Introduction: Welcome to AODstats, the Victorian alcohol and drug interactive statistics and mapping webpage.
AODstats provides information on the harms related to alcohol, illicit and pharmaceutical drug use in Victoria.
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Scott E. Hadland, MD, MPH, John R. Knight, MD, and Sion K. Harris, PhD1
Marijuana policy is rapidly evolving in the United States and elsewhere, with cannabis sales fully legalized and regulated in some jurisdictions and use of the drug for medicinal purposes permitted in many others. Amidst this political change, patients and families are increasingly asking whether cannabis and its derivatives may have therapeutic utility for a number of conditions, including developmental and behavioral disorders in children and adolescents. This review examines the epidemiology of cannabis use among children and adolescents, including those with developmental and behavioral diagnoses. It then outlines the increasingly well-recognized neurocognitive changes shown to occur in adolescents who use cannabis regularly, highlighting the unique susceptibility of the developing adolescent brain and describing the role of the endocannabinoid system in normal neurodevelopment. The review then discusses some of the proposed uses of cannabis in developmental and behavioral conditions, including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Throughout, the review outlines gaps in current knowledge and highlights directions for future research, especially in light of a dearth of studies specifically examining neurocognitive and psychiatric outcomes among children and adolescents with developmental and behavioral concerns exposed to cannabis
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Whilst OTC opioid issue in this article refers to the US current issue, the Australian context is beginning to catch up!
Nora D. Volkow, M.D., and A. Thomas McLellan, Ph.D.: N Engl J Med 2016; 374:1253-1263 March 31, 2016DOI: 10.1056/NEJMra1507771
However, two major facts can no longer be questioned. First, opioid analgesics are widely diverted and improperly used, and the widespread use of the drugs has resulted in a national epidemic of opioid overdose deaths and addictions. More than a third (37%) of the 44,000 drug-overdose deaths that were reported in 2013 (the most recent year for which estimates are available) were attributable to pharmaceutical opioids; heroin accounted for an additional 19%. At the same time, there has been a parallel increase in the rate of opioid addiction, affecting approximately 2.5 million adults in 2014. 9 Second, the major source of diverted opioids is physician prescriptions.10, 11 For these reasons, physicians and medical associations have begun questioning prescribing practices for opioids, particularly as they relate to the management of chronic pain. Moreover, many physicians admit that they are not confident about how to prescribe opioids safely, 12 how to detect abuse or emerging addiction, or even how to discuss these issues with their patients. 13
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You can view the Dalgarno Institutes AOD Policy by clicking on the links below
Cannabis Liberalization & Cross-Natoinal THC Use - 38 Counties
Alcohol and other drug Policy proposal - "A community safety, health and care approach"
Marijuana Use Detrimental to Youth - American College of Pediatricians 2015
Medical Marijuana Ruse - September 2015 DFA
Legalizing marijuana for medical purposes will increase risk
We need policy consistency!
Normalisation of drug use
30 Years of Harm Minimisation
It is important to express from the outset of this declaration that best practice health care and family/community well-being are an important value to Dalgarno Institute and that both the sick and vulnerable, particularly children, are protected to fullest extent possible from harms from all drugs both legal and illicit. We also acknowledge the long fought for and won regulatory processes and science behind drug prescription processes must be defended and maintained for the best health care outcomes for the community.
Self-medication is bad medicine
All professional health practitioners and responsible government understands this fact. The AMA has commented saying that “any therapeutic potential of cannabis requires more research!” 1 This statement by our leading medical body is important to note on two levels.
Firstly, the ‘self-medication’ experiment has been run and done! The USA had its highest number of registered addicts in the late 19th Century for one reason only - Substances such as opium and cocaine were ‘peddled’ as medicine without regulation or testing. Bought and sold on the free market as one would purchase an analgesic at a supermarket. People determined their own dose, according to their felt need, and perceived benefit, unaware of side effect or long term impact – This failed experiment led to the commencement of prescription processes and the regulation and classification of current illicit drugs.
The current folly in the U.S.A also demonstrates how chaotic and utterly abused the so called ‘Medical Marijuana for self-medication’ exercised has proven to be. The standard 'marijuana legalization bill' in the current U.S scenario ensures that, pot becomes "medicine", users become "patients", and drug dealers become "caregivers"!
Secondly, is that foundational principles of good healthcare/practice dictate that untested and unregulated psychotropic substances be kept from the community as their potential for damage and/or dysfunction of users is high. The two foundation principles of disease and/or dysfunction management are to
1) reduce/minimise susceptibility and
2) reduce/minimize exposure.
Best Practice Medicine
Taxpayer funded healthcare initiatives will also insist on these measure for best practice. Any practice or medication that can potentially increase either, susceptibility or exposure to further disease/dysfunction, cannot be permitted in patient care – Self-determined ‘experimentation’ on patients, by even the best medical practitioners with substances (let alone an unqualified parent or care-giver), would be an outrage and is not permitted under current legislation and protocols – this must be protected and defended.
Proper testing and regulation of all potential medicine is imperative and any mechanism that negates these protective processes must be scrutinized fully and carefully. Good science and wise socio-political policy making cannot be overridden by emotional vitriol and manufactured media consensus. One does not ‘vote’ on which chemicals should be made freely available to the population. To do so is to set a disturbing precedent that will ultimately unleash a ‘self-medication tsunami’. (as we are currently seeing in the USA)
As a juxtapose to the issue and warning; It is vital to note that in the USA ‘medical opium’ (prescribed regulated opiates i.e. codeine based medicines) is now killing four times the number of people (over 16000 in 2010) than the illegal form; heroin. 1 This too is the result of a combination of ‘self-medication’ by patients and/or simple ‘recreational use’ of prescription drugs for ‘pleasure’.
Marijuana is not a benign substance with some therapeutic values; it has a significant number of physiological, biological and psychological negative impacts.
“Although the general public may perceive cannabis to be the least harmful illicit drug, there has been a noticeable increase in the number of persons seeking treatment for cannabis use disorders over the past decade, particularly in the Americas, Oceania and Europe.” 2
Marijuana is a complex plant and whilst there are potential and even proven medicinal properties in these plants, they also have a significant number of dangerous constituents. The extraction and synthesizing of the potentially beneficial components has been subjected to over a decade of trials and processes which have yielded a number of currently registered pharmaceuticals for pain management and other medical conditions - on the market now , i.e. dronabinol (Marinol), nabilone, nabiximols (Sativex) and rimonabant.
Whilst it is also acknowledged that there are perceived benefits from some emerging formulations from Marijuana plants, it is imperative that thorough and fully understood testing is done before registering such for public consumption.
There can be no place for use of Marijuana or its constituents outside of properly authorized and prescribed T.G.A and A.M.A approvals process.
Both wisdom and compassion for current and future patients insists that we recommend...
Full investigation and testing of potential therapeutic components of Marijuana to ensure short and long term safety for patients. (Let’s not repeat the Cigarette ‘health promotion messages’ of the past)
Proper regulation and management of any therapeutic derivations from Marijuana through the T.G.A (Therapeutic Goods Administration) and dispensed only under strictest medical prescription guidelines.
Candidates eligible for use of these medications to be given low or no cost access to them as soon as possible.
That all and every measure be taken to ensure the pro-cannabis lobby and their parliamentary backers do not manipulate/hijack this health agenda to simply further the agenda of legalizing cannabis for ‘recreational’ use.
1 100 Americans die of drug overdoses each day. How do we stop that? (The Washington Post - February 2014)
2 Executive Summary: World Drug Report 2014
20 Flaws in Study Finding No Health Problems in Adult Males Who Were Chronic Marijuana Users as Teens, Young Adults2015
Beyond Smoke Screen D F Aon MM 2014
Current Position American Epilepsy Society Medical Cannabis March 2015
Drug Free Australia Brief to Australian Parliamentarians Medical Cannabis
MMJ A systematic review 2015