Cannabis: client demographics and treatment

In 2019–20, cannabis was reported as a drug of concern in one-third (33%) of all closed treatment episodes, either as a principal or additional drug of concern:

  • cannabis was the third most common principal drug of concern in nearly 1 in 5 (18% or 40,305) treatment episodes
  • the most common additional drugs of concern reported with cannabis included alcohol (32%), nicotine (24%) or amphetamines (23%) but these drugs are not the subject of any treatment within the episode (Figure DRUGS1; tables SD.6–8).

Cannabis use and harm

Cannabis (also called marijuana or gunja) is derived from the cannabis plant (usually Cannabis sativa) and is used in whole plant (typically the flowering heads), resin or oil forms. Cannabis has a range of stimulant, depressant and hallucinogenic effects. The risks associated with long‑term or regular use of cannabis include dependence, damage to lungs and lung functioning, effects on memory and learning, and psychosis and other mental health conditions. Cannabis withdrawal is now listed as a discrete syndrome in the Diagnostic and Statistical Manual of Mental Disorders (NCPIC 2011).

According to the 2019 National Drug Strategy Household Survey (AIHW 2020), more than 1 in 3 (36%) Australians aged 14 and over had used cannabis in their lifetime and 11.6% had used it in the previous 12 months. Both lifetime and recent use increased between 2007 and 2019 (AIHW 2020).

Diversion treatment programs

Among diversion clients, diversion episodes are most likely to be for cannabis, followed by amphetamines, alcohol, and heroin (Figure CANNABIS3). Throughout Australia, there are programs that divert people who were apprehended or sentenced for a minor drug offence from the criminal justice system. Many of these diversions result in people receiving drug treatment services. Services vary widely, ranging from short-term assessment, information or education sessions to longer term treatments such as counselling and withdrawal management, which are supported by Australian Government funding and a national framework. Diversion programs in the states and territories have led to the development of systematic approaches to diversion. Some states and territories have also incorporated their own additional drug diversion programs that have different priorities and target groups, including cannabis expiation notice schemes, youth programs and alcohol-related offenders, which have changed over time due to legislative, regulatory and policy frameworks related to drugs and drug use.

Client demographics

In 2019–20, 27,701 clients received treatment where cannabis was the principal drug of concern, two-thirds (66%) of clients were male and nearly 1 in 5 (19%) were Indigenous Australians (tables SC.6–SC.8, SCR.26).

For clients whose principal drug of concern was cannabis:

  • male (68%) and female (67%) clients were most likely to be aged 10–29 (Figure CANNABIS1)
  • the rate for Indigenous clients receiving treatment decreased from 973 per 100,000 people in 2015–16 to 893 in 2019–20.

Figure CANNABIS1: Clients with cannabis as a principal drug of concern, by sex and age group, 2019–20 (%)

The butterfly bar chart shows shows clients with cannabis as their principal drug of concern were most likely to be aged 10–29. This pattern was similar for both male (68%) and female (67%) clients.

Treatment

Since 2010–11, counselling has remained the most common form of treatment, accounting for around 40% (15,801 episodes in 2019–20) of cannabis treatment episodes annually. In 2019–20, both support and case management (6,599 episodes), and information and education (6,393 episodes) were the second most common main treatment types (both 16%) after counselling (Figure CANNABIS2; Table SD.42).

In 2019–20, for treatment episodes where cannabis was the principal drug of concern:

  • treatment was most likely to take place in a non-residential treatment facility (65%)
  • most (80%) episodes where counselling was the main treatment type took place in a
    non–residential treatment facility (Table SD.44)
  • almost half (46%) of episodes lasted 2 days to 90 days and 33% ended within 1 day (Table SE.25)
  • the median duration of a treatment episode was 22 days
  • treatment duration varied by treatment type:
    • the median duration for counselling was 8 weeks (57 days)
    • support and case management as the main treatment type had a median duration of 6 weeks (43 days)
    • rehabilitation lasted nearly 6 weeks (40 days)
    • information and education/assessment only had the shortest duration (1 day) (Table SD.47)
    • two-thirds (66%) of closed episodes ended with an expected cessation
  • where clients were diverted from the criminal justice system, 35% completed treatment due to programs sanctioned by a drug court, and 3 in 10 (31%) treatment episodes ended with an expected treatment completion, with 3% of episodes ending unexpectedly (Table SD.45).

Figure CANNABIS2: Closed treatment episodes with cannabis as a principal drug of concern, by main treatment type, reason for cessation or source of referral, 2010–11 to 2019–20 (%)

The line graph shows that where cannabis was the principal drug of concern, counselling was the most common main treatment type, fluctuating from 39% in 2010–11 to 44% in 2011–12 and 39% in 2019–20. Information and education was the second most common main treatment type most years, ranging from 15% to 24%. In 2019–20 support and case management and information and education were the second most common treatment types (both 16%) followed by assessment only (15%) and withdrawal management (6.7%).

Source of referral and diversion clients

In 2019–20, for treatment episodes where cannabis was the principal drug of concern:

  • the most common sources of referral were health service (30%), followed by self/family (28%)
  • 1 in 5 (8,497) treatment episodes where cannabis was the principal drug of concern were for clients whose referral was from a police or court diversion (Table SD.37)
  • about 1 in 9 (14,447) of all clients receiving treatment for their own drug use, had a diversion referral and were more likely to be treated for cannabis (54%) as a principal drug of concern; with 21% of diversion clients also receiving non-diversion referrals to treatment for cannabis as a principal drug of concern (Figure CANNABIS3; Table SE.27)
    • this was followed by amphetamines (15% referrals from diversion compared with 39% from non-diversion), alcohol (11% diversion compared with 16% non-diversion) and heroin (less than 1% diversion compared with 5% non-diversion) (Figure CANNABIS3; Table SE.27) .

Figure CANNABIS3: Client diversion referrals for own drug use by selected principal drug of concern, by client diversion episode type, 2019–20 (%)

The grouped horizontal bar graph shows the proportion of episodes provided for alcohol, cannabis, amphetamines and heroin as the principal drug of concern for clients with diversion episodes, those with non-diversion episodes provided to diversion clients, and those with non-diversion episodes provided to non-diversion clients. For diversion episodes, cannabis was the most common principal drug (54%), followed by amphetamines (15%), alcohol (11%), and heroin (0.4%). For non-diversion episodes provided to diversion clients, amphetamines were the most common principal drug (39%), followed by cannabis (21%), alcohol (16%), and heroin (4.6%). For non-diversion episodes provided to non-diversion clients, alcohol was the most common principal drug (37%), followed by amphetamines (29%), cannabis (16%), and heroin (6%).

References

See reference list.