug dependence
Levinthal
,
C.
(2002)
Drugs,
Behavior
and Modern
Society
.
Boston, MA : Pearson/
Allyn
and BaconSlide21
About ATODA The rational scale to assess the harm of drugs of misuseMeasures the drugs relative physicalharm and its propensity for
developing dependence.Another perspective
Nutt, D., King, L. A.,
Saulsbury
, W., Blakemore, C. Development of a rational scale to assess the harm of drugs of potential misuse.
The Lancet
369, (9566) 1047-1053Slide22
About ATODA Wha
t is the current policy on drugs in Australia?Drug policy in AustraliaSlide23
About ATODA The broad policy in Australia is described in the National Drug StrategyThe policy is one of ‘harm
minimisation’This means that we use a combination of strategies to prevent and minimise ATOD-related problems by reducing:SupplyDemandHarmThe
aim of the
National Drug Strategy 2010 – 2015
is to
:
“
build safe and healthy communities by
minimising
alcohol, tobacco and other drug-related health, social and economic harms among individuals, families and communities”
Policy
http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/publishing.nsf/Content/nds2015Slide24
About ATODA Arrests: In the 2009-10 year, 459 arrests for drug offences occurred (386 excluding Simple Cannabis Offence Notices: SCONs).
Alexander Maconochie Centre:Three-quarters of AMC inmates (74%) reported that the crimes for which they were imprisoned were drug-related. Some 32% reported injecting illegal drugs while at the AMC and 27% reported that the last time they had injected was in a prison.Road Safety:ACT Policing conducted 98,245 random breath tests for drink-driving in the year to 30 September 2011. In 1,448 cases the driver exceeded the prescribed limit, a rate of 15 per 1,000 tests.
Source: McDonald, D. (2012). The extent and nature of alcohol, tobacco and other drug use, and related harms in the ACT – Fourth edition, v3. Social Research and Evaluation
Drug Related Harms in the ACTSlide25
About ATODA Overdose: The ACT Ambulance Service attended 601 overdose incidents in the first 10 months of 2011, of which 42% were from alcohol, 22% from ‘polypharmacy
’, 10% from heroin and 6% from benzodiazepines.Hospital presentations:Alcohol is a major cause of deaths and hospital presentations. It is estimated that, over the 1992-2001 decade (the most recent data available), alcohol caused the loss of 341 lives in the ACT
Blood Borne Viruses:
In 2010, injecting drug use was the source of infection in 86% of the newly diagnosed cases of HCV infection in Australia for which data on the source were available. In 2010 there were 223 diagnoses of HCV infection in the ACT, higher than the national rate.
Source: McDonald, D. (2012). The extent and nature of alcohol, tobacco and other drug use, and related harms in the ACT – Fourth edition, v3. Social Research and Evaluation
Harms Continued….Slide26
About ATODA Demand reduction strategies prevent the uptake and/or delay the onset of use of ATOD;Supply reduction strategies prevent, stop, disrupt or otherwise reduce the production and supply of illegal drugs; and control, manage and/or regulate the availability of legal drugs.
Harm reduction strategies primarily reduce the adverse health, social and economic consequences of the use of drugs.A Harm Minimisation Approach Slide27
About ATODA Why its importantMany people may not be willing or able to stop their drug use immediately (or even in the short/long term)However, there are ways that they can reduce some of the harms from their drug use
i.e. use a joint rather than a bong, smoke heroin rather than hit it up, don’t combine two depressant drugs, less = more etcAs clinicians/workers in the ATOD field it is important to be informed about drug effects/harms so that you can pass on harm reduction information to your clients.
Harm
minimisation
informationSlide28
About ATODA Break up into small groups of 3-5 peopleName as many routes of administration (i.e. swallowing, smoking, snorting, injecting and shafting/shelving) you can think of for 3 of the following drugsAlcohol, nicotine, cannabis, ecstasy, cocaine, meth(amphetamines) and opiates
Discuss what is the safest and most harmful route of administration and why? Does it differ for each drug type?Can you think of ways to minimise harm with each drug?You have 20 minutes before we discuss in the large group
Small group exerciseSlide29
About ATODA Drugs that are commonly smoked include:Tobacco, cannabis, Kronic, methamphetamine, heroin, crack cocaine, etc.
Fastest route of drug administration (milliseconds faster than injecting)Within 5-10 seconds the drug is absorbed through the lungs and carried to the brainThe reason this route of administration is less risky for overdose (than say injecting heroin x16) is because it’s a titrated dose (some lost through the process of smoking)Biggest harms caused by smoking is lung, throat, mouth damage, cancer, emphysema, dependence, etc.
Harms: smoking (inhaling)
Brugal
, M.T., Barrio, G., De, L.F.,
Regidor
, E.,
Royuela
, L.,
Suelves
, J.M., 2002. Factors associated with non-fatal heroin overdose: assessing the effect of frequency and route of heroin administration.
Addiction
97,
319-327
Cancer Council (2011)
Levinthal
,
C.
(2002)
Drugs,
Behavior
and Modern
Society
.
Boston, MA : Pearson/
Allyn
and BaconSlide30
About ATODA Drugs that are swallowed include:Alcohol, pills, methamephatmine powder,
mephedrone, cannabis (cake, cookies, etc.), Gamma Hyrdoxy-butrate (GHB)Slowest onset of effects (30-90 minutes) as its absorbed through the stomach lining and then the into the bloodstream where it hits receptors in the brainHarms from swallowing include:Slow onset of effects means it can be difficult to guage the dose (i.e. eating cannabis, GHB)
Hence easy with these two drugs to experience an ‘overdose’ which with GHB (which is
metabolised
very quickly) can be fatal especially if mixed with alcohol
Some people with sensitive stomachs find it very unpleasant to swallow drugs because cramps or nausea
Harms: swallowing (ingestion)
Brugal
, M.T., Barrio, G., De, L.F.,
Regidor
, E.,
Royuela
, L.,
Suelves
, J.M., 2002. Factors associated with non-fatal heroin overdose: assessing the effect of frequency and route of heroin administration.
Addiction
97,
319-327
Cancer Council (2011)
Levinthal
,
C.
(2002)
Drugs,
Behavior
and Modern
Society
.
Boston, MA : Pearson/
Allyn
and BaconSlide31
About ATODA Drugs that are commonly snorted include:Cocaine, (meth) amphetamines, ketamine, powders, pills, Tobacco (snuff), Ritalin, etc
(drugs must be water soluble)Drugs are absorbed through the soft tissue in the mucous membrane of the sinus cavityMuch faster onset of effects than oral administration (within minutes) but slower than smoking or injecting)Some drugs have a higher rate of absorption, and are thus more effective in smaller doses, through this routeHarms from snorting include:damage to nasal cavity, collapsed nasal septum, etc.
Harms: snorting (bumping)
Levinthal
,
C.
(2002)
Drugs,
Behavior
and Modern
Society
.
Boston, MA : Pearson/
Allyn
and BaconSlide32
About ATODA Drugs that are commonly shafted include:Pills, powders (cocaine, (meth)amphetamines), heroin, etc.Rich blood supply in this area makes absorption fast (15-20
mins) offering a degree of ‘rush’ without significant risk of blood-to-blood contactOnset of effects is faster than swallowing, but slower than snorting, smoking and injecting.Harms from shafting include:Ulcers, diarrhoea, damage to the mucous membrane in the rectum/vagina, burning or tearing of rectal tissues (high risk activity for BBV)This technique will have a laxative effect if there is repeated use in one session
To reduce harm lube is recommended
Harms: shelving/shafting
http://www.bluebelly.org.au/reducingrisk/articledbc2.html?aid=231Slide33
About ATODA Drugs that are commonly injected include:(meth)amphetamines, heroin, OxyContin (oxycodone),
MSContin (morphine), codeine, benzodiazepines, etc.Injection is favoured by some users as the full effects of the drug are experienced very quickly (5-10 seconds)Shorter more intense high – ‘rush’ (stronger effect than swallowing the drug)Harms from shafting include:
BBV transmission, abscesses, increased chance of overdose (x16 compared with smoking) and dependence, vein and artery damage, social stigma, etc.
To reduce harm – use a clean fit and don’t share any injecting equipment (spoons, swabs,
tournqiuets
, etc.)
Harms: injectingSlide34
About ATODA ‘Taste’ a small amount of the drug firstLess (drugs) = more (fun)Where possible, avoid injecting
If injecting – use your own clean fit and never share injecting equipmentTo reduce chance of overdose avoid mixing drugs, especially two depressant drugsBe aware that amphetamine type stimulants (ATS and energy drinks) mask the sedative effects of alcohol (i.e. likely to drink more)Harm reduction messagesSlide35
About ATODA Give your body/brain a chance to recover – eat well, rest, etc.Give yourself a break if you notice you need to use more of a drug to get the same effect (developing tolerance)
Make sure someone is with you and can assist if things go wrongSeek medical assistance if at all concerned for your own or someone else’s welfare – 000 (the ambulance is not the police)Try to avoid using ATOD when you are pregnant and breastfeedingDon’t drink/drug drive(More) Harm reduction messagesSlide36
About ATODA To reduce the risk of needle stick injuries, needle and syringes should be disposed of in free syringe disposal containers made of yellow plastic. Never put injecting material, or anything that has been in contact with injecting material in garbage or recycling bins - even if it's in container. Needle and syringe disposal facilities are located around Canberra. Information is available at http://www.directionsact.com/nsp_disposal
. If you find a needle or syringe (also called a sharp) in a public place or on your private property, call the SHARPS Hotline on 13 22 81, who will arrange for its collection and disposal.If you find a sharp, do not touch it and, if possible, stand guard, particularly if there are children around. Be prepared to give the Sharps Hotline accurate information on the location of the item. A City Ranger from ACT Government Territory and Municipal Services will come and pick it up as soon as possible.Safe Needle & Syringe DisposalSlide37
About ATODA Alcohol, Tobacco and Cannabis
Part 2Slide38
About ATODA
AlcoholSlide39
About ATODA Estimated to cost the Australian community about $36 billionDirectly responsible for 70 000 assaults and 24 000 domestic violence cases per year
Twice the cost of illicit drug useMajor cause of death and injury for many Australians – especially the young, elderly and Indigenous8.1% of the population drink daily (about 1 in 12 people)‘Binge’ drinking continues to be a problem among young peopleAlcohol - costs
AER (2010)Slide40
About ATODA The effects of alcohol depend on several factorsHow much you drinkHow quickly you drink
Your sex/raceYour weightHow long since you’ve eatenThe condition of your liverYour tolerance for alcoholYour mood at the timeWhether you are using other drugs
Alcohol – effectsSlide41
About ATODA The effects of alcohol depend on several factorsHow much you drinkHow quickly you drink
Your sex/raceYour weightHow long since you’ve eatenThe condition of your liverYour tolerance for alcoholYour mood at the timeWhether you are using other drugs
Alcohol – standard drinksSlide42
About ATODA For healthy men and women, drinking no more than two standard drinks on any day reduces your risk of harm from alcohol-related disease or injury over a lifetimeDrinking
no more than four standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion*Binge drinking = 5 standard drinks in a rowAlcohol – guidelinesNational Health and Medical Research Council Guidelines (2009)Slide43
About ATODA One drink is often not one standard drinkTry and stick within the Australian drinking guidelinesHave some ‘alcohol free’ drinking day
Try and avoid binge drinking – increases relative harmStart with a non-alcoholic drinkDrink slowly (sips not gulps)Try low alcoholic drinks (i.e. light beer)Pace yourself – drink non-alcoholic beverages between alcoholic onesStay busy, don’t just sit and drink
Avoid rounds, ‘shouts’ or drinking games
Avoid salty snacks
Alcohol – harm reduction
www.alcohol.gov.au
Know your Risk - New National Guidelines for Alcohol Consumption Slide44
About ATODA Have an escape planDon’t drink and driveBe aware of ‘beer goggles’ – if you hook up –
practise safe sex!Alcohol – (more) harm reductionwww.alcohol.gov.au Know your Risk - New National Guidelines for Alcohol Consumption Slide45
About ATODA Nicotine (tobacco)Slide46
About ATODA Nicotine is the addictive drug in tobacco smoke that causes smokers to continue to smokeAddicted smokers need enough nicotine over a day to ‘feel normal’ – to satisfy cravings or control their moodAlong with nicotine, smokers also inhale about 4000 other chemicals in cigarette smoke (tar, carbon monoxide, Hydrogen cyanide,
etc)There are over 60 known cancer-causing chemicals in tobacco smokeSmoking harms nearly every organ in the body, causing many diseases and reducing health in generalTobacco - harmsSlide47
About ATODA The health effects relating to cigarette smoking have been well researched and documented:Heart attackStroke
CancerEmphysemaBronchitisAsthmaUlcersPremature ageingImpotence
Premature births and miscarriage
It claims the lives of 15 500 Australians every year
Smoking – health effects
http://www.cancer.org.au/cancer-control-policy/position-statements/smoking-and-tobacco-control
/Slide48
About ATODA Nicotine dependence and withdrawal can develop with all forms of tobaccoCessation procedures well-defined withdrawal syndromeUse nicotine to relieve or avoid withdrawal symptoms on waking or after situation where use restricted
Continued use despite knowledge of medical problems related to smokingNicotine dependenceAmerican Psychiatric Association, (1994) Diagnostic & Statistical Manual of Mental Disorders (DSM-IV), Arlington, VA. Slide49
About ATODA Ask about tobacco useAdvise to stop smoking
Assess willingness to quitAssist with quit planArrange follow upBrief interventions and pharmacotherapy
Clinical Practice Guidelines (2000)
Treating Tobacco Use and Dependence
, U.S. Department of Health and Human Services , Public Health Service. USA
. Slide50
About ATODA Clear, personalised, clinically-linked advice about quitting smoking from a health professional increases abstinence rates“When you stop smoking, your diabetes/cardiac/respiratory symptoms will improve”
“The best thing for your health would be to quit smoking”Assess willingness to quit“Are you interested in quitting?” “Would you be interested in a ‘cut down and then stop’ approach?”Assess level of dependenceFagestrom Test for Nicotine Dependence
Shortened
Fagestrom
Advise and assessSlide51
About ATODA Fagestrom Test for Nicotine DependenceSlide52
About ATODA Traditionally harm reduction was not accepted for tobacco smoking – abstinence focusNot a lot of research on HR in tobacco cessation but we know the more cigarettes you smoke in your lifetime the greater the risk of lung cancer. Therefore if you can reduce the number it makes sense that the risk may reduce – by how much we don’t know.
Use a patch or other nicotine replacement therapy (NRT) i.e. gum, inhaler, lozenges, to cut down without compensating (drawing back harder on the fewer cigarettes a person smokes)NRT is safe for pregnant womenThere are other benefits to working on cutting down – it can build a person’s confidence that they may be able to quit and can motivate them to have a goTobacco – Harm reductionSlide53
About ATODA Smoke outside (including not in the car with small children – its against the law in the ACT)Avoid mixing alcohol and tobacco (increased cancer risk)
When quittingPrepare and have a planBe aware of high risk situations and triggersReduce (avoid) your use of alcohol and caffeineUse the 4 D’sReward yourself
Tobacco – (more) Harm reductionSlide54
About ATODA Drink water – go get a drink before anything elseDo
something else – have a goodie bag handy of other things to doDelay – set a time limit before you decide to smokeDeep breathing – take at least 10 deep breathsThe 4 D’s of quitting
Tobacco, Community Health Education Resource (2009)
https://www.cherspokane.org/uploadedFiles/Health_and_Wellness/Resources/Tobacco%202%20newsletter%2009.pdfSlide55
About ATODA Put patch on before going to bed so that the nicotine level in the blood is high on waking especially if the client normally reaches for a cigarette on wakingMay need to put on another patch in the morning
Heavy smokers shouldSlide56
About ATODA Cannabis (marijuana)Slide57
About ATODA Cannabis is the most popular illicit drug in the worldCannabis is the most commonly used illicit drug in Australia, approximately:1 in 3 have ever used it
1 in 10 have used it in the last year (recent use)1 in 15 in the last month1 in 22 in the last weekMuch higher rates of use among Indigenous AustraliansAverage of initiation 18.5 years
Cannabis use in Australia
2010 National Drug Strategy Household Survey (AIHW, 2011)Slide58
About ATODA Much higher rates of use among Indigenous AustraliansAverage of initiation 18.5 yearsA decrease since 1995, when it was 19.1 years
Approximately 1 in 5 young Australians have ever used it Use peaked in 1998 and had been decreasing until 2010 surveyCannabis use in Australia
2008, Australian Secondary Students Alcohol and Drugs Survey ASSADSlide59
About ATODA National Aboriginal and Torres Strait Islander Health Survey19.1% lifetime use9.1% previous year
2004 survey in a rural community in Arnhem Land amongst 336 13-36 year olds69% of the males, 29% of the females had ever used67% of the males, 22% of the females had used it in the last month2010 National Drug Household SurveyAlmost one in four Indigenous Australians had used cannabis in the last year
Cannabis use – Aboriginal and Torres Strait Islander
National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) 2004/5
Clough AR, et al, (2006)
2010 National Drug Household SurveySlide60
About ATODA HydroponicPrice$20/gram ^
$280/ounce^Stable (80%) ^PurityMedium to high (43% each)Stable (69%)Availability
Very easily (62%)
Stable (86%)
Bush weed
Price
$20/gram ^
$280/ounce^
Stable (80%) ^
Purity
Medium
(53%)
Stable
(59
%)
Availability
Easy to very easy
Stable (74%)
Cannabis - in the ACT
Scott, L. (2012) Key findings from the 2011 ACT EDRS and IDRSSlide61
About ATODA Frequency orderNorthern Territory 16.5%Western Australia 13.4%
South Australia 11.3%Queensland 11.0%ACT 9.5%Victoria 9.4%New South Wales 9.3%
Tasmania 8.6%
Cannabis use -
prevalence
2010 National Drug Strategy Household Survey (AIHW, 2011)Slide62
About ATODA Short-term effects include:Feeling of well-beingLack of co-ordination/concentration
Bloodshot eyesLoss of inhibitionsAnxiety and paranoiaSleepinessIncreased appetite and dryness of the mouth and throatCannabis use – risk and harms
http://ncpic.org.au/workforce/alcohol-and-other-drug-workers/cannabis-information/factsheets
Slide63
About ATODA Research shows that young people who use cannabis in early adolescence are at greater risk of: Experiencing mental health problems
Up to 6x the risk of developing schizophreniaEarlier on-set of psychosis by up to 2.7 yearsDropping out of schoolBecoming dependent on cannabisHaving deviant peer affiliations and displaying antisocial behaviourUsing other drugs
Attempting suicide
Participating in criminal
behaviour
Reduced life opportunities
Cannabis use – adolescent use
http://ncpic.org.au/workforce/alcohol-and-other-drug-workers/cannabis-information/factsheets
Slide64
About ATODA The earlier a person starts using cannabis, and the more heavily they use it, the more likely they will continue to use it and develop problems with itLong term effects include:Increased risk of respiratory disease, including cancer
DependenceDecreased memory and learning abilitiesDecreased motivationCannabis use – risk and harmsSlide65
About ATODA Cannabis is commonly used with alcohol and tobaccoTobacco is often added to combine effects, help cannabis ‘burn better’ and make the cannabis ‘go further’A reduction in cannabis often means a reduction in tobacco (the withdrawal is similar)
Both dependencies may be needed to be treated concurrentlyMany people become dependent on the tobacco!Cannabis and tobaccoSlide66
About ATODA Cannabis smoke contains 3 x more tar and 5 x more carbon monoxide than standard cigarettes (one bong/joint equal to 3-5 cigarettes in lung damage)
Cannabis smokers tend to inhale deeper and hold the smoke up to four times longer in their lungsCannabis has a higher combustion temperature and burns hotter in the throat and mouthRespiratory harmsBleeker,
AM and Malcolm, A. (2001) Mulling it Over, MDECC, Sydney.Slide67
About ATODA Many people use bongs (or bucket bongs) because: its a more economical way to use cannabis
its a bigger ‘hit’ believe its a smoother inhalation Research shows that smoking bongs doesnot reduce exposure to tar, carbon monoxide or deeper inhalationUsing a plastic bong with hose, aluminium foil, etc. means that people also inhale all the by-products and petro chemicals in the plastic
If
you must use a bong, use a glass or ceramic one
Harms of bongs
NCPIC, (2011)
Clearing the Smoke Educators KitSlide68
About ATODA VaporisersSlide69
About ATODA Many believe that cannabis has become much stronger Hydroponically grown cannabis has become the norm in Australia the past 15-20 years
It is ‘estimated’ to be twice as strong as it once was, due to the following factors:genetic (selected seed varieties and cultivation of female plants)variation in cannabinoids and concentration of THC, CBN, etc. environmental (cultivation techniques, prevention of fertilisation
and seed production)
freshness (production sites are close to the consumer and storage degradation of THC is avoided)
Most importantly, we need to remember that users are now
smoking the stronger part of the plant (heads/buds), more often
Cannabis - potency
http://ncpic.org.au/workforce/alcohol-and-other-drug-workers/cannabis-information/factsheets/article/cannabis-potencySlide70
About ATODA Cannabis sativa contains around 500 compoundsapproximately 80 are cannabinoids, some of which provide the psychoactive effect
THC – delta-9 tetrahydrocannabinol has the strongest psychoactive effectThe effect of cannabis may depend not only on THC content but on the presence of other cannabinoids such as:Cannabidinol
(CBD)
not psychoactive but has anti-anxiety properties
Cannabinol
(CBN) mildly psychoactive
Cannabinodial
(CBDL) mildly psychoactive
THC and other
cannabanoids
http://ncpic.org.au/workforce/alcohol-and-other-drug-workers/cannabis-information/factsheets/article/cannabis-potency