To the Editor: Cannabis use is implicated in serious social disruption in many Northern Territory Aboriginal communities.1 Rising levels of cannabis use were first reported in Aboriginal communities in Arnhem Land in 2002, along with associated concerns about escalating social impacts and mental health effects compounded by other substance use.2
A random sample of 164 people in Arnhem Land initially interviewed and assessed in 2004 were followed up between October 2005 and June 2006. Their cannabis use was measured using health worker assessments and self-reports from interviews. Ethical approval was granted by the NT Health Department, Menzies School of Health Research, and James Cook University.
Despite a modest decline in cannabis use in this population between 2002 and 2004,3 the 2005–2006 data indicate persisting high rates, with 61% of males and 58% of females (aged 13–34 years) using cannabis at least weekly.
In a subsample of 60 cannabis users opportunistically recruited for in-depth interviews in 2005–2006 (37 male and 23 female, aged 13–42 years), 92% of males and 78% of females used cannabis daily; 88% reported cannabis dependence symptoms.
These figures appear to be far higher than national rates, although national data for similar age groups are not available.4,5 Research has found that, nationally, 6% of males and 3% of females (aged ≥ 14 years) reported using cannabis in the past week; 18% of males and 13% of females smoked cannabis daily;4 and 21% of adults (aged ≥ 18 years) using cannabis were dependent.5
Beyond high rates of cannabis use in Arnhem Land communities, we also found local characteristics and perceptions that illustrate the drug’s distinctive context of use (Box). Quantities of cannabis used appear to be higher than in the general population; unemployment among users is higher; and violence related to diminished supply is common. One Indigenous community leader described attitudes to cannabis use: “... if there’s a bowl of it on the table, it is smoked until gone, morning to night”. Interestingly, some respondents reported that using cannabis prevents them from engaging in criminal activity (Box). While key community members may believe that cannabis is a tool for social control — “good for calming down people” — they are increasingly recognising the significant social and mental health problems it causes:
People get chained by [cannabis], they don’t go hunting with family ... lots of fights when they can’t get any ... [Cannabis] becomes the boss.
Continued concerns about adverse mental health consequences for Aboriginal people in Arnhem Land who use cannabis seem to be warranted. Cannabis appears to be firmly entwined in these isolated communities in a manner not seen nationally. High levels of concurrent drug use, particularly tobacco, raise additional health concerns. Resources are urgently needed for prevention programs and targeted interventions for chronic cannabis users and those with psychiatric comorbidity. If these patterns of use continue, the implications for compounding of pre-existing mental illness and the potential mental health burden are disturbing.
Characteristics and perceptions of cannabis use in Arnhem Land Aboriginal communities (57 males and 49 females, aged 13–42 years*) in 2005–2006 compared with available national data from 1997† and 2004‡
Alcohol (86.2%); stimulants§ (8.2%–27.9%); none (10.8%); analgesics (6.6%); antidepressants (5.7%); tranquillisers/sleeping pills (4.4%); other (3.9%)‡ |
Tobacco (100%); alcohol, restricted access (40%); kava (15%); petrol (5%)¶ |
Socialisation (tempted, lonely, copying friends); mood altering (“calms me down”, “gets me going in the morning”, “makes my mind straight”); drug substitution (from alcohol or petrol); prevents criminal activity (stealing or other trouble) |
|||||||||||||
Alcohol (60.4%); no substitution (34.2%); ecstasy/designer drugs (1.3%); painkillers/ analgesics (0.8%); tranquillisers/sleeping pills (0.5%); heroin (0.3%); antidepressants (0.2%); cocaine/crack (0.1%); other (1.1%)‡ |
No substitution (83%); kava (7%); alcohol (5%); petrol (5%)¶ |
Limited supply; starting a family (females); “sick of fighting when cannabis runs out”; “made me sick”; “mind not straight”; expenses and time spent looking for cannabis; employment (males) |
|||||||||||||
* Self-report interview data from an opportunistically recruited sample (using age and sex quotas) of respondents, including people who had never used cannabis as well as current and former cannabis users. † People aged ≥ 18 years.5 ‡ People aged ≥ 14 years.4 § Including ecstasy. ¶ There have been no reliable reports of stimulant, benzodiazepine or barbiturate use in these communities. nd = data not available. | |||||||||||||||
- K S Kylie Lee1,2
- Alan R Clough1,3
- Katherine M Conigrave4,2
- 1 School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, QLD.
- 2 Faculty of Medicine, University of Sydney, Sydney, NSW.
- 3 School of Indigenous Australian Studies, James Cook University, Cairns, QLD.
- 4 Drug Health Services, Royal Prince Alfred Hospital, Sydney, NSW.
- 1. Wild R, Anderson P. Ampe akelyernemane meke mekarle: “little children are sacred”. Report of the Northern Territory Board of Inquiry into the Protection of Aboriginal Children from Sexual Abuse. Darwin: NT Government, 2007. http://www.nt.gov.au/dcm/inquirysaac/pdf/bipacsa_final_report.pdf (accessed Jun 2007).
- 2. Clough AR, Cairney S, Maruff P, Parker R. Rising cannabis use in Indigenous communities [letter]. Med J Aust 2002; 177: 395-396. <MJA full text>
- 3. Clough AR, Lee KSK, Cairney S, et al. Changes in cannabis use and its consequences over 3 years in a remote indigenous population in northern Australia. Addiction 2006; 101: 696-705.
- 4. Australian Institute of Health and Welfare. 2004 National Drug Strategy Household Survey: detailed findings. Drug Statistics Series No. 16. Canberra: AIHW, 2005. (AIHW Cat. No. PHE 66.) http://www.aihw.gov.au/publications/index.cfm/title/10190 (accessed Jun 2007).
- 5. Swift W, Hall W, Teesson M. Cannabis use and dependence among Australian adults: results from the National Survey of Mental Health and Wellbeing. Addiction 2001; 96: 737-748.