National Drug Strategy Research Articles

Age-related trends in cannabis use in Australia. Findings from a series of large nationally representative surveys

AimWe examine age-related trends in past-year cannabis use in a series of nationally representative surveys in Australia. MethodsWe analysed data from the largest nationally representative survey in Australia collected between 2001 and 2019 (National Drug Strategy Household Survey [NDSHS]; N = 157,151). Prevalence of past-year daily/occasional (non-daily)/non-use of cannabis use were estimated using weighted multinomial logistic regression and predicted marginal probabilities. Difference-in-difference analysis was used to examine if trends of cannabis use across age groups were different. ResultsThe youngest age group (14–17 s) witnessed the largest increase in past-year abstinence rate from 79% to 92% from 2001 to 2019 (p < .003); the increase in abstinent rate among the 18–24 and 25–39 were relatively moderate (from 68 to 76% and from 81% to 84% respectively; p < .003). The abstinent rate among the 40–54 s and 55–74 s decreased significantly from 93% to 90% and from 99% to 95% respectively (p < .003). There were similar diverging trends in occasional and daily cannabis use, with decreases in both patterns of use observed among the younger age group (14–17 s and 18–25 s) but increases among the older age group (40–54 s and 55–74 s). ConclusionThere is a diverging trend in cannabis use among younger and older age groups in Australia between 2001 and 2019. Cannabis use substantially decreased among the youngest age group (14–17 s) but modestly increased among older people (55–74 s).

Pathways to drug prevalence estimation: synthesizing three comments on triangulation.

Pathways to drug prevalence estimation: synthesizing three comments on triangulation.

Patterns and Prevalence of Daily Tobacco Smoking in Australia by Industry and Occupation: 2007-2016.

Australian workers' daily tobacco smoking over time was examined by industry and occupation, to identify factors associated with high and/or low prevalence. Secondary analyses of 2007, 2010, 2013, and 2016 National Drug Strategy Household Surveys were undertaken (pooled n = 49 395). Frequency analyses informed subsequent modeling of select industries and occupations. Four logistic regression models estimated adjusted effects of demographics on daily smoking in industries with high (≥20%) and low (≤15%) daily smoking prevalence and occupations with high (≥20%) and low-moderate (<20%) daily smoking prevalence. The sample comprised 55.7% men, 34.1% 25-39-year-olds, 31.4% New South Wales residents, 70.1% metropolitan residents, 66.9% high socioeconomic status workers, and 70.6% with low psychological distress. Daily smoking prevalence differed by industry and occupation in 2007, generally decreasing between 2007 and 2016. In high prevalence industries, daily smoking was associated with male gender and age (25-39-year-olds) and in low prevalence industries with males and nonmetropolitan workers. In high prevalence occupations, daily smoking was associated with males, female nonmetropolitan workers, and age 25-39 years and in low-moderate prevalence occupations with nonmetropolitan workers and negatively associated with females aged 14-24 years. In all models, increased odds of daily smoking were associated with low socioeconomic status and very high psychological distress. Low socioeconomic status and very high psychological distress were risk factors for daily smoking regardless of industry, occupation, or high preexisting smoking prevalence. Targeted, as well as universal, interventions are required for workplaces and workers with greatest smoking vulnerability and least smoking cessation progress. Specific strategies are warranted for identified industries, occupations, and subgroups with increased odds of daily tobacco smoking. Industries and occupations with low-moderate smoking prevalence may confer workers some protection but are not without risk; some subgroups in these settings (eg, nonmetropolitan areas) had elevated daily smoking risk. Hence, the following are supported: (1) universal interventions directed at low socioeconomic workers and workers with very high psychological distress regardless of workplace; (2) interventions targeted at high prevalence industries; (3) cessation efforts targeted for young workers in high prevalence industries and occupations; and (4) focused interventions addressing specific needs of nonmetropolitan at-risk workers in low prevalence industries.

Changing patterns and prevalence of daily tobacco smoking among Australian workers: 2007–2016

ObjectiveTo map patterns and prevalence of daily smoking among employed Australians over time. MethodsData from four waves of the triennial National Drug Strategy Household Survey (2007, 2010, 2013 and 2016) were used to assess daily smoking. Frequency analyses and significance testing examined smoking prevalence by sex, age, state, remoteness, Indigeneity, socioeconomic status (SES) and psychological distress. Logistic regression models estimated adjusted effects of demographics on smoking prevalence. ResultsWorkers’ daily smoking prevalence reduced by 32% between 2007 and 2016. The adjusted model showed the lowest smoking reductions among men and non‐metropolitan workers. Other interaction effects showed the highest daily smoking rates for: male workers aged 14–39 years; low SES non‐metropolitan workers; and low SES workers aged 40–59 years. ConclusionsSpecific workplace policies, prevention and intervention strategies are warranted for male workers, especially those aged 14–39; non‐metropolitan workers, especially low SES rural workers; and low SES workers especially 40–59‐year‐olds. Implications for public healthIn spite of significant smoking reductions among workers over time, reductions were unevenly distributed. Tailored, innovative workplace prevention and intervention strategies that apply principles of proportionate universalism and address individual, workplace settings and cultural factors are warranted to reduce smoking disparities among male, rural and low SES workers.

Personal Correlates of Support for Medical and Recreational Cannabis Legalization in Australia.

Introduction and Aims: Increasingly more Australians are in favor of legalizing medical and recreational cannabis use. This paper explored the personal characteristics of those who supported each of these policies in Australia.Design: Cross-sectional national survey.Methods: This study included 21,729 participants aged 18 years and above who responded to the 2016 National Drug Strategy Household Survey. Participants were provided the assurance of confidentiality for their participations. Logistic regression models were used to examine the relationships between personal characteristics and support for the legalization of medical and recreational cannabis.Results: Overall, 77 and 40% of participants supported the legalization of medical and recreational cannabis respectively. People of older age were more likely to support medical cannabis legalization while those who supported legalization of recreational cannabis use were more likely to be younger. Medical cannabis supporters were more likely to report chronic pain (OR = 1.44, 95% CI: 1.04, 2.00) while recreational cannabis supporters were more likely to suffer high level of psychological distress (OR = 1.28, 95% CI: 1.14, 1.43). Experience with cannabis use was strongly associated with supportive attitudes, with recent cannabis users almost 14 times (OR = 14.13, 95% CI: 5.37, 37.20) and 34 times (OR = 33.74, 95% CI: 24.22, 47.01) more likely to support the legalization of medical and recreational cannabis use, respectively.Discussion and Conclusions: The majority of Australians approve the legalization of cannabis for medicinal purposes but most remain cautious about legalizing recreational cannabis use. The sociodemographic and clinical profile of supporters of medical and recreational legalization suggests a potential interaction of self-interests and beliefs about the harms of cannabis use.

Population patterns in Alcohol Use Disorders Identification Test (AUDIT) scores in the Australian population; 2007–2016

ObjectivesDespite widespread use of the Alcohol Use Disorders Identification Test (AUDIT), there are no published contemporary population‐level scores for Australia. We examined population‐level AUDIT scores and hazardous drinking for Australia over the period 2007–2016. MethodsTotal population, age‐ and gender‐specific AUDIT scores, and the percentage of the population with an AUDIT score of 8 or more (indicating hazardous drinking), were derived from four waves of the nationally representative National Drug Strategy Household Survey, weighted to approximate the Australian population. ResultsIn 2016, the mean AUDIT score was 4.58, and 22.22% of the population scored ≥8. Both measures remained stable from 2007 to 2010 but declined in 2013 and 2016. Scores were highest in those aged 18–24 years, the lowest in those aged 14–17 or 60+. A downward trend in AUDIT scores was seen in younger age groups, while the 40–59 and 60+ groups increased or did not change. ConclusionsDespite an overall decline in AUDIT scores, nearly one‐quarter of Australians reported hazardous drinking. Implications for public healthThe marked declines in hazardous drinking among young people are positive, but trends observed among those aged 40–59 and 60+ years suggests targeted interventions for older Australians are needed.

Broad Spectrum epidemiological contribution of cannabis and other substances to the teratological profile of northern New South Wales: geospatial and causal inference analysis

BackgroundWhilst cannabis commercialization is occurring rapidly guided by highly individualistic public narratives, evidence that all congenital anomalies (CA) increase alongside cannabis use in Canada, a link with 21 CA’s in Hawaii, and rising CA’s in Colorado indicate that transgenerational effects can be significant and impact public health. It was therefore important to study Northern New South Wales (NNSW) where cannabis use is high.MethodsDesign: Cohort. 2008–2015. Setting: NNSW and Queensland (QLD), Australia. Participants. Whole populations. Exposures. Tobacco, alcohol, cannabis. Source: National Drug Strategy Household Surveys 2010, 2013. Main Outcomes. CA Rates. NNSW-QLD comparisons. Geospatial and causal regression.ResultsCardiovascular, respiratory and gastrointestinal anomalies rose with falling tobacco and alcohol but rising cannabis use rates across Queensland. Maternal age NNSW-QLD was not different (2008–2015: 4265/22084 v. 96,473/490514 > 35 years/total, Chi.Sq. = 1.687, P = 0.194). A higher rate of NNSW cannabis-related than cannabis-unrelated defects occurred (prevalence ratio (PR) = 2.13, 95%C.I. 1.80–2.52, P = 3.24 × 10− 19). CA’s rose more potently with rising cannabis than with rising tobacco or alcohol use. Exomphalos and gastroschisis had the highest NNSW:QLD PR (6.29(2.94–13.48) and 5.85(3.54–9.67)) and attributable fraction in the exposed (84.11%(65.95–92.58%) and 82.91%(71.75–89.66%), P = 2.83 × 10− 8 and P = 5.62 × 10− 15). In multivariable geospatial models cannabis was significantly linked with cardiovascular (atrial septal defect, ventricular septal defect, tetralogy of Fallot, patent ductus arteriosus), genetic (chromosomal defects, Downs syndrome), gastrointestinal (small intestinal atresia), body wall (gastroschisis, diaphragmatic hernia) and other (hypospadias) (AVTPCDSGDH) CA’s. In linear modelling cannabis use was significantly linked with anal stenosis, congenital hydrocephalus and Turner syndrome (ACT) and was significantly linked in borderline significant models (model P < 0.1) with microtia, microphthalmia, and transposition of the great vessels. At robust and mixed effects inverse probability weighted multivariable regression cannabis was related to 18 defects. 16/17 E-Values in spatial models were > 1.25 ranging up to 5.2 × 1013 making uncontrolled confounding unlikely.ConclusionsThese results suggest that population level CA’s react more strongly to small rises in cannabis use than tobacco or alcohol; cardiovascular, chromosomal, body wall and gastrointestinal CA’s rise significantly with small increases in cannabis use; that cannabis is a bivariate correlate of AVTPCDSGDH and ACT anomalies, is robust to adjustment for other substances; and is causal.

Understanding the crisis in harm reduction funding in Central and Eastern Europe

BackgroundThe harm reduction (HR) approach to injecting drug use was rapidly adopted in Central Europe following the fall of the Iron Curtain. The associated social and economic transformation had significant consequences for drug policies in the region. A large number of emerging services have been dependent on funding from a wide range of national and/or local funding programmes, which continue to be unstable, and closely associated with political decisions and insufficient institution building.A sharp distinction is made between health and social services, often without regard to client input. The main objective of the paper is to identify the causes of the funding problems currently faced by HR services in the context of their history of institution building which represents a major threat to the future of HR services in the region.MethodsQualitative content analysis of documents was conducted in the development of two case studies of the Czech and Slovak Republics. The body of documentation under study comprised policy documents, including National Drug Strategies, Action Plans, ministerial documents, and official budgets and financial schedules, as well as documents from the grey literature and expert opinions.ResultsThe insufficient investments in finalising the process of the institution building of HR services have resulted in a direct threat to their sustainability. An unbalanced inclination to the institutionalisation of HR within the domain of social services has led to a misperception of their integrity, as well as to their funding and long-term sustainability being endangered. In addition, this tendency has had a negative impact on the process of the institutionalisation of HR within the system of healthcare.ConclusionThe case study revealed a lack of systemic grounding of HR services as interdisciplinary health-social services. The aftermath of the financial crisis in 2008 fully revealed the limitations of the funding system established ad hoc in the 1990s, which remains present until today, together with all its weak points. The entire situation is responsible for the dangerous erosion of the interpretation of the concept of harm reduction, which is supported by various stereotypes and false, or ideological, interpretations of the concept.

Trends in cannabis use and attitudes toward legalization and use among Australians from 2001-2016: an age-period-cohort analysis.

Changes in cannabis legalization and availability in Australia necessitate monitoring use and attitudes. We estimated age-period-cohort effects of past-year cannabis use and attitudes toward criminalization and legalization. Analysis of six waves of the Australian National Drug Strategy Household Survey (NDSHS) every 3years (2001-2016). The study was nationally representative of Australian households using multistage random sampling, totaling 145 168 respondents 18-79years old. Data were collected using telephone, face-to-face, and drop-and-collect. Sample sizes per analysis varied based on data availability (~107 000-127 000 per model). Six waves of data for past-year cannabis use (by sex and education), attitudes toward criminalization and legalization. Past-year cannabis use decreased in young adults ages 18-35 from 2001-2016 (25.1%-18.6%) and increased in middle adults ages 36-55 (8.6%-10.1%) and older adults ages 56-79 (0.6%-3.0%). We observed a positive period effect and negative cohort effect for recent cohorts for past-year use (e.g. 1955 cohort had 1.41 (95% CI: [1.11, 1.70]) increased log odds vs. 1998 cohort had -2.86 (95% CI: [-3.17, -2.55]) increased log odds) compared with the mean across years. Results were consistent by sex and varied by education. We observed a negative period effect for criminalization favorability (0.14 (95% CI: [0.003, 0.28]) increased log odds in 2001 vs. -0.31 (95% CI: [-0.45, -0.17]) increased log odds in 2016) and positive cohort effect for recent cohorts. Last, we observed a positive period effect for legalization support (-0.03 (95% CI: [-0.20, 0.14]) increased log odds in 2001 vs. 0.38 (95% CI: [0.22, 0.55]) increased log odds in 2016) and negative cohort effect for recent cohorts. Cannabis use appears to be increasing in Australia among adults over 35, while decreasing among adolescents and young adults. Legalization support also appears to have been increasing since 2007, signaling discordance between use and attitudes among adolescents and young adults, and potentially predicting increases in use over time.

Gains in life expectancy in the Australian population due to reductions in smoking: comparisons between interventions targeting the population versus interventions in a specific high risk group

BackgroundFour decades of population-based tobacco control strategies have contributed to substantial reduction in smoking prevalence in Australia. However, smoking prevalence is still double in socially disadvantaged groups compared to those that are not. But not all tobacco control strategies successfully used in the general population is effective in specific high-risk population groups. Hence, an effective way to reduce smoking in high risk population groups may include targeting them specifically to identify and support smokers to quit. In this backdrop, we examined whether tobacco control interventions at the population-level are more effective in increasing life expectancy among Australians compared to interventions targeting a high risk group or a combination of the two when smoking prevalence is reduced to 10 and 0% respectively.MethodsUsing the risk percentiles approach, analyses were performed separately for men and women using data from various sources such as the 2014–15 National Health Survey linked to death registry, simulated data for high risk groups, and the Australian population and deaths data from the census. Indigenous status was simulated by preferentially assigning those who are indigenous to lower SES quintiles. The age-sex distribution of mental disorder status was simulated using its distribution from 2016 National Drug Strategy Household Survey with 25.9% of mentally ill being assigned to current smoking category and the rest to non-smoking category. The age-sex distribution of prisoners was simulated based on 2014 ABS Prisoners Australia survey with 74% of prisoners being assigned to current smoker category and the rest to non-smoker category. Homelessness status was simulated according to age, sex and indigenous status for 2011 census with all homeless being allocated to the lowest SES category. The age-sex distribution of total cholesterol level was simulated based on 2011–13 Australian Health Survey.ResultsThe results showed that the combined approach for reducing smoking is most effective for improving life expectancy of Australians particularly for the socially disadvantaged and mentally ill groups both of which have high fraction of smokers in the population. For those who were mentally ill the gain in ALE due to reduction of smoking to 10% was 0.53 years for males and 0.36 years for females which were around 51 and 42% respectively of the maximal gains in ALE that could be achieved through complete cessation.ConclusionsTargeting high-risk population groups having substantial fraction of smokers in the population can strongly complement the existing population-based smoking reduction strategies. As population and high risk approaches are both important, the national prevention policies should make judicious use of both to maximize health gain.

Subgroups of adults who drink alcohol at low-risk levels: Diverse drinking patterns and demography.

A significant minority of Australians drink within the 2009 national guidelines. Despite encouragement of low-risk drinking as opposed to consumption patterns associated with greater harm, little is known about the drinking patterns of this group. This paper identifies subgroups of low-risk drinkers and their distinguishable characteristics. Data were sourced from the 2016 National Drug Strategy Household Survey, specifically 8492 adults (18+) who consumed 1-730 Australian standard drinks (ASD; 10 g ethanol) in the past year, and never 5+ ASD on a single occasion. Cluster analysis enabled identification of subgroups from drinking variables. Drinking patterns, socio-demographic characteristics, drinking context and alcohol-related perceptions of subgroups were examined. Three subgroups were identified. Special occasion drinkers (64.6%) drank low to moderate amounts very infrequently. Regular moderates (19.6%) and Regular sippers (15.8%) drank 5-6 days a week on average, with the average number of ASD per day 1.2 and 0.5, respectively. Special occasion drinkers tended to be younger than members of more regular drinking subgroups. Perceptions of regular alcohol use also differed between Special occasion drinkers and members of the other subgroups. Alcohol consumption patterns among low-risk drinkers are not homogeneous. Younger drinkers who consume at low-risk levels are more likely to report infrequent consumption than moderate regular consumption. A better understanding of low-risk drinkers may help increase the prominence and acceptability of this type of drinking, challenge the normativity of heavier drinking norms and help target campaigns as new information emerges on health risks associated with low-level drinking.

How many more young Australians say that they would use cannabis if it were legal?

The potential for increased cannabis use by young people after legalisation remains a key concern of opponents of legalisation. This study used survey data to estimate how many young Australians may be prepared to use cannabis if it became legally available. The study included 3052 youths (adolescents aged 12-17 and young adults aged 18-25 years) in Australia who participated in the 2016 National Drug Strategy Household Survey. Incident cases were estimated by multiplying the prevalence and estimated population sizes from the Australian Bureau of Statistics. It was estimated that 17% of adolescents would try (13%) or use (4%), and 32% of young adults would try (15%) or use (17%) cannabis if it were legal. Among those who reported an intention to try it, 85% of adolescents and 59% of young adults had never used cannabis. These translate to 199 000 and 238 000 potential initiators, respectively. Among those with an intention to use cannabis, 21% of adolescents and 3% of young adults had never used cannabis. These translate to 14 000 adolescents and 12 000 young adults who intended to use cannabis if it were legal. A substantial minority of young Australians say that they would use cannabis for the first time if it were legalised. A proportion of young people who have used cannabis also expressed an interest in increasing their use. Both would warrant special attention if cannabis were legalised.

Is the Australian smoking population hardening?

BackgroundThe hardening hypothesis proposes that as smoking rates decline, the remaining smokers will become hardcore and resistant to quitting. This group of highly resistant quitters will potentially require more individualistic approaches to cessation and harm reduction. The harm reduction approach (specifically e-cigarettes) has been proposed as an option to address hardened Australian smokers. We tested the hardening hypothesis by analysing the rates of hardcore smoking in the Australian smoking population between 2010 and 2016. MethodsData were drawn from three waves of the National Drug Strategy Household Survey (NDSHS) in 2010, 2013 and 2016. Two different definitions were used to assess hardcore smoking to arrive at an upper and lower rate. Logistic regression models assessed hardcore smoker characteristics for both definitions of hardcore smoking. ResultsThe most inclusive definition of hardcore smoking (i.e., a smoker with no plan to quit) showed a significant decline in hardcore smoking between 2010 and 2016 (5.49%–4.85%) In contrast, the prevalence of hardcore smoking using the most stringent definition (i.e., a current daily smoker of at least 15 cigarettes per day, aged 26 years or over, with no intention to quit, a lifetime consumption of at least 100 cigarettes, and no quit attempt in the past 12 months) did not change significantly between 2010 and 2016. ConclusionThe observed trends in the prevalence of hardcore smokers (i.e., either stable or declining depending on the definition) suggest that the Australian smoking population is not hardening. These results do not support claims that remaining smokers are becoming hardcore.

Prevalence and sociodemographic factors of risky drinking in Australian older adults.

This study describes the prevalence of risky drinking in older adults (aged 60+ years) in Australia and explores the socioeconomic and lifestyle factors associated with this. The negative consequences of drinking behaviours in older adults were also explored. Cross-sectional design, with data obtained from the Australian 2016 National Drug Strategy Household Survey, yielding a sample size of 7976 participants. Multivariable logistic regression was used to assess the correlates of risky drinking. Approximately 17% of older Australians reported risky drinking and their most popular drinking location was in the home (93%). Respondents who were male [odds ratio 3.78, 95% confidence interval (3.22, 4.43)], of younger age group (60-69 years) [2.96, (2.25, 3.89)], in a higher socioeconomic status [1.76, (1.41, 2.21)], had no dependents [1.51, (1.10, 2.07)], were unemployed [1.64, (1.10, 2.44)] and were either current or ex-smokers [2.32, (1.90, 2.83) or 3.55, (2.95, 4.29)], were more likely to report risky drinking. Approximately 54% of risky drinkers experienced a negative outcome as a result of their drinking in the last year. Risky drinking in older adults is a key public health issue, with a concerning rate of risky drinking and associated negative outcomes seen in the current study. Interventions aimed at older drinkers thus need to focus beyond socio-economically disadvantaged groups, while self-moderation on risky drinking, controlling accessibility to take-away alcohol and increasing the awareness of harms of risky drinking may help to reduce risky drinking among older people.

Levels of support for the licensing of tobacco retailers in Australia: findings from the National Drug Strategy Household Survey 2004-2016

BackgroundAssessing public opinion towards tobacco policies is important, particularly when determining the possible direction of future public health policies. The aim of this study was to describe the implementation of tobacco retailer licensing systems by state and territory governments in Australia, and to use the National Drug Strategy Household Survey (NDSHS) to assess levels of public support for a retailer licensing system in each jurisdiction over time and by a range of socio-demographic and behavioural attributes.MethodsNational and state/territory estimates of public support for a tobacco retailer licensing system were derived as proportions using NDSHS data from 2004 to 2016. The effect of one’s jurisdiction of residence on the likelihood of supporting such an initiative in 2016 was assessed using logistic regression while controlling for various socio-demographic and behavioural characteristics.ResultsPublic support for a tobacco retailer licensing system ranged from a high of 67.2% (95% CI 66.5–67.9%) nationally in 2007 and declined to 59.5% (95% CI 58.9–60.2%) in 2016. In 2016, support was greatest amongst those from Tasmania, those aged 50 years and older, females, those from the least disadvantaged areas, those living in major cities, never-smokers and never-drinkers. After adjusting for the socio-demographic and behavioural attributes of respondents, those from Queensland were significantly less likely to support a licensing system (adjusted OR = 0.85, 95% CI 0.77–0.94) compared to those from other jurisdictions, while those from Tasmania were significantly more likely to support a licensing system compared to those from other jurisdictions (adjusted OR = 1.29, 95% CI 1.09–1.52).ConclusionsA clear majority of the public support a tobacco retailer licensing system, regardless of whether or not such a system is already in place in their jurisdiction of residence. Tobacco control initiatives other than a retailer licensing system may explain some of the residual variations in support observed between jurisdictions.

T87. CHANGING RATES OF PAST-YEAR CANNABIS USE BY PEOPLE WITH A PSYCHOTIC DISORDER

BackgroundGeneral population data show that cannabis use by younger people has been declining but increasing in older adults and overall, the gap between men and women appears to be narrowing. Despite rates of past-year cannabis use by people with a psychotic disorder being much higher than that of the general population, little has been documented about sex and age differences in patterns of cannabis use over time by people with a psychotic disorder.MethodsTo better understand trends in cannabis use by people with a psychotic illness, we examined sex and age differences in rates of past-year cannabis use using nationally representative data from two cross-sectional Australian national surveys of psychosis (1997, 2010). We then compared our findings to comparable general population data collected in the Australian National Drug Strategy Household Survey (1998, 2010).ResultsPrevalence of past-year cannabis use by people with psychotic illness dropped significantly from 38.2% to 33.7%. Both sexes showed a decline in use. The steeper decline in use by men aged 18–29 years (70.2% to 47.8%) contributed to a narrowing of the sex gap. Conversely, use by men aged 55–64 increased from 4.8% to 18.8%. In comparison, general population data showed a similar pattern of change across sex and age groups including a steeper decline in use by men aged 18–29 years, but only a very modest increase in use from 3% to 5%, by men aged 55 and over.DiscussionDespite declining rates of past-year cannabis use in people with a psychotic illness, rates remain more than double that of the general population. Traditionally, men were more likely to use cannabis than women, but convergence in rates in younger people shows this is changing. Furthermore, cannabis use is not restricted to young people. Increasing use of cannabis by older men will place additional demands on drug and alcohol services.

Look west for Australian evidence of the relationship between amphetamine-type stimulant prescribing and meth/amphetamine use.

To investigate Western Australian (WA) data on the relationship between the prescription of Amphetamine-Type Stimulants (ATS), and the non-medical use of prescription ATS and other forms of meth/amphetamine, for both adults (18+) and minors (<18). Two WA specific data sources were identified. The Stimulant Regulatory Scheme provided comprehensive ATS prescribing data from 2004 until 2017, and Australian Secondary School Alcohol and Drug (ASSAD) surveys provided details of non-medical prescription ATS use by WA adolescents (12-17). Other data sources included National Drug Strategy Household Surveys (NDSHS), the Pharmaceutical Benefits Scheme (PBS), and the National Wastewater Drug Monitoring Program (NWDMP). Over 95% of WA ATS prescribing has been for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). WA adults have consistently received prescription ATS at a much higher rate than other Australian adults. The most recent published data reported that in 2017 WA adults were 2.6 times as likely as other Australian adults to be supplied an ATS for ADHD. Drug treatment, NDSHS and NWDMP data indicate that WA adult rates of non-medical meth/amphetamine use have also regularly exceeded the Australian rate. Furthermore, the little data that exist on the non-medical use of prescription ATS by Australian adults suggests that it may also be disproportionately common in WA. From 1993 until 2002 the proportion of WA minors prescribed ATS grew rapidly and was the highest in Australia. Following regulatory reforms prescribing rates declined. By 2010 they were approximately half the 2002 rate. Over a similar timeframe there was a 72% fall in WA adolescent self-reported, past-week, non-medical amphetamine use. Since 2011 WA minor ATS prescribing rates have rebounded significantly. Unfortunately, useful data on adolescent meth/amphetamine use since 2011 is not available. Nonetheless, two ASSAD snapshots, in 2005 and 2017, suggest that more WA adolescents use prescription ATS non-medically than medically. The data for WA adults suggest a correlation, but does not establish a causal connection, between ATS prescribing and the non-medical use of ATS and other forms of meth/amphetamine. Although it is clear that there is significant illicit prescription ATS use by WA adolescents, little is known about the contribution that the prescription of ATS makes to subsequent meth/amphetamine and other drug use. There is a critical need for research that investigates long-term, population-wide patterns and individual experiences of both those prescribed ATS and the broader population, to inform policy, prevention and treatment responses.

Examining beverage-specific trends in youth drinking in Australia before and after the implementation of the alcopops tax.

Alcohol consumption among young Australians has declined markedly since the early 2000s. As yet, there has been no data on how this decline has been spread across different beverages and instead high-level survey data with significant potential for recall and other bias has been used. Trends in beverage choice among young people following an increase in the 'alcopops' tax have also not received much attention. Data on 'yesterday' drinking occasions were obtained from five waves (2004, 2007, 2010, 2013, 2016) of the National Drug Strategy Household Survey. A total of 23 536 respondents aged 14-29 years were included in this study. Descriptive and regression analyses were conducted to explore trends in alcohol consumption and changes in beverage preferences. Youth drinking declined by 45% across the study period, with declines of 66% in premix, 48% in spirits, 46% in beer and 33% in wine. Consumption of premix was significantly lower in 2013 and 2016 compared to 2007 amongst the overall sample, males, females, respondents aged 14-21 and 22-29 years, light and heavy drinkers. Significant reductions were also observed in the consumption of premix immediately following the tax (2010) for the younger age group, males and light drinkers. Youth consumption of alcohol has declined during the study period with significant variation across beverage types. We found some evidence of a separate impact for the alcopops tax, although for some groups, declines in premix consumption occurred well after the implementation of the tax.

Estimation of the proportion of population cannabis consumption in Australia that is accounted for by daily users using Monte Carlo Simulation.

To estimate the proportion of cannabis consumed in Australia by daily cannabis users. Monte Carlo simulation using parameters estimated from nationally representative and repeated cross-sectional household surveys in 2007, 2010, 2013 and 2016. Australia PARTICIPANTS: Adult samples (mean age=49.9; 55% females) from four National Drug Strategy Household Surveys (n=92 243). Frequency of cannabis use (daily/weekly/about once a month/every few months/once or twice a year). The weighted estimated prevalence of users in each of these frequency levels was multiplied by population size to estimate the total number of users. Quantity of cannabis use was measured as number of joints consumed. The consumption of those who reported using bongs was converted into joints based on the bong to joint ratio estimated from the survey data. We estimated the proportion of cannabis consumed by daily users by Monte Carlo simulation using parameters estimated from the household surveys. We conducted 10 000 simulation trials, and in each trial we [1] simulated the number of users at each consumption level (stratum) based on estimated prevalence and population size[2], for each simulated individual, we simulated the number of days of cannabis use in a year based on frequency data[3], for each consumption day, we simulated the quantity consumed [4] and lastly we calculated the total joints consumed at each consumption level and estimated the proportion of joints consumed by daily users out of the total consumption. The prevalence of past-year cannabis use increased from 8.9% [95% confidence interval (CI)=8.5-9.4] in 2007 to 10.5% (95% CI=10.0-11.1) in 2016, 16% of whom were daily users. Between 2007 and 2016, daily users accounted for between 81.6 and 85.7% of all cannabis consumed. Weekly users accounted for an additional 12.1-15.9%. Between 2007 and 2016, only one in six Australian cannabis users were daily users, but they accounted for more than 80% of the estimated cannabis consumed in Australia.

Adult low-risk drinkers and abstainers are not the same

BackgroundAlcohol consumption, even at low-levels, can not be guaranteed as safe or risk free. Specifically, the 2009 Australian National Health and Medical Research Council drinking guidelines recommend that adults should not drink more than two standard drinks on any day on average, and no more than four drinks on a single occasion. Nearly 40% of Australians aged 12 years and older drink alcohol but don’t exceed these recommended limits, yet adult low-risk drinkers have been largely overlooked in Australian alcohol survey research, where they are usually grouped with abstainers. This paper examines the socio-demographic profile of low-risk drinking adults (18+ years old), compared to those who abstain.MethodsData from the 2013 National Drug Strategy Household Survey were used. In the past 12 months, 4796 Australians had not consumed alcohol and 8734 had consumed alcohol at low-risk levels, accounting for both average volume and episodic drinking (hereafter low-risk).ResultsMultivariate logistic regression results indicated that low-risk drinkers were more likely to be older, married, Australian-born, and reside in a less disadvantaged neighbourhood compared with abstainers. There was no significant difference by sex between low-risk drinkers and abstainers.ConclusionsThe socio-demographic profile of low-risk drinkers differed from that of abstainers. Combining low-risk drinkers and abstainers into a single group, which is often the practice in survey research, may mask important differences. The study may support improved targeting of health promotion initiatives that encourage low-risk drinkers not to increase consumption or, in view of increasing evidence that low-risk drinking is not risk free, to move towards abstinence.